Cluster Headaches

Before you jump on that migraine headache bandwagon….pull on those reins. It could be an altogether different headache. Your migraine you have been suffering from for years may actually be a little-known cluster headache. Cluster headaches are a series of relatively short but very painful headaches every day for weeks or months at a time. You tend to get them at the same time each year, such as in the spring or fall. Because of this, people often mistake cluster headaches for symptoms of allergies or work stress. “Experts” don't know what causes them, but a nerve in your face is involved, creating intense pain around one of your eyes. I use the term “experts” loosely as most practitioners have no clue what a cluster headache is, much less the actual nerve that is affected. If you are a super anatomy nerd then that nerve is Cranial Nerve 5. It's so bad that most people can't sit still and will often pace during an attack. Cluster headaches can be more severe than a migraine, but they usually don't last as long.

These are the least common type of headaches, affecting fewer than one in 1,000 people. Men get them more than women do. You usually start getting them before age 30. Cluster headaches may go away completely (this is called going into remission) for months or years, but they can come back without any warning. I don’t put any stock into the one in 1,000 number because the diagnostic techniques of physicians are lacking in this area. Most, if not all practitioners just don’t know enough about them.

What Happens?

You get a cluster headache when a nerve pathway in the base of your brain is triggered. That signal seems to come from a deeper part of the brain called the hypothalamus, home of the "internal biological clock" that controls your sleep and wake cycles. I can’t prove it or disprove it, but I think the time change has a lot to do with affecting those sensitive people that suffer from cluster headaches. By time change, I don’t mean clock time….I am referring to the actual natural change of the season. Our brain runs on a natural rhythm. That natural rhythm knows when the sun goes down and when it comes up. This in turn controls our sleep cycle. If a person’s sleep cycle and their hypothalamus don’t coordinate together then this creates a conflict and can cause some misfiring in the brain. Add this altogether and you get a cluster headache.

As I had previously stated the nerve that's affected, the trigeminal nerve, is responsible for sensations such as heat or pain in your face. It's near your eye, and branches up to your forehead, across your cheek, down your jaw, and above your ear on the same side. They are really big with muscles of mastication.

Characteristics of Cluster Headaches

There are a few things that set this type of headache apart. They include:

Speed. Cluster headaches generally reach their full force quickly, within 5 or 10 minutes.

Pain. It’s almost always on one side of your head, and it stays on the same side during a period, the time when you're getting daily attacks. (When a new headache period starts, it might switch to the opposite side, but that's rare.) It's often described as a burning or piercing. It may be throbbing or constant. You'll feel it behind or around one eye. It may spread to your forehead, temple, nose, cheek, or upper gum on that side. Your scalp may be tender. You can often feel your blood pulsing.

Short duration. Cluster headaches usually last only 30 to 90 minutes. They can be as short as 15 minutes or as long as 3 hours, but then they disappear. You'll probably get one to three of these headaches a day. Some people have as few as one every other day, while others get them up to eight times a day.

Predictable. Attacks seem to be linked to the circadian rhythm, your body's 24-hour clock. They happen so regularly, generally at the same time each day, that they've been called "alarm clock headaches." They might even wake you up an hour or two after you go to bed. Nighttime attacks can be more severe than daytime ones.

Frequent. Most people will get daily headaches for 2 weeks to 3 months; in between these periods, they'll be pain-free for at least 2 weeks.

Symptoms

The pain usually starts suddenly. You may notice:

• Discomfort or a mild burning feeling
• A swollen or drooping eye
• A smaller pupil in the eye
• Eye redness or watering
• Runny or congested nose
• Red, warm face
• Sweating
• Sensitivity to light

Cluster headaches are more common in people who smoke or who are heavy drinkers. During a cluster period, you'll be more sensitive to alcohol and nicotine. Just a bit of alcohol can trigger a headache. But drinking won't trigger one during headache-free periods.

Triggers

When you’re in a cluster period, any of these can bring on a headache:

• Cigarette smoke
• Alcohol
• Strong smells
• Stress
• Anxiety
• Low Vit D levels
• Genetics
• Barometric pressure changes 

Migraine vs. Cluster Headache

Both types of headaches cause intense pain. But the way they hurt and where you feel them is different. Migraine headaches begin slowly and can last a few hours to a few days. You might get some warning signs up to a day before the pain starts, like cravings for certain foods or changes in your mood. You might also see auras just before the migraine hits. Migraine gives you a throbbing pain. A cluster headache usually hurts on just one side of your head, but you might feel a migraine on both sides, on one side only, or along your forehead. It will probably get worse when you move your head. You may also have: 

Nausea and Vomiting

• Sensitivity to light, sound, and smells
• Colored spots, lines, flashing lights, or sparkles in your vision, called auras
• Numbness or tingling
• Weakness
• Trouble speaking or hearing 

Alternative Treatments 

Capsaicin. A nasal spray of this pain reliever might help.

Melatonin. This medication, known for easing sleep problems like jet lag, might lower the number of headaches.

Oxygen therapy: There is some good evidence out there that suggests that oxygen therapy can help with the treatment. In some cases, almost knocking the headache out completely.