Ice Pick Headache: A Guide

Dr. Juliana VanderPluym of Mayo Clinic discusses ice pick headache and its relationship with migraine

In terms of the phrases people frequently use to describe their headaches, “stabbing” is probably near the top of the list. For people who try searching the internet for answers, this might lead to the discovery—and use—of the term “ice pick headache.”

But according to Dr. Juliana VanderPluym of Mayo Clinic, ice pick headache is not just a casual descriptor—it’s a classification of headache all its own.

“I would say more often than not, people come across the term ‘ice pick’ accidentally,” Dr. VanderPluym says. “They might not have gone and searched ‘Dr. Google’ to find out what they have, but just because of what the headache feels like, they end up accidentally diagnosing it themselves.”

Ice pick headache is not to be confused with other kinds of headache—including migraine. Dr. VanderPluym walks us through how this disease is diagnosed and treated.

Getting the Correct Diagnosis

According to the International Classification of Headache Disorders, the official name for ice pick headache is “primary stabbing headache.” The condition is characterized by intense, brief, stabbing headaches often described as an “ice pick” feeling.

Dr. VanderPluym says stabbing head pain may be caused by a lot of different problems. But with ice pick headache, there are no other symptoms present beyond the pain itself. Dr. VanderPluym notes that if you’re getting tearing or redness of the eye, a runny or stuffy nose, swelling or flushing of the face, then you might not have ice pick headache.

“When we talk about primary stabbing headache, we are talking about a primary headache disorder,” Dr. VanderPluym says. “It can happen more commonly in patients who have migraine, but it is not necessarily a symptom of migraine.”

Because these brief, stabbing pains can also be seen with other more serious conditions, people who experience these head pains should be evaluated by a qualified clinician to be properly evaluated.

Ice Pick Headache Treatment

For the majority of patients with this disorder, treatment can be difficult. Primary stabbing headache is not as well-studied as migraine, so there aren’t any FDA approved treatments. There are many lifestyle interventions that can help with migraine. There are, however, no studies on lifestyle changes and primary stabbing headache.

Dr. VanderPluym says the short duration of these headaches also means there isn’t anything that can be used to get rid of them rapidly enough. However, when the attacks occur frequently enough to disrupt a person’s life, there are some daily preventive treatments doctors may recommend. Dr. VanderPluym says melatonin or indomethacin can sometimes be helpful for this purpose.

Talk to Your Doctor

The symptoms of ice pick headache are simple and the treatments are few. Dr. VanderPluym says this might lead some people to skip talking about the problem with their doctor. But Dr. VanderPluym notes that there are other conditions that may mimic this disorder. Doctors need to know about what patients are experiencing in order to get them the best treatment possible.

“At the end of the day, if you ever have a gut feeling that something isn’t right, then that’s good enough reason to talk to someone about it,” Dr. VanderPluym says. “If you’re ever having headaches that are very sudden, that’s a reason that you should be seeking a medical opinion on an urgent basis and getting that clarified.”

To learn more about primary stabbing headache and other migraine topics, visit the American Migraine Foundation resource library. For help finding a specialist near you, check out our Find a Doctor tool.

Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.