A World of Hurt: Cluster Headaches

Wed, Nov 4, 2009

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In the third installment of the A World of Hurt series, we’ll be getting away from migraines and be starting to talk about headaches.

The first one on our list is one that’s considered to be the most painful of the headaches: cluster headaches. Obviously, by the name alone, you can tell that this is when someone has multiple headache attacks during a six to twelve week period. Also, these typically are found in men more than women, about a ten to one ratio. One important feature of this type of headache is that it starts quickly and typically is one-sided.

Cluster headaches are typically felt between the eyes and around the nose and are described as a tingling, or more accurately, stabbing pain. It’s not uncommon to get the description of a red, hot poker going into your eye. Now with the eyes and nose taking the brunt of the pain, you can see secondary symptoms such as:

strong lacrimation (tears) which can lead to a runny nose
bloodshot eyes
sweaty, pale skin on the face
facial swelling
the pain can radiate to other parts of the head and neck

Many people believe that cluster headaches have a strong association with the season, such as late fall going into early winter. Like I said earlier, these headaches start quick with multiple attacks every day in typically no longer than 12 weeks. Each attack can last from 10 minutes to 2 hours and are made worse with noxious drinks like alcohol (puts a damper on Friday nights, right?). Smokers are at a higher risk of getting cluster headaches. How you determine a cluster headache is that they appear like clockwork. People can wake up in the middle of the night at 1:00 AM, 4:00 AM, and 7:00 AM.

A few things that are done to treat these headaches are using 100% oxygen, ice, chiropractic adjustments, and acupuncture. However, with cluster headaches, these only break the single headache, not necessarily the entire cluster. This may be do to increased hypothalamus function in the brain; whether it be too much of a particular hormone like cortisol, or too much of a certain neurotransmitter like serotonin.

So lifestyle changes like making dietary changes, going into an anti-inflammatory, may help. Oddly enough, placebos work well with cluster headaches, too. There are also some injectable drugs (even ones that are inhaled) that are used for migraines that are pretty effective in treating this. With cluster headaches, with their sudden onset and “short” durations, NSAIDs like ibuprofen and acetaminophen are pretty much useless. (I say “short” because I’m sure it feels like forever to someone that has gone through these.)

So a few things that you can do to help limit or even eliminate these headaches are avoiding things like alcohol, tobacco products, areas with noxious products like solvents and gasoline, avoiding nitrates in your food, and being weary in high altitudes. Like most things, prevention is key. Especially with cluster headaches, you may be able to stop one, but it’s extremely difficult to stop the chain. But if it’s something you experience, it should not be something to go through alone. Go see your physician for help, so they can determine it’s not anything more dangerous, and more importantly for support. Friends and family should also be willing to offer you support during this time.

So this may sound sappy, but if you have cluster headaches, you shouldn’t isolate yourself (completely). Be willing to get help from those around you for support. Have a cluster support system. Hopefully, with support and a good prevention plan in place, you can get off the “pain train”.

Image Credit: sarah_azavezza.