Ice Pick Headaches (Ophthalmodynia Periodica): Causes, Symptoms and Treatment

Dr. Juliana VanderPluym of Mayo Clinic discusses ice pick headache (Ophthalmodynia Periodica), its relationship with migraine, its causes, symptoms, and treatments.

In terms of the phrases that people often 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” or ophthalmodynia periodica.

But according to Dr. Juliana VanderPluym of Mayo Clinic, ice pick headache is not just a simple way to describe it—it’s a type 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 Ice Pick Headache Diagnosis

According to the International Classification of Headache Disorders, the official name for ice pick headache is “primary stabbing headache.” When the pain affects the eyes, it is known as “ophthalmodynia periodica” which comes with intense, brief, stabbing headaches often described as an “ice pick” feeling.

Dr. VanderPluym says a lot of different problems may cause stabbing headaches. But with ice pick headache (pphthalmodynia periodica), there are no other symptoms 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 redness of the face, 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.”

How Long Does an Ice Pick Headache Last?

The sharp pain in the head that comes with this type of headache is generally brief, severe, and goes away within a few minutes or less.

Are Ice Pick Headaches Serious?

Not necessarily. Primary stabbing headache is the formal diagnosis for ice pick headache—“primary” is a term meaning that the head pain itself is the problem, and the pain doesn’t have another cause.

However, if you’re experiencing what you think may be primary stabbing headache, please don’t assume that’s what they are. Because these brief stabbing pains can also be seen with other more serious conditions, people who experience these head pains should speak with a qualified clinician.

Other primary headache disorders that are similar to primary stabbing headache include:

  • SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing)
  • SUNA (short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms)
  • Occipital neuralgia or other cranial neuralgias
  • Trigeminal neuralgia (a facial pain disorder with brief, sharp pain on one side of the face)

After an evaluation, your doctor will be able to determine the cause of your head pain and explain these other conditions to you.

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. Many lifestyle changes 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 quickly enough. However, when the attacks happen often enough to disrupt a person’s life, doctors may recommend some daily preventive treatments. Dr. VanderPluym says medication like 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 she notes that other conditions may be similar to 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.” In addition, if you ever have head pain that comes on extremely fast and leaves you feeling disabled within a couple of minutes, it may be best to consult your doctor or visit the emergency room.

To learn more about primary stabbing headache, hemiplegic migraine 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.