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Cluster Headache Explained

Cluster headaches are the most intense type of primary headache and can be extremely difficult to deal with for sufferers. Unlike migraines, cluster headaches tend to be many times more severe than migraines.

Below, we’ll discuss what cluster headaches are, what gives them their name, associated symptoms with cluster headaches, and possible treatments for this excruciating disorder.

What Are Cluster Headaches?

A cluster headache is a type of neurological disorder. 

The name “cluster headache” is linked to the characteristic way in which these headaches come on — in cycles or clusters.  Headaches often occur every day or every other day for weeks or months, followed by a headache-free remission period for months or years.  Each headache lasts anywhere from fifteen minutes to three hours, and headaches occur up to 8 times a day.

Most individuals (90%) have episodic cluster headache, with headache cycles usually lasting a few months every 1-2 years.  A few (10%) with chronic cluster headache do not experience this remission period, or, alternatively, their remission period may only last a few weeks.

Symptoms of Cluster Headaches

Cluster headaches are mostly characterized by intense, searing pain around the eye (orbital) and on one side of the head (unilateral). From cycle to cycle, or headache to headache, which side the cluster headaches are experienced on may vary.

Overall symptoms of cluster headaches include:

  • Excruciating pain around or behind one eye

  • Redness, tearing, and swelling of the affected eye

  • Drooping of the affected eyelid

  • Runny nose and stuffiness on the affected side of the face

  • Excessive sweating on the affected side of the face and forehead

  • Paleness of the skin or, alternatively, flushing of the skin

  • Restlessness or a need to rock or pace during a headache

The pain associated with cluster headaches is unlike any other. Individuals describe it as feeling like a hot poker or icepick is burning or boring into their eye.

Are Certain Triggers Associated With Cluster Headaches?

While migraines and other headache disorders are often associated with experiencing certain emotional stressors or eating specific foods, cluster headaches have very few triggers. Alcohol and nitroglycerin (a medication used to prevent chest pain) can trigger cluster headaches, often within an hour.

At the same time, cluster headaches tend to come on with a clock-like regularity each 24-hour period. One individual may say they get them every day at midnight, another every day at 5pm.  The most common time is around 2am. 

Why Are Cluster Headaches Sometimes Called “Suicide Headaches”?

All migraine and headache disorders are painful; however, cluster headaches appear to be the most painful. Some women who have suffered from cluster headaches have described them as more painful than giving birth.

Because of the severity and the duration (for hours multiple times a day), some individuals have taken their own lives. This often occurs when the individual knows that a cluster headache attack is impending or during an attack itself.

Treatments Available for Cluster Headaches

What causes cluster headaches is still poorly understood; although some connections have been found between cluster headaches and the hypothalamus, an area of the brain that controls hormones and circadian rhythms.

Because of the questions still remaining about the cause of cluster headaches, there is no singular treatment for this disorder. Acute, individualized treatment must be catered to each patient and carried out by a medical professional (or a team of professionals) who have experience with cluster headaches.

Fortunately, there are several successful treatments available for this disorder, and sufferers are encouraged to work with a medical team to find the best solutions possible. These treatments may include steroid therapy, the prescription of daily medications, the use of high-flow oxygen, and even noninvasive devices that stimulate certain nerves.