What is cluster headache?

Cluster headaches are severe headaches on one side of your head that happen in groups, or "clusters." They usually occur over weeks or months.

Cluster headaches can be so painful that you are not able to follow your normal routine or do your usual activities. The pain is often called the worst type of headache pain.

Cluster headaches come in cycles (also called cluster periods). Most people who get cluster headaches have one or two cluster periods each year. A cluster period might last 1 month or longer. After a cluster period ends, you may not get another headache for months or even years.

As you get older, it's likely that you'll have longer and longer times without headaches. At some point, you may not get cluster headaches ever again.

Having cluster headaches can be scary. But even though they are very painful, cluster headaches don't cause long-term harm. During a cycle, you may be able to reduce how often you have them, how bad they are, and how long they last.

The main symptom of cluster headaches is a severe burning or sharp, piercing pain on one side of your head. The pain spreads out from your temple and eye. Your eye may become red, watery, or puffy. The eyelid may droop, and you may have a runny or stuffy nose on that side of your head.

The pain usually gets bad very fast. The pain gets worse within 5 to 10 minutes after the headache starts and can last for 15 minutes or longer.

Cluster headaches usually happen at the same time of day each time you get them. But they can happen at any time. You may have 1 to 8 headaches a day.

A doctor can usually tell if you have cluster headaches by asking about your symptoms and examining you. Your doctor may order other tests, such as a CT scan or an MRI, if he or she thinks your symptoms are caused by another disease. But most people won't need these tests.

When a headache starts, you can take medicine or breathe in oxygen from a machine to ease the pain or stop the headache. You use these treatments only when you feel a headache coming on. You don't use them every day.

When a cluster headache begins:

• Start your treatment right away. Don't wait for the headache to get worse. Take your medicine exactly as planned with your doctor.
• Do what feels best. You may feel better if you walk, jog in place, sit, kneel, or stand. Lying down may make the pain worse.

If your treatment doesn't work, ask your doctor if you can try something else. It may take time to find what works best for you.

Over-the-counter pain medicines, such as aspirin, acetaminophen, and ibuprofen, usually don't work for cluster headaches.

Dealing with repeated cluster headaches can lead to stress and depression, which in turn can continue the headache cycle. Finding ways to cope with stress (such as with regular exercise) and improve depression may reduce the severity or frequency of your cluster headaches.

• Watch for new symptoms with a headache. These include fever, weakness or numbness, vision changes, and confusion. They may be signs of a more serious problem.
• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
• If your doctor recommends it, take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
• Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• Carry medicine with you to quickly treat a headache.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
• If your doctor prescribed at-home oxygen therapy to stop a cluster headache, follow the directions for using it.

To prevent cluster headaches

• Keep a headache diary. Avoiding triggers may help you prevent headaches. Write down when a headache begins, how long it lasts, and what might have triggered it. This could include stress, alcohol, or certain foods.
• Exercise daily to lower stress.
• Limit caffeine by not drinking too much coffee, tea, or soda. But do not quit caffeine suddenly. This can also give you headaches.
• Do not smoke, and avoid being around others who are smoking. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Tell your doctor if your headaches get worse and medicines don't help. You may need to try a different medicine.