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Cluster Headaches

Cluster Headaches


What you need to know about
Cluster Headaches

Cluster headaches are a succession of brief but excruciatingly painful headaches that occur on a daily basis for weeks or months at a time. They usually appear at the same time every year, such as in the spring or fall. As a result, cluster headaches are frequently misdiagnosed as allergies or work stress.

Experts aren’t sure what causes them, but they involve a nerve in your face, which produces excruciating agony around one of your eyes. It’s so awful that most people can’t sit still during an attack and will often pace. Cluster headaches are more severe than migraine headaches, however, they usually last less time.

These are the rarest types of headaches, affecting less than one person in 1,000. Men are more likely to get them than women. They usually begin before the age of 30. Cluster headaches may go gone for months or years (this is known as remission), but they can return at any time without notice.

When a neuronal route in the base of your brain is triggered, you get a cluster headache. That signal appears to originate in the hypothalamus, which houses the “internal biological clock” that regulates your sleep and waking cycles.

The trigeminal nerve, which is damaged, is responsible for facial feelings such as heat and pain. On the same side as your eye, it branches up to your forehead, across your cheek, down your jaw, and over your ear.

These headaches aren’t caused by a brain ailment like a tumour or aneurysm.


There are a few characteristics that distinguish this sort of headache. They are as follows:

Speed. Cluster headaches usually reach their peak intensity in 5 to 10 minutes.

Pain. It’s almost always on one side of your head, and it stays on one side for a period of time, usually while you’re having daily attacks. (When a new headache cycle begins, the pain may shift to the opposite side, but this is uncommon.) It’s commonly described as a piercing or searing sensation. It could be throbbing or continuous. It will be felt behind or around one of your eyes. On that side, it could expand to your forehead, temples, nose, cheek, or upper gum. It’s possible that your scalp is irritated. Your blood is pulsating all the time.

The duration is brief. Cluster headaches persist between 30 to 90 minutes on average. They can last anywhere from 15 minutes to three hours, but then they vanish. Each day, you’ll probably suffer one to three of these headaches. Some people only get one every other day, while others have up to eight every day.

Predictable. The circadian rhythm, or your body’s 24-hour schedule, appears to be associated with attacks. They’ve been dubbed “alarm clock headaches” because they occur so frequently, usually at the same time each day. They may even awaken you an hour or two after you have gone to bed. Attacks that occur at night can be more severe than those that occur during the day.

Frequent. Most patients will experience daily headaches for 2 to 3 months, with at least 2 weeks of pain-free time in between.

The discomfort frequently appears out of nowhere, usually around or behind the eye. You may have seen the following:

  • Discomfort or a tingling sensation
  • A drooping or enlarged eye
  • The pupil of the eye is smaller
  • Redness or wetness of the eyes
  • Nasal congestion or runny nose
  • The face is red and heated
  • Sweating
  • Light sensitivity
  • Pacing, restlessness or agitation

Smokers and heavy drinkers are more likely to suffer from cluster headaches. You’ll be more sensitive to alcohol and nicotine during a cluster phase. Even a small amount of alcohol might cause a headache. During headache-free periods, however, drinking will not cause one.


Your doctor will inspect your eyes and ask you questions about your symptoms. They’ll look for other conditions that can produce comparable issues, such as:

  • Amaurosis Fugax is a condition in which there is a shortage of blood flow to the eye, resulting in temporary blindness. It can occur as a result of a blockage in an artery leading to the eye.
  • The artery that supplies blood to the retina spasms.
  • Giant cell arteritis is a condition in which blood vessels become inflamed. It has the potential to cause vision difficulties and even blindness.
  • Other autoimmune disease-related blood vessel problems.
  • Abuse of drugs.
  • Sickle cell disease and polycythemia are two conditions that prevent your blood from clotting properly.
  • Transient ischemic attack (TIA) or stroke.


The exact cause of ocular migraine is unknown. Some believe the issue is linked to:

  • Spasms in the blood vessels of the retina, the back of the eye’s lining
  • Changes that propagate across the retina’s nerve cells

It’s uncommon, but persons who suffer from these types of migraines may be at a higher risk of losing eyesight in one eye permanently. Experts are unsure whether migraine-prevention medications, such as tricyclic antidepressants or anti-seizure drugs, can help prevent vision loss. However, even if your ocular migraine goes away on its own, it’s a good idea to discuss your symptoms with your doctor.


Any of the following can cause a headache during a cluster period:

  • Tobacco smoke
  • Alcohol
  • Strong odours
  • Switch to a higher altitude
  • a bright source of light
  • Exercising or exerting oneself
  • Heat
  • Bacon and lunch meat, for example, are high in nitrates
  • Cocaine

Migraine vs. Cluster Headache

Both forms of headaches are excruciatingly painful. However, the manner they hurt and where you feel them are two distinct things.

Migraine headaches start slowly and last anywhere from a few hours to many days. You may notice some warning signals up to a day before the discomfort begins, such as food cravings or mood changes. Auras may also appear immediately before the migraine begins.

Migraine causes throbbing pain in your head. A cluster headache normally affects only one side of the head, whereas a migraine might affect both sides, one side only, or the entire forehead. When you move your head, it will most likely get worse. You might also want to consider:

  • Nausea and vomiting
  • Sensitivity to light, sound, and smells
  • Coloured spots, lines, flashing lights, or sparkles in your vision, are called auras
  • Numbness or tingling
  • Weakness
  • Trouble speaking or hearing

You may get a “hangover” after a migraine, in which you feel fatigued or confused. This may be referred to as a postdrome time by your doctor.

A migraine can be triggered by a variety of factors, including:

  • Weather changes
  • Too much or too little sleep
  • Strong odours
  • Stress
  • Noises that are too loud
  • Too little food
  • Anxiety or depression
  • Certain medications
  • Changes in hormones
  • Caffeine, certain foods, and food additives


When it comes to managing cluster headaches, you have a few options:


When it comes to managing cluster headaches, you have a few options:

When a headache strikes, there are certain remedies that can help:

  • Sumatriptan. These medications are among the most effective pain relievers. Sumatriptan is a Zolmitriptan that can be taken as an injection or inhaled.
  • Dihydroergotamine. The ergot fungus is the basis for this prescription medication.
  • Octreotide. This is a synthetic version of the growth hormone somatostatin. It’s given to you through an IV in your vein.
  • Lidocaine. This is a nasal spray that acts as a pain reliever.
  • Oxygen. It’s possible that your doctor will refer to it as breathed oxygen. For 15 minutes, you’ll breathe it in through a face mask.

Preventive treatment can often prevent a headache from occurring in the first place. Your doctor may recommend medicine to help shorten a cluster and lessen the severity of attacks, such as:

  • Prednisone and other corticosteroids
  • sodium Divalproex
  • Galcanezumab
  • Tartrate of Ergotamine
  • Gabapentin
  • Carbonate of Lithium
  • Topiramate
  • Verapamil

Blocking the occipital nerve (your doctor may also call it occipital nerve injection). A mixture of anaesthetic and steroids will be injected into these nerves by the doctor. They’re located in the base of your skull and are frequently the source of headaches. This is a stopgap measure until a preventative can be implemented.

Stimulation of the nerves. If medication fails, some people have found success with:

  • Stimulation of the occipital nerve. A device that sends electrical impulses to this group of nerves at the base of your skull is surgically implanted by your doctor.
  • Neuromodulation. The following are examples of non-invasive devices: Cefaly. Electrodes are placed on your forehead and connected to a controller that looks like a headband and transmits signals to your supraorbital nerve. GammaCore. This device, also known as a noninvasive vagus nerve stimulator (nVNS), sends signals to the vagus nerve via electrodes.


For folks who don’t get a break from cluster headaches, surgery may be a possibility if nothing else helps.

Deep brain stimulation, which entails implanting an electrode deep within the brain, is losing favour in favour of less invasive alternatives.

The trigeminal nerve, which is a major pain channel, is usually blocked during most surgeries. It regulates the area around your eye, but if you make a mistake, it might cause jaw weakness and loss of sensation in your face and head.

Lifestyle changes

Avoid cluster headaches by using the following exercises:

  • Maintain a consistent sleep routine. A headache might be triggered by a change in habit.
  • Avoid consuming alcoholic beverages. When you’re in a cluster series, any form of alcohol, even beer and wine, can cause a headache.

Alternative treatments

Consult your doctor about the following topics:

  • Capsaicin. This pain reliever can be used as a nasal spray.
  • Melatonin. This medicine, which is used to treat sleep disorders such as jet lag, may help to reduce headaches.

Breathing exercises

Breathing exercises have real-world consequences on your body that can help you stay calm and stress-free. They can also be an important aspect of treatment for patients who suffer from tension headaches or migraines.

Are they, however, up to the task of dealing with the excruciating pain of a cluster headache? While there haven’t been any studies to back it up, some doctors believe it’s worth a shot. After all, there’s nothing to lose and nothing to gain.

Breathing exercises can help you feel less anxious. They’re a terrific tool to help you keep even and relaxed if you’re worried about your next assault.

You can experiment with various breathing techniques. Whichever one you choose, it will assist you in:

  • Look for a peaceful place where you won’t be disturbed.
  • Take a seat and relax.
  • For a few minutes, let go of your problems.

It’s also a good idea to schedule time for it every day. This regular practice can help your body to more quickly fall into breathing when you need it. It will be far more difficult to truly dig into it if you just do it when you are in pain.

Also, keep in mind that these exercises are not a substitute for medical treatment. They should be used in addition to your regular treatment.

Deep breathing

When you’re agitated or anxious, your breaths become shorter than usual. This activity will assist you in resetting your mind. Slow, deep, and steady breathing is the goal:

  • Concentrate on your belly button. You might wish to lend a helping hand.
  • Pull the air into your belly as you breathe in through your nose. As you fill your lungs, feel them expand.
  • Take a long, steady breath out through your nose. As you exhale, pull your belly button in. “Relax,” you can even tell yourself.

Your nervous system slows down a notch with each full, deep breath.

Rhythmic breathing

This exercise may help you calm down your breathing technique if it is generally short and fast:

  • Count to five while softly inhaling through your nose.
  • Count to five while slowly exhaling through your nostrils.
  • Rep with each breath and check if you can feel yourself relaxing.

As you get more relaxed, you provide body feedback that encourages you to relax even more.

Visualized breathing

This one requires you to blend breathing with mental images:

  • Relax, close your eyes, and take a deep breath.
  • Imagine peaceful air filling your lungs and expanding your chest and abdomen as you breathe in through your nose. Assume you’re breathing in a steady stream of calmness.
  • Imagine pushing the tension out together with your breath as you exhale.
  • Repeat, breathing calmly in and breathing out the stress.