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Cluster Headache Characteristics

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.


What Are Cluster Headaches?

People with cluster headaches have no warning signs before the headache hits like a freight train. These headaches have also been referred to as suicide headaches. They are more severe than migraine headaches.

The headaches tend to occur with frequency for weeks or even months, which is called a cluster period. They may occur seasonally, such as every spring. Then, they may go into remission for a period of time, and the remission may last for months or rarely even years.

Migraine and cluster headaches are considered primary headaches, as secondary headaches are associated with illnesses. Cluster headaches last from 15 minutes to 3 hours. Cluster headaches are rare and not life-threatening. These headaches only affect 1 out of every 1000 people.

They cause severe pain on one side of the face, and they may occur up to eight times a day, and in cycles of weeks to months before the person gets relief. They tend to follow a pattern as they often occur at the same time frame each day. They frequently occur at night, when they feel more severe. People between 20 and 50 years of age are the more often affected, and men are affected most often than women.

Signs and Symptoms of Cluster Headaches

There are several signs and symptoms of these headaches they include:

  • Pain that is excruciating around and in one eye that may radiate to other areas of your face, neck and head
  • Excessive tearing
  • Runny or stuffy nose
  • Droopy or red eye
  • Restlessness
  • Facial and forehead sweating on the affected side
  • Flushing or pale skin (pallor)
  • A drooping eyelid on the affected side or a pupil constriction
  • Swelling around the affected eye
  • Migraine-like nausea and aura

An individual that has a cluster headache may pace or rock back and forth, which doesn’t happen with migraine headaches. When a person has a cluster headache they may be sensitive to sound and light, just like people with migraine headaches.

Nerve Responsible for Pain

Nerve Responsible for Pain

Possible Causes

Physicians do not know the exact cause of these headaches, but they appear to be related to any sudden release of histamine or serotonin in the body.

Some triggers for these headaches include:

  • Bright light
  • Alcohol use
  • Exercise or other exertion
  • Smoking
  • Altitude change
  • Cocaine usage
  • Heat from weather or a hot bath or shower
  • Foods containing nitrates (bacon or lunch meat)
  • Nitroglycerin
  • Histamine
  • Noise
  • Family history

Researchers think these headaches are caused by a dilation of blood vessels that press on the trigeminal nerve, but now this theory has been called into question. They are not sure what causes these awful headaches. The trigeminal and the facial nerve are now thought to cause the pain.

Diagnosis of Cluster Headaches

To diagnose cluster headaches, your doctor will do a thorough exam and you will be asked for a description of the attacks, which should include the location of the pain, the severity of your headaches and any associated symptoms.

The duration of the headaches and how long they last is also pertinent information. Your diagnosis is primarily based on your symptoms.

A neurologist or headache specialist may be necessary to rule out other problems that cause intense headaches. They will often order an MRI or CT SCAN.


Treatment for Cluster Headaches

There are several treatments for these headaches, and some are via an injection or a nasal spray. First, learn what your triggers are and avoid them.

The treatments include:

  • Oxygen, using a mask
  • Prednisone - a steroid that reduces inflammation and swelling as a fast-acting treatment
  • Calcium channel blockers (Verapamil, Calan, Verelan) for prevention
  • Triptan - treatment but not prevention
  • Verapamil - relaxes the blood vessels
  • Civamide - nasal spray
  • Nerve block - uses an anesthetic and a corticosteroid for temporary relief that is injected near the occipital nerve at the back of the neck
  • Lithium carbonate - used for bipolar treatment but works for prevention
  • Melatonin - people with these headaches tend to have low levels in their bodies
  • Topiramate (Topamax, Topiragen) - a medication for treatment of seizures that sometimes works as a preventative treatment for cluster headaches
  • Occipital nerve stimulation - electrodes are implanted that send impulses to the occipital nerve - While this is still experimental, small studies show quick pain relief and reduction of the frequency of the headaches.

On rare occasions when no medication works, surgery (sphenopalatine ganglion stimulation) may be ordered. According to Mayo Clinic, a neurostimulator is implanted, and the patient has a hand-held remote controller, which provides quick pain relief. More studies are needed to measure the results of this surgery.

Deep brain stimulation is another promising, yet unproven, treatment, where electrodes are implanted in the hypothalamus.

Alternative Treatments

Three are several possible alternative treatments that may provide relief, including:

  • Acupuncture - small needles are inserted into the skin at various points to relieve the pain
  • Physiotherapy focuses on stretching, moving joints and massaging areas that provide relief and prevention.
  • Spinal manipulation is the chiropractic adjustment of the spinal alignment.
  • Capsaicin cream (OTC) may be swabbed inside the nose using a Q-tip.
  • Box breathing (slow deep breaths) and pursed lip breathing are good for stress relief and may reduce pain.
  • Magnesium supplement as headaches occur with low magnesium levels.
  • Kudzu extract also has properties that seem to help with these headaches.

Living With Cluster Headaches

Cluster headaches are intense headaches that interfere with the quality of your life. There is really no cure, but there are several treatments for the pain.

Ongoing research is looking for better treatments and more importantly, a cure. Fortunately there are some alternative treatments that may be worth trying to treat or prevent the frequency of these headaches.


This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Pamela Oglesby


Pamela Oglesby (author) from Sunny Florida on February 24, 2021:

Hi Flourish,

It does sound like you have cluster headaches. If you do have cluster headaches there may be a medication that could help.

I had migraines that were quite painful, but they didn't hurt my eye. Over years mine have stopped.

Thank you for reading and coming back to comments, Stay safe and healthy!

FlourishAnyway from USA on February 23, 2021:

I read this when it first came out and I think I forgot to comment. Thank you for writing about this topic. I think these may be the really bad “eye headaches” I sometimes get! They hurt so bad and incapacitate me for awhile. I assumed they were migraines and my neurologist didn’t tell me otherwise.

Pamela Oglesby (author) from Sunny Florida on February 23, 2021:

Hi Chitrangada,

I certainly appreciate you very nice comments. I am glad you don't get headaches. I have a friend with these headaches, so you never know when you can help someone.

Stay safe and healthy!

Chitrangada Sharan from New Delhi, India on February 23, 2021:

A wonderful article about the Cluster headaches and it’s characteristics. Normally, I don’t get headaches. But, it’s good to be aware. I might help someone.

Thank you for sharing this important information.

Pamela Oglesby (author) from Sunny Florida on February 23, 2021:

Hi Devika,

I'm so glad you do not get those headaches anymore. I appreciate your comments. Stay safe and healthy.

Devika Primić from Dubrovnik, Croatia on February 23, 2021:

I did have such headches in the past, but over the year it has subsided. Thank you for this valuable write up here.

Pamela Oglesby (author) from Sunny Florida on February 23, 2021:

Hi Brenda,

I'm sorry to hear you get intense headaches. They may be cluster headaches as those are the most painful ones I know of. I hope you have seen a doctor. I wish you the best health, Brenda.

Thank you for your comments.

BRENDA ARLEDGE from Washington Court House on February 22, 2021:


You always do such a great job writing your articles.

Headaches can be debilitating.

I commonly get what I call Head Pain.

It seems worse on thise days the weather is changing, rather it be a thunderstorm brewing or a change in temperatures. Even the winter dipping into the single digits gets it going...and then again when temps creep back up.

Sometimes I think I must be part alien. But I know it is due to pressure occurring inside my skull.

Cluster headache ? Maybe a part of it, but it's probably a bit worse.

I call them volcanoes waiting to explode.

Have a great day & thanks for sharing.

Pamela Oglesby (author) from Sunny Florida on February 22, 2021:

Hi Shauna,

You are right as either headache is painful. I'm glad your headaches are rare, as are mine.

I am glad you found this information good, and I appreciate your comments. Stay safe and healthy!

Pamela Oglesby (author) from Sunny Florida on February 22, 2021:

Hi Sp,

Our bodies are complicated, and researchers have much to learn. These headaches are awful, and I am glad there are some medications to treat this disorder.

I appreciate your comments, Sp. Have a good week!

Shauna L Bowling from Central Florida on February 22, 2021:

Pamela, thank goodness I've never had a cluster headache. I feel for those who are susceptible to migraines and/or cluster headaches. It's all I can do to function when I have a regular headache that won't respond to Advil, which is rare.

Great information once again, Pamela!

Sp Greaney from Ireland on February 22, 2021:

I would hate to get these. But I'm sure many people do and just have to make do. But at least there are some things people can do to attempt to reduce the pain.

It's very interesting that the initial cause is now being questioned. Our bodies are so complicated. Who knows what is happening inside us.

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Hi MG,

Your comments are very kind, and I appreciate them. I am glad you found the article so informative. I hope you have a good week!

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Hi Linda,

I was glad to find that illustration as it clarifies each headache type.

There are several medications to try, but some people don't get too much relief. Like so many other illness, the research is ongoing.

I appreciate your comments, as always, Linda. Have to good week!

MG Singh emge from Singapore on February 21, 2021:

Pamela, very informative. You have covered the topic comprehensively and it made compelling reading.

Linda Lum from Washington State, USA on February 21, 2021:

What an absolutely ghastly illness. Thank God I don't suffer from headaches. The drawing that illustrated migraine, tension, and cluster headaches was very helpful. Good to know there is help for someone who has these. Thanks for another great one.

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Hi Peggy,

I have a friend with these headaches, and I know they are very painful. I am sorry to hear you suffer from them.

I'm glad you understand the difference between those 2 types of headaches. I use to have migraines but they gradually went away as I aged.

I appreciate your comments. I am glad to see TX is warmer today. Have a good week, Peggy.

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

You're welcome.

Peggy Woods from Houston, Texas on February 21, 2021:

I sometimes get those headaches, and they are a pain (no pun intended). Thanks for differentiating the differences between migraine and cluster headaches. People who seldom suffer from headaches are fortunate.

manatita44 from london on February 21, 2021:

Aww, so sweet, Pamela. Thank you!!

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Hi Adrienne,

These are extremely painful headaches. I'm sorry to hear about your husband having migraines. I use to get them several years ago, and they gradually went away. Maybe that will happen for your husband.

I appreciatw your comments. Have a good week!

Adrienne Farricelli on February 21, 2021:

Oh my, headaches that have also been referred to as suicide headaches, must be horrible to endure. I feel for those who suffer from these. My husband gets migraines and those are horrible enough.

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Misbah, I am glad you have see the optician. A doctor visit would be wise. Thanks again for commenting.

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:


Happy Sunday! I'm glad you don't get headaches, and I don't either, rarely that is. I'm glad you appreciate this information.

Thank you for your comments. Have a great week!

Misbah Sheikh from — This Existence Is Only an Illusion on February 21, 2021:

I visited the optician though

They said there is no problem with my eye sight

But I will soon go to doctor for a check up

Thanks once again Pamela


Bill Holland from Olympia, WA on February 21, 2021:

I am so incredibly blessed. I only get a headache maybe twice a year, if that. It's a good thing, because headaches stop me in my tracks. And God forbid I ever have a migraine. I can't imagine how people function with migraines. Anyway, great information...I am blessed.

Happy Sunday my friend!

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Hi Misbah,

I certainly think you should see a doctor. It may not be a cluster headache. It could have something to do with your eye. No matter what is causing this pain I think you should get some treatment.

I am glad you found this article interesting. I appreciate your comments. Blessings.

Misbah Sheikh from — This Existence Is Only an Illusion on February 21, 2021:

Very interesting article Pamela

I really find this one very helpful

I feel the pain in one eye and one side of the head very often

but I never take it very serious and have not yet visited the doctor for any treatment

first I thought it might because of high BP, but no it wasn't that

I think I should see a doctor

when I feel such pain it's very difficult for me to keep my eye open

Thanks for sharing


Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Hi Manatita,

All those triggers so make sense, and I agree that life is always colorful. I am glad you found the article informative.

I appreciate your comments, and I so appreciate what you did last week. You helped make my birthday one of the best I have ever had. Blessings to you.

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Hi Umesh,

Thank you for reading and commenting on this article. I am glad you found it informative.

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Hi Liz,

I am glad you found this information interesting. I think it is good to have that knowledge. I appreciate your comments. Have a wonderful week.

Pamela Oglesby (author) from Sunny Florida on February 21, 2021:

Hi Rosina,

I don't have those headaches either, but I have a friend who gets the cluster headaches. She really suffers unfortunately.

I am so glad you appreciate this information. Thank you so much for your comments.

manatita44 from london on February 21, 2021:

Lovely article. I can understand the drug, noise and even light problems. Life is always colourful in one way or another. Informative Hub!

Umesh Chandra Bhatt from Kharghar, Navi Mumbai, India on February 21, 2021:

Very informative. Thanks.

Liz Westwood from UK on February 21, 2021:

This is a very interesting and helpful article. You explain the different types of headache well and give useful advice.

Rosina S Khan on February 21, 2021:

I don't have migraine or cluster headaches. But it's good to have knowledge on these aspects as your articles always educate us on medical issues especially. I really appreciate that, Pamela. A great article!