Mild headache pain is a nuisance that’s usually treated with over-the-counter painkillers. But if you experience severe headache attacks for days around the same time every year, then it’s best to contact a healthcare provider immediately about cluster headaches and what you can do about them.
So what exactly are cluster headaches and how are they treated? Cluster headaches are extremely painful headaches that occur in a cluster period followed by headache-free periods. To manage cluster headache disorders during a headache cycle, patients can try alternative medicine, rational polypharmacy, and nerve block or trigger point injections.
Headache pain is a universal human pain experience that millions of people suffer from. According to the International Headache Society (IHS), there are about 14 different headache groups and over 170 different headache types.
Headache disorders like tension headaches and migraine headaches are quite common, but they only usually cause mild to moderate headache pain. Some patients may also experience headaches accompanied by other symptoms, like sinus headaches that come with a runny nose or nasal congestion.
Rare headache disorders like true cluster headache may be unusual for most people but it causes pain so debilitating that patients have to stop and stay still to prevent it from worsening. Having repeated cluster headaches can cause severe pain that prevents patients from doing the things they love.
To help determine the best cluster headache treatment for a patient, it’s crucial to fully understand the headache condition basics first.
Cluster headaches are short but extremely painful headache attacks that persist for weeks or months at a time. Patients usually experience them around the same time every year, so they’re often confused with work stress or seasonal allergies.
Cluster headaches got their name because they come in groups or clusters before temporarily going away. Each cluster headache attack may last for about 30 to 45 minutes, but some people may feel it for a shorter or longer time. Patients may also experience up to 8 headache attacks within 24 hours. The cluster headache may go into remission for about a few months or years before returning.
Cluster headaches are considered a primary headache disorder because there’s no underlying health condition that causes it. The exact cause of cluster headaches is still unknown, but experts classify it as a type of trigeminal autonomic cephalalgia.
When a patient experiences a cluster headache, a nerve pathway at the base of the brain is triggered. The affected trigeminal nerve is responsible for sensations of pain and heat in the face, which may explain why patients experience headache pain. The trigeminal nerve is found near the eye. It branches up to the forehead, cheeks, jaw, and above ear.
Patients in their cluster period may experience severe headache pain when exposed to triggers like:
A cluster headache attack may strike out of nowhere without warning, but some patients may experience migraine-like symptoms first. Some of the most common signs and symptoms of cluster headaches include:
Patients usually pace around during a cluster headache attack. Some of them also experience migraine-like symptoms like sensitivity to light and sound, but it’s only felt on one side of the face.
Cluster periods last for several days, weeks, and months, but the duration and start date may become consistent every year. During a cluster period, patients may observe the following:
Cluster headaches can be diagnosed because they have unique characteristics when it comes to the type of pain that patients experience, as well as the pattern of the headache pain they have. During a consultation, the doctor may ask for a detailed description of the pain, severity, location, and other associated symptoms.
Aside from checking the patient’s physical symptoms, headache diary, and previous medical records, doctors may also perform neurological examinations and imaging tests. Neurological exams assess the patient’s brain function while imaging tests (MRI and CT scan) rule out serious causes of headaches, like aneurysms or tumors.
Cluster headaches can be classified as chronic or episodic depending on the occurrence of cluster periods and remissions.
The good news is that cluster headaches get better as the patient ages. Their cluster periods become less frequent and their remission periods become longer.
Cluster headaches are unique among other common types of headache disorders because they’re severe but predictable due to their pattern. Cluster headache attacks may start suddenly, but some people may also experience visual disturbances similar to migraine symptoms before their headache begins.
Another thing to remember about cluster headaches is that they usually occur at night a few hours after the patient falls asleep. However, the pain is often enough to wake them up. Other patients may also start experiencing headache pain when they’re awake. The pain may peak about 5 to 10 minutes after the onset of cluster headaches.
Cluster headache pain occurs on one side of the head, but it may switch sides in some cases. Many patients describe the sensation as a deep piercing or burning pain behind or around their eye that extends to the forehead, teeth, nose, temples, neck, or shoulders.
If you experience sudden, severe headaches that you suspect might be cluster headaches, then it’s best to see a doctor immediately to rule out other medical conditions. They can also help you find the best cluster headache treatments.
Additionally, patients with a history of headaches are advised to see a headache specialist to check for pattern changes. They should consult with a doctor immediately if their headaches suddenly feel different. It’s crucial to call emergency care immediately if the patient experiences these signs and symptoms:
Unfortunately, there are no known cures for cluster headaches yet. Most treatments are only meant to decrease the severity of headache pain, prevent frequent attacks, and shorten the cluster period.
Since the pain from cluster headaches appears abruptly, quick-acting medications are the best headache treatment option for most people. But at Advanced Headache Center, we may recommend the following treatments:
Rational polypharmacy is the use of multiple medications to treat headache pain. Every medication recommended to a patient is meant to help them manage cluster headache symptoms without adding adverse effects like rebound headaches or medication dependency.
At Advanced Headache Center, our prescribed medicines can be used to stop or prevent cluster headaches. Here are some of them:
Taking too many headache medications may lead to side effects like rebound headaches. While our experts at Advanced Headache Center promise to guide you throughout your pharmacological treatments, we still understand that some patients prefer alternative or complementary approaches to relieve headache pain.
Here are some alternative treatments we offer at Advanced Headache Center:
If oral medications aren’t enough to stop or prevent cluster headache symptoms, a headache specialist may recommend trigger point or nerve block injections. This type of preventive treatment directly delivers medication to the patient’s trigger points or nerve blocks, resulting in quick-acting and long-lasting pain relief.
Here are some of the trigger point and nerve block injections we offer at Advanced Headache Center:
Cluster headaches may be predictable as long as you’re aware of the pattern, but the pain they cause is still severe enough to prevent patients from getting through the day comfortably. Many treatment options may help relieve cluster headache pain, but it’s still best to consult a medical professional for accurate diagnosis and reliable treatment plans.
Advanced Headache Center is the trusted center when it comes to integrative treatments for cluster headaches. We also offer a wide range of different services for patients who are suffering from other types of headache disorders like migraine, sinus headaches, tension headaches, and more. Call us today to take the first step to your pain-free life.
Dr. Hosny is an Ivy League Trained, UCNS-accredited, board-certified headache specialist who offers the latest preventive and abortive treatments to provide safe and effective head pain relief. As an active member of prominent organizations and professional societies that advance headache science, education, and management, such as the National Headache Foundation, Dr. Hosney specializes in diagnosing and treating a wide range of head pain disorders, including tension headaches, migraines, and cluster headaches, to name a few.
Dr. Hosny's reputation for enhancing headache care quality through the use of the most effective and technologically advanced treatment options for persistent primary and secondary chronic headaches has been acknowledged by Castle Connolly and Healthgrades, where he has received over 200 positive reviews. Dr. Hosny is also recognized as a distinguished New York City physician and headache specialist by New York Magazine.
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