Cluster headaches are headaches that involve pain on one side of your head, usually felt around your eye (although this pain can switch sides).
Cluster headaches can be very painful and come as sudden attacks. Most people will get recurrent attacks of cluster headaches (‘bouts’) that last around 4-12 weeks at a time, followed by periods of remission where they’re headache-free. This period can last for months or even years.
Cluster headaches can recur every few years, every year for a long time, or may be lifelong. They should get less frequent over time, but every person’s experience of cluster headaches is different.
Unfortunately, there’s no cure for cluster headaches. However, the pain and symptoms can be controlled effectively with treatment.
What are the symptoms?
The main symptom of a cluster headache is intense pain on one side of the head, usually felt around the eye, forehead or face.
The defining feature of cluster headaches is that they are followed by most of the following other symptoms:
- a red, watery eye
- droopy eyelid or swelling in one eyelid
- a small pupil in one eye
- a blocked or runny nostril
- a sweaty and flushed face
- a red ear
Symptoms of cluster headaches usually come in attacks that last between 15 minutes and 3 hours. These attacks can happen between 1 and 8 times a day.
How common are they?
It’s estimated that about about 1 in 500 - 1000 people in the UK are living with cluster headaches.
Despite this, not many people have heard of them, or know very much about the condition.
Why do they happen?
Why cluster headaches happen is not currently known for sure. However, they have been linked to a type of activity in a certain part of the brain called the hypothalamus.
Cluster headaches are also thought to run in families, which suggests that there’s a genetic link. You’re more likely to get them if someone in your family has them.
Who can get them?
Anyone can get cluster headaches, although they’re most common in men aged over 20 who smoke.
What are the treatment options?
There are several treatment options for cluster headaches. However, they can’t be treated effectively with over-the-counter painkillers like ibuprofen or paracetamol as these take too long to start working.
The main treatments for cluster headaches are:
- sumatriptan injections (up to twice a day)
- sumatriptan or zolmitriptan nasal spray (if you don’t want to have injections)
- oxygen therapy
All of these treatments can be performed at home, and will relieve the pain of a cluster headache within about 15-30 minutes.
Are there any ways to prevent them?
Your doctor might prescribe you medication to help prevent cluster headaches from developing, which you need to take as soon as you experience the first signs.
The main treatment for preventing cluster headaches is called verapamil, a tablet taken several times throughout the day. Your doctor will have to monitor your heart regularly when you’re taking this, because verapamil can cause heart problems in some people.
What are the triggers?
During a period of recurring attacks, some people notice that certain factors will trigger their cluster headaches. These can include:
- drinking alcohol
- hot weather or temperatures
- exercise or physical activity
- strong smells, like perfume or petrol
Are cluster headaches the same as migraines?
Both types of headache can cause severe pain, but cluster headaches will only affect one side of your head, and will come and go very suddenly.
Migraines can affect the whole of your head, and tend to last a lot longer (between 2 and 72 hours).
Getting support for your cluster headaches
Cluster headaches aren’t dangerous but the symptoms can seriously affect your quality of life. It’s important to see a specialist doctor who understands the condition and knows how best to treat it.
You should try to involve the people in your life as much as possible. It’s important that your family, friends and work colleagues are aware of your condition so that they can help and offer their support when you need it.
You can get more advice and support from groups such as the Organisation for the Understanding of Cluster Headache (OUCH): http://ouchuk.org/home. There are also lots of forums and support groups online, where you can talk to other people with cluster headaches.