A Brief Guide to Cluster Headaches

Daniel Marcus';

By Daniel Marcus

Posted on June 29th, 2021 in News, Myths & Tips

In the United States, there are 326,500 people living with cluster headaches, a very rare condition that affects only 1 in 1,000 individuals.

These are extremely severe headaches, and the sufferers are almost exclusively men. They tend to start when the person is in their 30s or 40s.

People experience cluster headaches in cyclical patterns, or cluster periods and they are one of the most painful types of headaches. In fact, people who struggle with this condition say that the pain is excruciating. They often wake up in the middle of the night with intense pain in or around one eye on one side of their head.

The bouts of frequent cluster headaches, known as cluster periods, may last from several weeks to several months. Despite the extreme pain involved in this condition, cluster headaches are fortunately not dangerous. Taking certain medications, such as sumatriptan injections and zolmitriptan nasal spray, can significantly reduce the frequency and intensity of cluster headaches. These medications usually relieve pain within 15 to 30 minutes.

What Are the Most Common Symptoms of a Cluster Headache?

Usually, a cluster headache begins rapidly and without any warning. The pain is extreme and is typically described as a sharp, burning, or piercing sensation on one side of the head. In most cases, it affects the same side of the head. People who experience cluster headaches may experience some or all of the following symptoms:

  • a red and watering eye
  • drooping and swelling of one eyelid
  • a smaller pupil in one eye
  • restlessness
  • a sweaty face
  • a blocked or runny nostril

Most cluster headaches last between 15 minutes and 3 hours and usually occur between 1 and 8 times a day, which may greatly affect the life of the sufferer. Interestingly, smokers tend to get cluster headaches more often than people who do not smoke. Furthermore, people who struggle with this condition typically experience cluster headaches at the same time during the day. The majority of cluster headaches affect the person at night. Lastly, cluster headaches are more common in the spring and the autumn.

The Characteristics of a Cluster Period

The majority of people experience episodic cluster headaches, which occur for one week to one year. This is followed by a remission period that may last as long as 12 months until the person has another cluster headache. However, chronic cluster periods can last for more than one year, and the period of time during which the individual no longer experiences cluster headaches may be less than a month. During a cluster period, the person will experience the following:

  • they will have one or more cluster headaches every day
  • the pain will last between 15 minutes and 3 hours
  • the cluster headaches affect the person at the same time of the day
  • the majority of cluster headaches occur at night, one to two hours after the individual goes to bed

With a cluster headache, the pain typically ceases as suddenly as it started, and it has a fast decreasing intensity. Following a cluster headache, the person will be free of pain but very tired.

What Is the Cause of Cluster Headaches?

Even though the exact cause of cluster headaches is currently unknown, medical researchers believe that the patterns involved in cluster headaches suggest abnormalities in the hypothalamus, the biological clock of the body, which is a portion of the brain. In contrast to migraines and tension headaches, cluster headaches do not occur as a consequence of triggers such as food, hormonal changes, or stress.

It is important to know that, once a cluster period begins, drinking alcohol may rapidly cause a very painful headache. Finally, another possible but not official cause of cluster headaches may be the use of medications such as nitroglycerin, whose purpose is to keep heart disease under control.

The Risk Factors of Cluster Headaches

Unfortunately, science has not yet discovered the exact cause of cluster headaches, but medical researchers found several risk factors that may increase the likelihood of experiencing this condition, such as:

  • sex: men are more prone to experiencing cluster headaches
  • age: the majority of people begin having cluster headaches between the ages of 20 and 50, but they can occur at any age
  • smoking: numerous people with cluster headaches are smokers, but, regrettably, quitting this habit will not make cluster headaches disappear
  • alcohol use: if you are in a cluster period, drinking alcohol may trigger a cluster headache, which means you should avoid it
  • family history: having a close family member, such as a parent or a sibling, who has cluster headaches makes you more susceptible to experiencing them as well

How Is a Cluster Headache Diagnosed?

Because cluster headaches have a characteristic type of pain and pattern of attacks, your doctor will assign you a diagnosis after you describe how you experience the headache. They will ask you about the frequency and intensity of pain, the location of your headache, and the other symptoms you experience because of it. Nonetheless, to make sure there is no underlying cause of your headaches, your doctor may order the following tests:

  • neurological examination: this test will help your doctor identify physical signs of a neurological disorder, which are not present in people with cluster headaches
  • CT or MRI scan: these imaging tests will also allow your doctor to view in great detail what is going on inside your brain and to rule out serious causes of head pain, such as brain tumors or aneurysms

The Treatment of Cluster Headaches

Regrettably, there is no cure for cluster headaches, and the purpose of treatment is to help you cope with this condition by decreasing the frequency and intensity of your symptoms. Additionally, treatment may also prevent cluster headaches in some cases. Since cluster headaches occur so suddenly and entail so much pain, fast-acting medications are necessary. The following therapies have proven to be the most effective when it comes to treating cluster headaches:

  • Oxygen therapy: Inhaling oxygen through a mask can greatly alleviate your cluster headache within 15 minutes. This treatment is usually safe, as well as inexpensive, and does not imply any side effects. However, the main disadvantage of oxygen therapy is that you will not be able to permanently have an oxygen cylinder and regulator with you at all times, which makes this treatment quite inconvenient.
  • Triptans: This is the injectable form of sumatriptan, a drug used to treat migraines that is also useful in the treatment of cluster headaches. Your first injection will generally be given under medical supervision. Moreover, some people with cluster headaches may benefit from sumatriptan in the form of nasal spray. It is noteworthy that you cannot take this medication if you have high blood pressure or heart disease.
  • Octreotide: As the injectable synthetic version of the brain hormone somatostatin, this medication may provide some relief to people who struggle with cluster headaches, but it is usually less effective than triptans.
  • Local anesthetics: Local anesthetics such as lidocaine may alleviate the pain of some people who experience cluster headaches, and they are typically administered through the nose.
  • Dihydroergotamine: This medication comes in the form of injections or nasal sprays and may also provide significant pain relief in people who have cluster headaches.

When Should I Seek Emergency Medical Care?

Firstly, if you began experiencing what seems to be cluster headaches, you should visit your doctor as soon as possible so that they can rule out other causes of your pain. In most cases, headaches do not signal a serious underlying disease, but they are sometimes the symptom of a brain tumor or a rupture of a weakened blood vessel, medically known as an aneurysm. If you have a diagnosis of cluster headaches but notice the following changes, you should seek emergency medical assistance:

  • experience a severe and abrupt headache like a thunderclap
  • have a headache accompanied by fever, nausea or vomiting, mental confusion, numbness, speaking difficulties, or seizures
  • experience a headache after a head injury, regardless of its severity
  • have a cluster headache with significantly more intense pain than you usually experience
  • experience a headache that worsens with each passing day and changes in pattern

As a person who struggles with cluster headaches, you may feel like your lifestyle is greatly affected by your condition since it can easily make you feel anxious and depressed. Experiencing cluster headaches can be very frightening and difficult, but with the help of a strong support system, as well as with the professional advice of a mental health practitioner, you can live a normal life with cluster headaches.

Joining a support group through which you can meet other people who suffer from cluster headaches may also be a good idea, as it can make you feel like you are not alone. Therefore, working with your doctor, who will help you find the most effective treatment for cluster headaches, and benefiting from the support of your loved ones is crucial in coping with cluster headaches.