Make Pain a Thing of the Past – Health and Wellness – Physician Partners of America

Chronic headaches can interfere with focus and overall enjoyment of your day-to-day activities. Migraines and tension headaches are two of the most commonly known classifications of headache disorders, but other types may explain your chronic head pain.

More rare headache disorders include cluster headaches, cervicogenic headaches (CGH), and ice pick headaches. Though these headaches are not commonly experienced by most people, ice pick headaches in particular could provide insight into your headache symptoms.

What are ice pick headaches?

Ice pick headaches are a type of uncommon headache disorder that is characterized by stabbing pain that may be felt in the head or eye. Pain from ice pick headaches comes on suddenly, unexpectedly, and might only last a few seconds. During the time you feel ice pick headache pain, you might describe it as a quick series of stabs similar to how you imagine being stabbed by an ice pick could feel.

There are other terms used in place of ‘ice pick headache,’ the official medical diagnosis is ‘stabbing headaches,’ but they may also be called:

• Jabs-and-jolts syndrome
• Needle-in-the-eye syndrome
• Ophthalmodynia periodica

Who gets ice pick headaches?

Ice pick headaches do not discriminate between those they affect. People of all ages may experience the sharp pains of stabbing headaches, though only about 2% of the global population experiences them regularly. 

Women who experience chronic migraines are more prone to ice pick headaches, in fact, they may occur alongside migraine headaches in the spot where the migraine originated. People who report these symptoms are often between the ages of 45 and 50, but they can affect people of any age.

What are common symptoms of ice pick headaches?

If you experience an ice pick headache, you may report some of the following symptoms:

Sudden, stabbing pain

Pain that comes on suddenly and is described as a stabbing sensation is the most common symptom of ice pick headaches. This pain usually comes and goes within 3 seconds, but it may last up to two minutes in rare situations. 

The pain level is described as moderately severe to extremely painful and occurs many times in a day. Some people report experiencing stabbing pain up to 50 times a day or more on one of both sides of the head.

Sensitivity to light

Sensitivity to light is a common symptom of migraines and may be experienced with ice pick headaches as well. Light sensitivity may occur alongside sensitivity to sound during the onset of a stabbing attack. Though the light sensitivity may seem extreme, it cannot cause vision damage and is not caused by eye strain.

Pain on the top or front of the head

During an ice pick headache episode, you may have pain on the top or front of the head, or on either side. The pain can be localized to one area, or experienced in multiple locations of the head at one time. When ice pick headache pain is experienced in the same location with increasing frequency, it may be a sign of a serious underlying condition.

What causes ice pick headaches?

Researchers have yet to determine the underlying cause of most ice pick headaches. The general consensus is that the occurrence of these attacks is associated with short-term disruptions to the brain’s central pain control center.

Because migraine sufferers commonly experience these stabbing headaches as well, they may have better luck identifying triggers for their attacks.

Some of the most common triggers for ice pick headaches include:

• Stress and anxiety
• Sleep deprivation or disruption
• Alcohol consumption
• Changes in hormones
• Some food additives

Sometimes ice pick headaches are categorized as “secondary headaches” in that they are a result of an underlying condition. 

The following conditions may be identified as the primary condition that results in ice pick headaches:

• Migraine
• Cluster headaches
• Temporal arteritis
• Intracerebral meningioma
• Autoimmune disorders
• Bell’s palsy
• Shingles

How can people prevent ice pick headaches?

Certain lifestyle adjustments can help prevent ice pick headaches. Getting adequate sleep and rest, eating a healthy diet, and managing stress effectively can help. Activities such as acupuncture, massage, and physical therapy can be both therapeutic and help to prevent future headache attacks.

What are the most common treatments for ice pick headaches?

Often ice pick headaches occur so briefly that there is not enough time to take medication. If stabbing attacks become more frequent, the use of preventative medication could provide some relief.

Identifying and treating any underlying condition that results in ice pick headaches is the best form of treatment. It’s also important to distinguish if the pain you’re experiencing is an ice pick headache or one of the other common or uncommon types of headaches. Discuss your symptoms with one of our pain professionals to receive a treatment plan that is individualized to your situation.

Frequently Asked Questions

Can anxiety cause ice pick headaches?

Stress and anxiety may cause the onset of a stabbing headache attack. Certain triggers of migraines may also trigger ice pick headaches, such as anxiety, alcohol or caffeine consumption, and sleep deprivation.

How long should ice pick headaches last?

The stabbing pain associated with ice pick headaches usually lasts 3 seconds or less, but may occur up to 50 times in one day. 

When should you speak to your doctor about headaches?

If your headache symptoms become chronic or are increasing in intensity, you should reach out to a healthcare professional for testing and a pain treatment plan. Any pain in the body that prevents you from carrying out your daily tasks is worth seeking treatment for.

Should I be worried about sharp pains in my head?

It’s important to rule out any serious conditions that could cause symptoms similar to what’s experienced during an ice pick headache. Generally speaking, ice pick headaches are not dangerous and do not cause damage to the brain, but the pain may be debilitating at times.

What causes sciatica?

Sciatica, also known as lumbar radiculopathy, is a term for pain that originates from the sciatic nerve. The sciatic nerve begins at the back of your pelvis and stretches down the length of the back of your thigh. This nerve is the largest in the body and the main nerve in the leg.

Pain along the sciatic nerve often feels like a dull ache, a mild tingling sensation, or a burning sensation. The pain may be mild or severe enough to prevent a person from moving freely. Sciatica pain usually occurs on one side of the body in part of the leg or hip, or even the back of the calf or foot sole. 

Sharp pain sensations caused by sciatica may occur alongside numbness in other parts of the leg or buttocks. This numbness can cause people to feel weak and prevent them from lifting their feet well while walking.

Sciatica pain is caused by pressure on the sciatic nerve from a specific cause. The most common causes of sciatica include:

• Bulging or herniated discs
• Spinal stenosis
• Pelvic injury
• Obesity
• Poor posture
• An abscess or tumor along the nerve
• Other nerve disorders

It’s important to note that sciatica is not a disease in itself, but rather a symptom of some other condition.

How long does sciatica pain last?

As sciatica pain is a sign of something causing pressure to the sciatic nerve, the underlying cause must be treated for you to feel relief. Sciatica usually gets better one to two months after the onset of pain. More mild sciatic pain may begin to improve within two weeks.

The good news is that it’s common for sciatica symptoms to improve over time and certain treatments can accelerate improvement. Less back pain during daily activities and increased comfort while being physically active are two signs of sciatica improving.

Do you ever fully recover from sciatica pain?

Some people experience sciatica pain that comes and goes. Depending on what part of the sciatic nerve is being compressed, pain symptoms may be constant or fade in and out infrequently. 

The time in which sciatica pain is being experienced can be excruciating and hinder your daily activities, but it rarely causes permanent nerve damage. Our pain management treatment plans are customized to each person with sciatica based on their individual experience, causes, and symptoms.

Tips to ease sciatica pain

Though preventing sciatica is your best bet to avoid this condition, there are some ways to ease sciatica pain once it has begun. In very mild cases, invasive treatment is not necessary and recovery will occur naturally. Most cases of sciatica do not require surgery, but your doctor may develop a plan for you that includes one of the following treatments.

Gentle exercise

Keeping your body in motion will help minimize inflammation. Bed rest is generally not recommended to treat sciatica. With any form of exercise or stretching treatment, it’s important to take movements slow to prevent further nerve damage. 

Here are some exercises that may help ease sciatica pain:

• Pelvic tilts. 
  • Lie on your back with your legs bent, feet flat on the floor, and arms by your side. 
  • Using your abdominal muscles, press your back into the floor and rock the hips and pelvis slightly upward. Try to visualize making your belly button touch your backbone to get the form correct. 
  • Stay in this position for a few seconds while taking deep breaths, then release. Take a break and then repeat when you feel recovered. 

• Glute bridges. Exercises that warm up the glute muscles can help release the tension on the sciatic nerve in the buttocks.
  • Start on the floor in the same position as you were for the pelvic tilts. 
  • Leave both feet touching the floor, but push up through the heels, lifting your hips until your body forms a straight line from your knees to your shoulders. 
  • Hold this pose for five seconds and then slowly lower your hips to the floor.

With both of these exercises, it’s important to focus on maintaining the form without arching or rounding your back which can increase inflammation or sciatic pain.

Stretching

Take stretching exercises slowly and focus on your breathing to avoid overstretching and causing more pain. Here are two great stretches that may help alleviate sciatic pain:

• Hamstring stretches. 
  • While holding onto something sturdy for support, stand up straight and put one foot on a higher surface, such as a stair step. 
  • Straighten the leg that is on the step and point the toes of that foot up toward the sky.
  • Lean forward just a bit while keeping your back straight and breathe deeply for 30 seconds. 
  • Switch legs and repeat. 

• Gluteal stretch.
  • Lie down on your back with your legs bent, and feet flat on the floor. 
  • Raise your right ankle and cross it onto your left knee. 
  • Lace your fingers behind your left thigh and gently pull it toward you, while keeping your back and head on the floor. 
  • Practice breathing deeply for 30 seconds and then slowly release. 
  • Repeat with the other leg.

Hat and ice application

Certain forms of temperature therapy may provide some pain relief for those experiencing sciatic pain. The application of ice or cold compresses will provide some numbing relief to the nerve while heat from a warm compress will loosen tension.

When is it time to see a pain doctor about my sciatica?

It’s time to reach out to a professional for sciatica pain relief when it is affecting your daily activities or causing you consistent discomfort. Our pain doctors will take the time to listen to your pain and story and create an individualized treatment plan for you.

Frequently Asked Questions

How does it feel when sciatica is healing?

No longer experiencing pain in the leg, calf, foot, or buttocks and having less numbness in other areas impacted by the sciatic nerve are signs of sciatica improving.

How long does it usually take for a sciatic nerve to feel better?

Sciatica pain can improve in as little as 2 weeks or up to 3 months in more extreme cases. Treatment plans should be individualized to your experience and address the underlying cause of your sciatic nerve pain.

What are the last stages of sciatica?

Late-stage sciatica is chronic pain that lasts longer than 6 weeks without improvement. 

What causes knee pain when squatting?

Does the idea of dropping something and having to bend over to pick it up make you groan? Maybe you experience outer or inner knee pain when you squat down to look in the oven or tie your shoe. 

Sharp pain in the knees from squatting down or kneeling is a common annoyance that may be a sign of an underlying condition. This pain may just be a nuisance or it can prevent you from enjoying your day, but the good news is that it can be corrected. 

Here are some of the most common causes of knee pain when squatting or kneeling:

Knee arthritis

Arthritis is caused by inflammation in the joints. Inflammation from arthritis can lead to pain, swelling, and stiffness. Any joint in the body can experience arthritis, but knee arthritis is one of the most common forms.

Knee arthritis can cause inner knee pain during everyday activities such as climbing stairs or walking. This disability may cause you to miss out on experiences with your friends and family or be unable to work.

The “wear-and-tear” arthritis causes in the knee occurs most often in people 50 years of age and older, though it may also occur in younger people. This form of knee inflammation is caused by the gradual degeneration of cartilage in the knee. As the cartilage wears away, it decreases the protective space between bones in the knee which leads to them rubbing together. 

The most common symptoms of knee arthritis are stiffness and swelling causing pain when bending or straightening the leg, pain that is made worse by vigorous activity or after a period of rest, and weakness in the knees that may lead to “locks,” creaks or clicking sounds, or buckling.

Runner’s knee

Runner’s knee is the informal term for Patellofemoral Pain Syndrome. This form of knee pain is felt around the front of the knee (the patella) where it connects to the lower part of the thigh (the femur).

Though it is most often associated with running, runner’s knee may also be caused by a structural defect or certain ways of walking. Examples of situations that can contribute to the development of runner’s knee include:

• Weak thigh muscles
• Tight hamstrings
• Tight Achilles tendons
• Poor arch support
• Excessive training or overuse
• Existing injuries

Pain from runner’s knee is felt when a person is active or after sitting for an extended period with legs bent. A feeling of rubbing or grinding, or a clicking sound at the kneecap, may also be experienced with runner’s knee and the kneecap may be tender to the touch.

Tissue trauma

Knee tissue trauma is caused by a sudden movement or direct force that strains the knee beyond its normal range of movement. This trauma results in the soft tissue of the knee being torn or strained. Soft tissue includes ligaments, muscles, tendons, and menisci.

Trauma that causes a knee injury is most often experienced by athletes, but it may also occur on intensive job sites, while chasing children or pets, or with other forms of activity.

The most common symptom of tissue trauma is an immediate sharp pain that may be followed by swelling. After the trauma has occurred, you may feel like your knee is close to “giving out” when you walk. You might have difficulty straightening your leg, have bruising, and/or experience stiffness around the trauma site.

Iliotibial band syndrome (ITBS)

Iliotibial band syndrome (ITBS) occurs when a tendon called the iliotibial band gets irritated or swollen from friction in the knee joint. The ITB stretches from the top of the knee to the top of the pelvic joint and creates friction when it tightens.

ITBS may occur in one or both legs. If it is experienced in both legs, it is called bilateral iliotibial band syndrome. This knee condition is most commonly experienced by basketball players, cyclists, hockey players, runners, skiers, and soccer players. 

Certain people may have an increased risk of developing ITBS including people with bowed legs or one leg that is longer than the other, people who have knee arthritis, and people who rotate their ankle, leg, or foot inward when they move. 

Symptoms of Iliotibial band syndrome include hip pain, knee pain when flexing or extending the knee, sensations such as a pop or click on the outside of the knee, and discoloration and warmth on the outside of the knee. At first, this pain will be felt at the onset of exercise and as it worsens, it will also be felt while resting.

What are the best treatment options for knee pain when kneeling or squatting?

Knee pain caused by activities such as kneeling or squatting may have you feeling discouraged, but there are treatment options available that can help alleviate your symptoms. Our expert pain doctors will work with you to identify the cause of your knee pain and then will develop an individualized treatment plan to address the issue.

The following are some of the best treatment options for knee pain experienced when kneeling:

Improvement of ankle flexibility

Lack of ankle mobility may be the source of some knee pains, and improving the ankle’s flexibility could be the only treatment some people need. When your ankles are restricted in their mobility, the next nearest joint will take over some of the load, causing inflammation of the knee.

It’s important to improve ankle flexibility not just to avoid or treat knee pain, but also to prevent pain in other joints of the body. As one of the lower weight-bearing joints, the ankles have a lot of work to do to help keep the body in motion effectively. 

People who have experienced an ankle sprain at any point in their lives may have limited ankle flexibility, poor mobility, and resulting knee pain.

Strength training exercises

Many different forms of strength training can help alleviate knee pain. With all of these exercises, it’s important to remember to warm up and cool down to prevent additional pain in the body.

Here are some of the best exercises for increasing strength, reducing friction, and helping address knee pain:

• Straight leg raises
• Wall squats
• Calf raises
• Step-ups
• Side leg raises

Periods of rest

Taking a break from rigorous workouts or normal day-to-day activities may be required to treat certain forms of knee pain. Resting allows the body to recover and heal the strain that is caused by repetitive movements. 

For minor injuries, a day or two of rest may be all that is needed to alleviate symptoms. More severe pain may require a longer recovery time. Taking rest days between especially difficult workouts can benefit your recovery in the long term.

If knee pain during exercise or daily activities plagues your life, our pain management doctors across Texas, Florida, and Orange County, California can work with you to develop an individualized recovery plan. 

Frequently Asked Questions

What does knee bursitis feel like?

Knee bursitis may cause a warm, tender, and swollen feeling when pressure is applied to the knee. Pain can also be felt while moving or even when resting. Knee bursitis is most commonly caused by jobs that require a lot of time spent kneeling on hard symptoms.

What are a few common symptoms of knee tendonitis?

Knee tendonitis or Patellar tendonitis is felt as pain between the kneecap and shinbone. This pain may only be felt during physical activity, but over time it will worsen and appear at all times of the day.

What happens if knee bursitis is left untreated?

If knee bursitis is left untreated, symptoms will gradually worsen over time. The bursa that lies over the knee cap may also become infected leading to additional pain, swelling, and fever.

Does knee bursitis require surgery?

Treatment for knee bursitis usually involves a combination of lifestyle changes, self-care practices, and treatments administered by a doctor that help alleviate pain and inflammation.

What is facet arthropathy?

Facet joints are located on the back of the spine at each vertebral level, with one on each side. The joints provide flexibility and stability by allowing the spine to bend or turn with movement and preventing excessive motion. Facets provide counterbalance support within the spine that keeps vertebrae in healthy positions.

Facet arthropathy, or facet joint disease, is a form of arthritis in the back that causes back pain, swelling, and pain with movement. Facet joint degeneration can be exacerbated by age, obesity, lifestyle choices, as well as a genetic predisposition to having frail joints.

Causes of facet arthropathy

Causes of facet arthritis vary from patient to patient and their origins are not fully understood by medical professionals. One common cause is wear on bones and joints from aging. 

Certain conditions can contribute to the degradation of facet joints and the development of facet arthropathy. Those conditions include: 

• Osteoarthritis, the most common type of arthritis, affects millions of people around the world. Osteoarthritis is caused by the protective cartilage on the end of bones wearing down over time. Most often this disorder affects joints in the spine, knees, hips, and hands.

• Synovial cysts can lead to facet arthropathy in aging adults. Most often these cysts are found in the lower back, also known as the lumbar region. The term ‘synovial’ refers to joints lubricated by synovial fluid, a thick liquid located between joints. Synovial cysts are non-cancerous and the symptoms they cause vary depending on their size and location.

• Back trauma can contribute to the development of arthropathy. Back trauma includes any type of accident that contributed to an injury of the spine.

Symptoms of facet arthropathy

General symptoms include pain and stiffness in the back. This condition causes a dull aching on one or both sides of the lower back, centered on a specific area of the spine. It may be worse after an extended period of rest or sleep as well as when twisting, bending backward, and standing. 

The location of the pain varies depending on the type of facet arthropathy being experienced. Neck facet arthritis is often felt behind the ears and in the shoulder region whereas lumbar facet arthritis pain is felt in the lower back and radiates toward the hip, thigh, or buttocks.

Facet arthropathy may cause the development of other conditions of the spine including spinal stenosis and bone spurs.

In cases of facet arthropathy caused by synovial cysts, some people experience pain in the back and legs that is made worse by standing or walking. Similarly, bone spurs caused by facet arthropathy can lead to pain, numbness, and weakness in the legs and buttocks.

Diagnosing facet arthropathy

If you are experiencing any of these symptoms, reach out to our spine specialists immediately for a complimentary consultation. At your appointment, the doctor will review your symptoms and medical history and perform a physical exam. 

The doctor may then order one of the following tests to diagnose facet arthropathy:

• Bone scan

• Computed tomography (CT) scan

• Magnetic resonance imaging (MRI)

• X-ray

Treatments for facet arthropathy

There are several ways facet arthropathy can be treated. If your pain is mild, your doctor may recommend avoiding motions that increase your pain. For example, extending the lower back, lifting heavy objects, or excessively twisting your torso, all of which can exacerbate lower back pain. 

Anti-inflammatory medications may be prescribed to relieve some pain in the spine. An epidural steroid injection is the delivery of strong anti-inflammatory medicine directly into the space around the spinal cord (the epidural space). This is an outpatient procedure that is recommended to patients who did not experience relief from changes in activity or medications.

Laser-assisted spine procedures can help with symptoms of facet disease. These minimally-invasive spinal decompression procedures include:

• Foraminotomy: the enlargement of the area around one of the bones in the spinal column to relieve pressure on compressed nerves.
• Laminotomy: the removal of a portion of the lamina, the back part of a spinal bone which will create a hole that is just large enough to relieve pressure.
• Laminectomy: the removal of all or most of the lamina.
• Radiofrequency ablation (RFA): shrinking the size of nodules, growths, and tumors, or cysts along the spine.
• Discectomies: the removal of the damaged part of a disk in the spine

If physical therapy or other noninvasive treatments are unsuccessful and in cases of more advanced facet arthropathy, your doctor may recommend back surgery. Back surgery is needed when there is a nerve-root compression which requires the removal of facet joints that are fused together. 

Facet joint ablation is an additional type of treatment that involves the destruction of the facet nerves using electrical shocks.

Treatment for facet arthropathy varies depending on the extent of your lower back pain. If you are experiencing symptoms similar to those we’ve described, let us show how you can live pain-free.

Frequently Asked Questions

Can facet arthropathy lead to other conditions?

Facet arthropathy can contribute to the development of bone spurs and spinal stenosis.

What is the outlook for facet arthropathy?

Those experiencing pain from facet arthropathy usually respond well to forms of physical therapy. More progressed stages of this condition may require minimally invasive procedures or surgery, but pain relief is still possible. 

Does facet arthropathy require surgery?

Facet arthropathy may require surgery if other forms of treatment or physical therapy are not successful at alleviating lower back pain. Noninvasive or minimally-invasive techniques can be attempted before surgery.

Can a pain doctor help alleviate facet arthropathy?

Pain management doctors may help alleviate pain from facet arthropathy by recommending stretches and exercises of the lower back. In certain cases, medication and surgery may be required.