Ice Pick Headache – Location, Causes and Treatment

Ice pick headache is a sharp, intense pain that lasts for a brief duration. These can be primary or secondary and mostly occur without any cause or sometimes due to an underlying disease. This can be one of the most painful headaches ever experienced.

Location of pain

This can generally occur in any part of your head, most commonly around the eyes and temples.

Duration of pain

It often lasts from 5 seconds to 1 minute and slowly vanish in the next half an hour. In some cases, it reoccurs several times in a 24-hour time span.


The duration is so brief that there is no time for other associated symptoms to show up. However, some of the symptoms include:

  • Feels like stabbing with spokes of ice.
  • Abrupt onset of a stabbing, throbbing headache.
  • Duration lasting only 5 to10 seconds.
  • The pricking occurs several times during the day.
  • Pain in back of head, on top of head, on forehead and temples.
  • Facial flushing
  • Tearing
  • Eyelid drooping.


The exact cause is still unknown but some physicians consider this to be associated with disruptions in the control mechanisms of the brain, for a brief duration of time. Ice pick headache occurs in primary and secondary forms.
This occurs without any obvious cause and the headache itself is the cause.
There are some underlying conditions such as multiple sclerosis, Bell’s palsy, Herpes Zoster e.t.c

Other similar headache disorders

There are other headaches that should be ruled out as their symptoms resemble an Ice pick headache and should not be overlooked.

Trigeminal Neuralgia:

It is a chronic nerve condition that primarily affects the Trigeminal nerve, but the Headache due to this is brief and abrupt in onset like an Ice pick headache.

Occipital Neuralgia:

The pressure is exerted on a pinched nerve that causes pain at the back of the head and neck. But the pain in Occipital Neuralgia lasts longer than an Ice pick headache and can be distinguished.

Thunderclap Headache:

Thunderclap headache is the worst type of headache lasting only a few seconds to a few minutes, followed by some other symptoms that might indicate a serious, life-threatening underlying condition. Their brief duration can easily be confused with an Ice pick headache.

Paroxysmal Hemicranias:

Paroxysmal Hemicranias is another type of headache which is abrupt in onset but is brief in duration, lasting up to 20 seconds. However, these might occur several times a day.

Migraines and Ice pick headache:

According to some researches, people who have different types of migraines are more prone to Ice pick headaches. They might have frequent attacks


For people with migraines who have Ice pick headaches as well, may have the following triggers:

  • Stress and anxiety
  • Hormonal changes
  • Disturbed sleeping pattern.


Due to a short duration of pain, you don’t really need any sort of treatment. However, people with migraines and clusters, who suffer from frequent Ice pick headache attacks might need some prophylactics:

  • Melatonin: usually given as a treatment for insomnia and insomnia triggered headaches.
  • Indomethacin: is a non-steroidal anti-inflammatory drug (NSAID) that reduces inflammation and helps relieve the pain.
  • Acupuncture: This has proven to be a very helpful treatment for recurrent attacks.


Is an Ice pick headache, in any way related to migraine?

According to recent studies, people who suffer from migraines are more likely to have Ice pick headache in later life.

Is melatonin a proven treatment for Ice pick headache?

It has a short duration thus you might not even need a treatment for it. Melatonin is usually given as a treatment for insomnia and insomnia triggered headaches, so it can act as a prophylactic.

What are some of the other headaches I might be confusing an Ice pick headache with?

Occipital Neuralgia, Trigeminal Neuralgia, Migraine, Paroxysmal Hemicranias and possibly a Thunderclap headache.

What is the location of the pain of an Ice pick headache?

It generally affects only half of the head or just one point in head, that can be anywhere.