What is a Cluster Headache?

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A man’s tired face with one eye open

Cluster headaches are rare—affecting fewer than one in 1,000 adults—but can be one of the most painful types of headaches. More prevalent in men than women (affecting six men to every woman), most people who develop cluster headaches are in their 20s or older.

Cluster headaches occur in clusters that last between two weeks and three months. In between these clusters, sufferers are headache-free.

While pain can be intense like a migraine, the individual headaches that make up the cluster don’t usually last long and tend to occur without aura, nausea, vomiting, or light sensitivity.

Cluster headaches fall into two categories: episodic and chronic.

  • Episodic: Clusters last anywhere from seven days to one year and are separated by pain-free episodes that are at least one month long.
  • Chronic: Clusters occur for more than one year either without interruption or with an interruption of less than one month.

Pain associated with cluster headaches is described as excruciating, sharp, and stabbing—instead of throbbing—and tends to stay in one location but can switch sides. Pain is usually located in or around an eye and can also occur along the back of the neck. During the headache, sufferers may experience a runny or blocked nose as well as watering, redness, or drooping of the eyelid on the affected side.

These types of headaches come on quickly but tend to be short-lived, lasting anywhere from five minutes to several hours. They will, however, return several times during a 24-hour period, with this coming-and-going phase lasting days or months

Triggers

As with other types of headaches, sufferers should keep a headache journal to determine what triggers attacks. Possible triggers include:

  • Sleep disturbances
  • Strong emotions
  • Alcohol
  • Weather or extreme temperatures
  • Watching television
  • Stress
  • Relaxation
  • Glare
  • Allergic rhinitis
  • Sexual activity
  • Excessive physical activity
  • Tobacco

Treatment for cluster headaches

During an attack, nine out of 10 sufferers will become agitated and restless. While some prefer walking or pacing to lying down, others find relief by sitting and rocking. Nonsteroidal anti-inflammatory pain relievers (NSAIDs) such as ibuprofen can provide relief for mild to moderate pain. These drugs work by inhibiting inflammatory reactions and pain by decreasing prostaglandin synthesis.

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