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All About Ice Pick Headaches

Sufferers Feel a Brief, Stabbing Pain Near the Eyes

By Betsy Lee-Frye

Updated February 03, 2009

(LifeWire) - It's a stabbing pain, commonly referred to as an "ice pick headache," and it can be as jarring as the eerily descriptive name suggests.

People who experience ice pick headaches say they feel a sharp jabbing sensation, often around their eye or in the temple area. Intensity varies, although most sufferers indicate that the pain is disabling while the headache is occurring. In two-thirds of sufferers, the headaches lasts 1 second or less, but for others, the pain can last 10 seconds or longer.

R.K. Lansche, a leading 1960s headache researcher, first defined the phenomenon in 1964. Since that time, the condition has been known by many different names. Its cause remains a mystery, and its treatments vary. The International Headache Society classifies these headaches as "primary stabbing headaches" because there is no identifiable cause underlying the pain.

For a diagnosis of primary stabbing headaches or ice pick headaches, the International Headache Society outlines the following criteria: The pain is confined to the head, the pain is stabbing or jarring and the headaches recur erratically from once a day to the extreme of 50 times per day.

Thankfully, ice pick headaches are not that common. Research suggests that only 2% of the population ever experience ice pick headaches and usually not until middle age. This type of headache rarely affects children and teenagers; one study found a mean onset age to be 47 years. According to textbook The Headaches, a comprehensive medical analysis of headache types and treatments, more women suffer from ice pick headaches than men.

Linked to Migraines and Cluster Headaches

Migraine patients are also more likely to experience ice pick headaches. More than 60% of ice pick headaches are associated with migraines. When they do occur simultaneously, most people experience the stabbing pain on the same side of the head. Ice pick headaches are also commonly linked with cluster headaches.

Aside from the association with other types of headaches, little is known about the cause of ice pick headaches. Some research suggests a relationship to cranial trauma, benign cranial lesions, herpes or disease of the blood vessels in the brain, but there is no conclusive scientific data at this point.

Although ice pick headache pain often occurs without other symptoms, occasionally nausea, vertigo, shedding of tears, runny nose and/or blood shot eyes are also experienced at the same time. Some sufferers report that headaches begin with or are worsened by exposure to bright light, stress or movement during a migraine.

Treatment: From Rx Medicine to R & R

Treatment options for ice pick headaches are still developing. Traditionally, doctors prescribe indomethacin (Indocin), an anti-inflammatory medication similar to ibuprofen. However, this treatment plan only works for about 65% of patients.

An indomethacin treatment program typically begins with 12.5 mg of the drug taken 2 to 3 times per day. For those still suffering from symptoms, the drug dosage is increased every other day until the number or intensity of headaches is decreased. Most people experience a decrease in symptoms when they are taking an indomethacin dose of 25 to 50 mg daily.

Researchers have sought other treatment methods for ice pick headaches, because long-term use of indomethacin increases the risk of heart attack or stroke, especially among those with heart disease. Prolonged use of indomethacin has also been linked to stomach and intestinal bleeding, as well as eye problems, such as redness, yellowing or blurred vision. Some doctors recommend an annual eye exam for regular users of indomethacin, and blurred vision is always considered as cause to immediately consult a physician.

A few case studies have found that melatonin, the same neurohormone used to aid jet lag and insomnia, can successfully treat ice pick headaches. Available without a prescription, melatonin can still cause fatigue, dizziness, mood changes and a lower seizure threshold, so a physician should be consulted before beginning a melatonin regimen. Melatonin is not recommended for women who are pregnant or nursing.

Since ice pick headaches often coincide with other types of headaches, home remedies may help ease the pain. The Mayo Clinic recommends reducing stress, getting enough rest and making time for exercise.

It may also help to spend a few moments each day in a relaxed state. Simply lying down, putting one hand on the abdomen and taking several deep breaths, can aid relaxation. It may also help to tense and then relax each muscle group, one at a time.

Physicians also recommend keeping a headache diary. Note the time of onset, the activity engaged in at the time, the length of the headache and what produces relief. Keeping a descriptive diary can help provide headache sufferers with an accurate accounting when talking to a doctor. The diary can also help sufferers notice what activities might be contributing to the headaches and what medications seem to be helping to relieve them.

Sources: Borkum, Jonathan. Chronic Headache: Biology, Psychology and Behavioral Treatment. 1st Edition. Mahwah, NJ: Lawrence Erlbaum, 2007.

Mayo Clinic Staff. "Headaches: Self-Care Measures for Headache Relief." MayoClinic.com. 28 Apr. 2006. The Mayo Clinic. 6 Mar. 2008 <http://www.mayoclinic.com/health/headaches/HE00006>.

"Indomethacin (Oral Route)." MayoClinic.com. 1 Dec. 2007. The Mayo Clinic. 6 Mar. 2008 <http://www.mayoclinic.com/health/drug-information/DR602195>.

"Less Frequently Encountered Headache Types." ClevelandClinic.org. 17 May 2004. The Cleveland Clinic. 6 Mar 2008 <http://www.clevelandclinic.org/health/health-info/docs/3400/3469.asp?index=11663&src=news>.

"Melatonin." MayoClinic.com. 1 Aug. 2005. The Mayo Clinic. 6 Mar. 2008 <http://www.mayoclinic.com/health/melatonin/NS_patient-melatonin>.

Olesen, Jes; Peer Tfelt-Hansen, K. Michael Welch, Peter J Goadsby, and Nabih M Ramadan. The Headaches. 3rd Edition. Philadelphia, PA: Lippincott Williams & Wilkins, 2005.

"The International Classification of Headache Disorders." Cephalalgia 24(2004): 49-50.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Betsy Lee-Frye is an independent journalist living in Kansas City, Mo.

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