Cluster headaches are rare when compared to other types of headaches and represent one of the most painful types. The pain they produce is severe and tends to recur in the same way each time. They occur in groups, or clusters, and each attack lasts about 1 to 3 hours on average. The frequency of occurrence may range from every other day to multiple times a day. Cluster periods are followed by remissions that may last months or years.
Males are affected by cluster headaches more than females and they typically start around age 30.
Causes of cluster headaches
Researchers do not know exactly what causes cluster headaches. They seem to be related to the sudden release of histamine or serotonin in the body.
The following may trigger cluster headaches:
- Alcohol use or smoking cigarettes
- Change to a high altitude
- Bright light
- Exercise or exertion
- Heat, either weather or a bath
- Foods that contain nitrates, such as bacon or lunch meat
- Cocaine use
Signs and symptoms
A cluster headache attack comes on quickly, usually without warning; however, you may initially experience nausea and an aura similar to that accompanying a migraine. Common signs and symptoms accompanying the headache include:
- Severe pain generally located in or around one eye or behind it, and can spread to other areas of your face, head, and neck
- Pain on one side
- Restlessness or agitation
- Increased tearing
- Red eyes on the affected side
- Nasal congestion or runny nose on the affected side
- Sweating on the forehead or face on the affected side
- Pale skin or increased facial flushing
- Swelling around the eye on the affected side
- Drooping eyelid on the affected side
Unlike those with migraines, people with cluster headaches are likely to pace or sit and rock back and forth. Some migraine-like symptoms — including sensitivity to light and sound — may accompany cluster headaches, although they usually occur on one side only.
Characteristics of a cluster period
A cluster period generally lasts for several weeks to months. The starting date and the duration of each cluster period might be consistent from period to period. For example, cluster periods can occur seasonally, such as every spring or every fall.
Most people have episodic cluster headaches. In episodic cluster headaches, the headaches occur for one week to a year, followed by a pain-free remission period that can last as long as 12 months before another cluster headache develops.
Chronic cluster periods might continue for more than a year, or pain-free periods might last less than one month.
During a cluster period:
- Headaches usually occur every day, sometimes several times a day
- A single attack can last from 15 minutes to three hours
- The attacks often occur at the same time each day
- Most attacks occur at night, usually one to two hours after you go to bed
The pain usually ends as suddenly as it began, with rapidly decreasing intensity. After attacks, most people are pain-free but exhausted.
Treatment of cluster headaches
There’s no cure for cluster headaches. The goal of treatment is to decrease the severity of pain, shorten the headache period and prevent the attacks.
Because the pain of a cluster headache comes on suddenly and might subside within a short time, cluster headache can be difficult to evaluate and treat, as it requires fast-acting medications.
At Alimran Medical Center, we may recommend any of the following treatments:
Pulsed radiofrequency – Sphenopalatine ganglion stimulation or occipital nerve stimulation
Regenerative medicine treatment (Prolotherapy)
Repetitive Transcranial Magnetic Stimulation (rTMS)
Transcranial direct current stimulation (tDCS)
Steroid injection – Sphenopalatine ganglion or occipital nerve
- Electrical stimulation
- Short and long wave
- Laser therapy
- Ultrasonic therapy
- Magnetic therapy
- Exercises
Chiropractic care