A sudden, stabbing pain in your face or head feels like you'e being attacked with a sharp object. It arrives without warning and is short, sharp and intensely uncomfortable for up to 30 seconds. You've just experienced an "ice pick" headache, and the bad news is that it could recur several times during the day. The official name given to these attacks by the International Headache Society is a Primary Stabbing Headache, and they can occur in migraineurs and non-sufferers alike even when no organic disease exists in underlying head structures or the cranial nerves. Up to 40 percent of migraine sufferers experience these headaches, which are often in or near the same location as their migraines occur.

Recognizing the Symptoms

Patients who suffer regularly from migraines or cluster headaches are prime candidates for ice pick headaches, and some studies show a higher frequency among women. Headaches usually occur outside of a regular migraine attack, and are characterized by one or more stabbing pains in the orbital area (the region surrounding the eye), the temporal area or the parietal region behind it. The headaches are irregular and can happen only once or many times in a day. They usually descend without any warning and last for between 5 and 30 seconds.

Causes of Ice Pick Headaches

Some patients recall experiencing ice pick headaches during their childhood, but the causes haven’t been fully identified. Many common migraine triggers apply, however, including the presence of bright lights, sudden movement, emotion and stress. These are all possible reasons for an ice pick headache, which can even occasionally wake the patient from a deep sleep. The presence of pathological causes like tumors or aneurysm have been ruled out.

If you suffer from this type of headache, keeping a migraine diary will help you to identify the commonalities between the ice pick and any other type of headache. Make a note whenever you experience the stabbing pains; record their duration and your activities before, during and after. Provide details of your surroundings, the amount of light, food and drinks you have consumed directly before the attack. Analyze how you were feeling emotionally in the hours before the headache, and identify any stresses you experienced. A comprehensive record of these factors will help your doctor to spot any patterns pointing to triggers, and help him develop a treatment plan for you.

Treatment Options

Caring for this type of headache is challenging, partly because the duration of the attack is so short that it’s often over before any medication can be administered. In cases where patients experience several such headaches in a day, it could be beneficial to use over the counter non steroidal anti inflammatory drugs such as ibuprofen. A few patients have experienced relief using melatonin.

If the headaches become increasingly frequent, your doctor might recommend the prescription NSAID indomethacin as a preventive measure. As with other anti-inflammatory medications, side effects to watch out for include heartburn, nausea, gastric ulcers and reflux. Eye problems are also a possible side effect of this medication, so practitioners recommend annual eye examinations for patients who use it regularly.

For patients dealing with stress and other emotional issues, relaxation techniques could be helpful. In all cases, a cool compress applied to the forehead and the back of the neck and combined with rest in a cool, dark room can deliver some immediate relief.

Long-Term Outlook

The most important factor in treating ice pick headaches is to rule out any independent causes. Patients with all the symptoms of this type of headache should get an official diagnosis from a specialist, who will be able to determine whether to treat the headache or another condition. Once you have confirmed the type of headache you have, you’ll be able to implement long-term management protocols to help prevent or reduce the severity of attacks.