Ice pick headache: Causes, symptoms, and treatment

Primary throbbing headache, also known as "ice pick headache" or "prick and jerk headache" is characterized by severe throbbing pain that strikes without warning and generally lasts 1 to 10 seconds.

The shooting pain usually occurs around the eye but maybe felt at multiple sites on the trigeminal nerve. Onset typically occurs between 45 and 50 years aged. Some people may have only one headache per year while others have multiple headaches daily.

Most attacks are spontaneous, but headaches can be triggered by sudden movements, bright lights, or emotional stress.

Ice pick headache occurs more frequently in people with migraine, continuous hemicrania, tension-type, or cluster headaches.

The disorder is difficult to treat because each attack is extremely short. Indomethacin and other headache preventive medications can relieve pain in people that have multiple episodes of primary stabbing headache.

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Primary exertion headaches can be caused by coughing or sneezing fits, or by vigorous physical activity such as running, playing basketball, lifting weights, or having sexual activity. The headache begins at the beginning of the activity. The pain rarely lasts more than several minutes but can last up to 2 days. Symptoms can include nausea and vomiting.

What is an ice pick headache?

Ice pick headache is a type of headache that is typically seen in people who have a family history of migraines. Warm-up exercises prior to physical activity can help prevent headache pain, and indomethacin can ease headache pain.

If a throbbing pain is the central symptom of your headache, it is possible that you have what is commonly known as an "ice peak headache" and it can be as shocking as the oddly descriptive name suggests.

Symptoms of ice pick headache

If you had a headache during the ice peak, you may have experienced a strong tingling sensation, often around your eyes or around the temple. The stab wounds or jabs do not appear in a pattern, but rather occur erratically, once to several times a day. The pain lasts for a very short time, usually 3 seconds or less.

In about 30% of people, the pain occurs in a specific place, while in others it moves. When the headache shots are fixed on one point, a headache specialist must first rule out a cranial nerve problem or a problem with brain structure. Once a nerve or brain problem is ruled out, these ice pick headaches are called primary headaches.

Headaches caused by migraines and cluster headaches

Interestingly, some people with ice peak headaches report that their headaches start or get worse when exposed to bright light, stress, or movement during a migraine. This means that you can experience both migraine and an ice pick headache (a double whammy, so to speak).

Also, if you have a history of migraines, you are more likely to have an ice peak headache. When they occur simultaneously, most people experience stabbing pain on an equivalent side of the top. Ice peak headache is also related to cluster headache, a type of headache that causes a sharp, piercing, or burning pain around a person's eye or near the temple.

Other than the association with other types of headaches, little is known about the cause of ice pick headaches. Some research suggests a relationship with head trauma, mild head injury, herpes, disease of the blood vessels in the brain, or nerve sensitization. At present, however, there is no conclusive scientific data at this point.

Treatment of headaches with an ice pick

Traditionally, doctors prescribe Indocin (indomethacin), a nonsteroidal anti-inflammatory drug (NSAID), similar to ibuprofen, for the treatment of headaches caused by ice problems. With that said, Indocin is linked to some side effects like stomach and intestinal bleeding and kidney problems. Remember to always talk to your doctor before taking any medicine, including any over-the-counter medicine.

Researchers have searched for alternatives to indomethacin without much success. COX-2 inhibitors (like Celebrex) may be beneficial, but they also cause side effects like indomethacin, although they are thought to be gentler and safer on the stomach.

Melatonin, the same neurohormone used to relieve insomnia caused by jets, has been used to treat headaches caused by ice bites. Available without a prescription, melatonin can still cause side effects such as fatigue, dizziness, and mood swings. A doctor should therefore be consulted before starting treatment with melatonin. Additionally, melatonin is not recommended for pregnant or breastfeeding women.

Home remedies to treat ice peak headaches

Since Ice pick headaches often coincide with other types of headaches, home remedies can help ease the pain. Simple at-home strategies include:

• Reduce your stress level
• Getting adequate sleep and maintaining a regular sleep pattern (for example, going to bed at the same time each night)
• Exercise regularly
• Take the time each day to engage in a pleasant and relaxing activity

Another consideration is to keep a descriptive headache diary, which can provide your doctor with an accurate record of your head pain. The journal can also help people with throbbing headaches notice what activities may be contributing to their headaches and what medications seem to be relieving them.

Final thoughts

Ice pick headaches are not common, but if they do affect you, they are painful and can be heavy. That said, the good news is that there are treatments available. Also, for many people, headaches from the ice peak last so short and don't persist that treatment may not even be necessary.

Regardless, be sure to consult a headache specialist for a correct diagnosis of your headache. Other health issues can mimic your peak ice headaches, and these should be eliminated first.