Ice Pick Headache: 5 Common Causes & What to Do

Updated in April 2023

Ice pick headaches usually occur due to poor sleep, excess stress, fatigue, dehydration or colds. They may also occur due to a migraine or a tension headache. Although less common, ice pick headaches may also be a sign of a more serious health condition, however, like a stroke, aneurysm or a brain tumor. 

Also referred to as primary stabbing headaches, these types of headaches are sudden and last for seconds. They are described as a sharp pain or a series of sharp pains. 

If you have prolonged or frequent ice pick headaches that do not resolve with medications, it is important to see a family doctor or neurologist for assessment and treatment as necessary. 

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The most common causes of ice pick headaches are:

1. Tension headache

A tension headache can also cause sharp, ice pick headaches. Tension headaches are usually the result of bad posture, anxiety, insomnia, difficulty sleeping or stress. 

Normally, the pain is felt in the forehead, however it can affect other areas of the head as well as neck. The pain usually emerges on its own, without other symptoms like vomiting or nausea. 

What to do: Generally, the pain can be relieved through relaxation techniques, like massages or a hot bath, which help to relieve tension.

Nonetheless, if the pain is persistent or frequent, you are advised to consult a family doctor or neurologist for assessment and treatment. Treatment may involve medications like ibuprofen or amitriptyline. 

2. Migraine

Ice pick headaches caused by migraines generally occur on one side of the head. They are usually triggered by stress, too much or lack of sleep, or after eating certain foods, like chocolate or wine. 

In addition to the sharp pain, migraines can also cause symptoms like vision changes, nausea, vomiting, changes to sleep, and sensitivity to some smells. Read more about migraine symptoms and who is most at risk.

What to do: To treat a migraine and manage the ice pick headaches, the doctor may recommend relaxation techniques, psychotherapy, regularly-timed meals, regular exercise and adequate sleep. 

Nonetheless, if you suspect you may have a migraine, it is important to consult a family doctor or neurologist to confirm a diagnosis and start treatment, which may include the use of medications like ibuprofen, sumatriptan or topiramate to manage flare-ups. 

3. Stroke

A cerebral vascular accident, or a stroke, can occur due to decreased blood flow to the brain or due to bleeding within the brain. It can cause a very sudden and intense ice pick headache. 

Strokes are also associated with other symptoms like fainting, vision changes, loss of sensitivity in one part of the body, and difficulty lifting an object or picking one up.

What to do: If you suspect you are experiencing a stroke, call 911 or proceed to an emergency room for assessment. Prompt treatment can help to prevent serious complications. 

4. Brain aneurysm

A brain aneurysm is characterized by the dilation of a blood vessel that takes blood to the brain. This dilation can cause an ice pick headache, double vision, confusion, nausea, vomiting and fainting. Read more about the symptoms of a brain aneurysm

What to do: If you suspect you may have a brain aneurysm, it is important to consult a neurologist for evaluation and diagnosis. Treatment depends on the doctor’s assessment the characteristics of the aneurysm.

Normally, when the aneurysm is small and there is the risk for bleeding is low, the doctor may not prescribe any treatment. However large aneurysm that present with a high risk for bleeding may require surgical repair.  

5. Brain tumor

A brain tumor may occur due to genetics or due to metastases from another type of cancer. Symptoms depend on the location of the brain tumor, and may include ice pick headaches, changes to touch sensitivity, weakness, tingling in the body and imbalance. 

Learn more about the general symptoms of a brain tumor and how they present depending on the area affected.

What to do: If you suspect you may have a brain tumor, you are advised to see a neurologist or family doctor for testing and diagnosis. If confirmed. treatment may involve surgical removal of the tumor, chemotherapy, and radiation therapy. The treatment approach dpeends on the tumor location, type and size.