Dave from Schuylkill Haven presented at our office with an unusual type of headache… an ice pick headache.
WHAT IS AN ICE PICK HEADACHE
So, what does an ice pick headache feel like? Well, pretty much like it sounds—like an i
Ice pick headaches are sharp, stabbing pains occurring as a single stab or as a series of stabs, occurring mostly in the eye and orbit, temple, or sides of the head. The sharp stabs last a few seconds, and may recur throughout the day, usually at irregular intervals.
Dave is not a migraine suffer and never had a headache like this before. He reported the headaches started with a little neck ache and stiffness. He did not think much of it. He had the ache and stiffness before. But when the headache started the sharp pains came like clockwork every one and a half minutes and lasted about three seconds. He could also bring them on by turning his head to the right. When he came into the office, the headaches were present for a day and a half. He could not sleep because of the constant minute and a half recurring stabbing pain.
Dave’ examination was normal except for a slight neck problem on the left side. Besides turning his head to the right, I could not provoke the headache.
Treatment of Ice Pick Headache
Headache textbooks tend to be somewhat dismissive of stabbing headache, indicating that reassurance should be offered, since this headache type does not indicate underlying pathology such as a tumor or aneurysm. This, however, is not terribly helpful to the sufferer who is experiencing the sensation of needles, ice picks, spikes, or tiny knives being jabbed into their head on a recurring but unpredictable basis.
Some sufferers of stabbing headaches indicate that they have identified emotional or other stressors as triggers. Other than stress, triggers of ice pick headache have not been clearly identified.
Treatment is problematic because there is not an underlying pathology and since the attacks are so short. There is a small case series (three patients) reported benefit for ice pick headache from melatonin, but that did not help Dave.
Since the only positive examination finding was in the neck that is where we decided to start treatment. We used a special type of electrical stimulation over the Spinal Accessory Nerve. On the right side on the neck, the response to the treatment was typical of other patients. However, on the right side I could only apply the minimal application of the electrical stimulation because it caused his upper trapezius muscle contract severely.
After only two minutes of this special type of electrical stimulation, the ice pick headache improved about 80%. Dave was able to sleep for a good part of the night before the sharp shooting pains started again.
The next day the treatment helped a bit more and lasted a little longer. Interesting, we found a supplement related to curcumin family that also helped.
It took about six treatments over two weeks before the headaches were completely gone. As of this writing, it has now been five months since Dave had a headache.
We treat all finds of headaches with conservative care first. Most of the time conservative care, like chiropractic and physical therapy, can resolve the problem. However when conservative care fails, we have Dr. Bruce Levin MD, a Philadelphia headache and pain management specialist, that works out of our office that we can arrange an appointment for you.
Bottom line; don’t suffer… there is always help.