Cluster headaches are severe, one-sided headaches that happen in groups, or "clusters." They usually occur over weeks or months and can be so painful that you are not able to follow your normal routine or do your usual activities. The pain is often called the worst type of headache pain.

Cluster headaches come in cycles (also called cluster periods). Most people who get cluster headaches have one or two cluster periods each year. A cluster period might last 1 month or longer. After a cluster period ends, you may not get another headache for months or even years.

As you get older, it is likely that you'll have longer and longer times without headaches. At some point, you may not get cluster headaches ever again.

Having cluster headaches can be scary. But even though they are very painful, cluster headaches don't cause long-term harm. During a cycle, you may be able to reduce how often you have them, how bad they are, and how long they last.

Causes

Experts aren't sure what causes cluster headaches. They run in families, but it’s not clear why some people get cluster headaches and others do not.

Symptoms

The main symptom of cluster headaches is a severe burning or sharp, piercing pain on one side of your head. The pain spreads out from your temple and eye. Your eye may become red, watery, or puffy. The eyelid may droop, and you may have a runny or stuffy nose on that side of your head.

The pain usually gets bad very fast. The pain gets worse within 5 to 10 minutes after the headache starts and can last for 30 minutes or longer.

Cluster headaches usually happen at the same time of day each time you get them. But they can happen at any time. You may have 1 to 8 headaches a day.

Treatment

A doctor can usually tell if you have cluster headaches by asking about your symptoms and examining you. You probably will not need tests such as a CT scan or an MRI. Your doctor may order other tests if he or she thinks your symptoms are caused by another disease.

There is no cure for cluster headaches. You can't do anything to prevent a cycle of cluster headaches from starting. But as soon as a cycle starts, you can take medicine that may help prevent more headaches or reduce how many you have during a cycle. You take this medicine every day during the cycle.

Prevention

Certain things may be more likely to cause a headache during a cycle. These are called triggers. Avoiding them may help prevent headaches. Triggers include:

  • Drinking alcohol
  • Smoking
  • Sleep problems (It’s best if you go to bed and wake up at the same time every day. Don't take naps.)
  • Stress

When a headache starts, you can take medicine or breathe in oxygen from a machine to ease the pain or stop the headache. You use these treatments only when you feel a headache coming on. You don't use them every day.

Over-the-counter pain medicines, such as aspirin, acetaminophen, and ibuprofen, usually don't work for cluster headaches.

When a cluster headache begins:

  • Start your treatment right away. Don't wait for the headache to get worse. Take your medicine exactly as planned with your doctor.
  • Do what feels best. You may feel better if you walk, jog in place, sit, kneel, or stand. Lying down may make the pain worse.

If your treatment doesn't work, ask your doctor if you can try something else. It may take time to find what works best for you.

A headache diary can give you and your doctor clues to help you manage your headaches. Write down when and how often the headaches happen, how severe they are, and what you think may be causing them. Share this with your doctor.

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