Cluster headaches are among the most painful type of primary headache. They are excruciatingly painful, and may occur several times every day for months at a time, often around the same time of day or night. Fortunately, cluster headaches are not common, and can disappear for months or years in between cluster periods.
This type of headache is more common in men than women and more common at night than during the day, often waking the sufferer. The headaches are unilateral and are usually accompanied by pain behind the eye, tearing, redness and drooping eyelid along with a runny nose on the same side as the headache. Because of these symptoms cluster headaches are sometimes confused with allergies or sinus problems.
Some people experience migraine symptoms with headaches, including nausea, light and sound sensitivity, and an aura. There may be swelling on the affected side of the face, as well as sweating, pallor, and a constricted pupil. Pain sometimes radiates to the neck and shoulders. The eye pain has been described as a hot poker in the eye or a feeling as though the eye is being pushed out of the socket.
Cluster headaches can occur at any age, but they are more common in people ages 20-50. They are also more likely to affect smokers and may be provoked by alcohol. The headaches can run in families, and are sometimes associated with head trauma. The pain usually reaches an apex within about 10 minutes of onset, and can last one or several hours. The cluster periods often occur seasonally, such as spring and fall.
Because the onset is so rapid, fast acting drugs are required to prevent or decrease intensity of the headache. Sufferers often feel restless or agitated, and prefer movement to lying down unlike most severe headache sufferers. Treatment may include injectable drugs or nose sprays, as well as maintenance medications to help prevent or decrease severity of headaches.
In severe cases, the headaches can become chronic, continuing for years with only a month or so between clusters. In these cases electrical stimulation of the occipital nerve or even cutting or otherwise destroying the affected nerve may be necessary to provide relief.
Mayo Clinic lists some lifestyle interventions to avoid cluster headaches:
• Maintain a regular sleep schedule
• Avoid alcohol and tobacco products
• Limit exposure to volatile substances like solvents and gasoline
• Avoid high altitudes during cluster periods
• Stay away from foods and medications containing nitrates
While cluster headaches are very painful and can be frustrating to deal with, there are treatments. If you experience symptoms of cluster headache, see your health care provider so you can work to shorten your cluster periods.
Sources:
Bader MK & Littlejohns LR. (2004). AANN Core Curriculum for Neuroscience Nursing (4th Ed.). St. Louis, Saunders.
MayoClinic.com: Cluster headache
http://www.mayoclinic.com/health/cluster-headache/DS00487
National Institute of Neurological Disorders and Stroke: Headache: Hope Through Research
http://www.ninds.nih.gov/disorders/headache/detail_headache.htm