What You Need to Know About Cluster Headaches: Symptoms, Causes, and Treatments

Fact checked by Olga Sadouskaya, MD
Clinical Pharmacologist, Chief Medical Officer

Cluster headaches, much more so than migraines, are excruciatingly painful conditions to endure. The medical community classifies both forms of headaches as primary headaches, as opposed to secondary headaches.

When the pain-processing region of the brain reacts, primary headaches begin. A primary headache is its own unique medical condition rather than a symptom of something else.

When a headache is secondary, it means it is the result of another medical issue. Ear infections, nasal congestion, and dehydration are just a few of the factors that might bring on one of these headaches.

Cluster headaches may last for weeks to months, severely impacting daily living. They often appear at the same time every day.

It’s possible that these headaches are worse at night than they are during the day. Let’s find out more about cluster headache symptoms and their treatments.

What is a cluster headache?

Cluster headaches are characterized by daily occurrences of intense pain that last for just a few minutes at a time, but with episodes recurring for weeks or months. They often occur at the same time of year annually, such as in the spring or autumn.

For this reason, cluster headaches are often misdiagnosed as allergies or a result of stress.

Though their origins remain a mystery, experts agree that the discomfort experienced around one eye is caused by a pinched nerve in the face. The pain is so intense that most individuals experience extreme restlessness and may even pace during an incident.

As painful as a cluster headache might be, it often doesn’t last as long as a migraine.

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Symptoms of a cluster headache

A cluster headache often occurs suddenly and without warning, but nausea and aura resembling a migraine may precede it.

Excruciating pain is often located in, behind, or anywhere around one eye but may spread to other facial, head, and neck regions. Here are common symptoms of cluster headaches:

  • One-sided pain
  • Restlessness
  • Extreme tearing
  • Redness of the affected eye
  • Congestion or nasal discharge on the affected side
  • Sweaty forehead or face on the affected side
  • Pale skin or facial flushing
  • Eyelid enlargement on the affected side
  • Eyelid drooping on the affected side

People with cluster headaches are more prone to pace or rock back and forth than those with migraine. Cluster headaches may manifest migraine-like symptoms, such as sensitivity to light and sound, but only on one side.

What are the causes of cluster headaches?

Cluster headache discomfort is brought on by the dilation of blood vessels in the head and face. It is the trigeminal nerve’s function to carry facial sensations to the brain, and this dilatation puts pressure on that nerve. The cause of this dilatation has yet to be determined.

Cluster headaches may be caused by problems in the hypothalamus, a tiny region of the brain that regulates core body functions including temperature, blood pressure, sleep, and hormone secretion.

A man in a dark room with a cluster headache triggered by stress

An unexpected release of the anti-allergy molecule histamine or the mood-balancing hormone serotonin has been linked to cluster headaches. Some other causes include the following:

  • Bright light
  • Cocaine abuse
  • Alcohol or smoking
  • Exercise or exertion
  • Change to a high altitude
  • Foods that contain nitrates

Cluster vs. migraine headaches: What’s the difference?

Both cluster and migraine headaches are quite painful. However, the manner in which they are painful and the locations where you experience them are distinct.

Migraine headaches often start off gradually and may last anywhere from a few hours to several days. You might experience some warning symptoms as much as a day before the discomfort begins, such as an increased desire for certain foods or mood shifts. There’s also a possibility that you’ll notice auras just before the migraine begins.

A migraine causes throbbing pain in your head. When you have a migraine, you may experience pain on both sides of your head, just one side, or along your forehead.

A cluster headache, on the other hand, often only causes pain on one side of your head.

When you move your head, it will most likely make the pain worse. Additionally, you could have:

  • Nausea and vomiting
  • Sensitivity to light, sound, and/or scents
  • Visual auras (e.g., colored dots, lines, flashing lights, or sparkles)
  • Sensations of numbness or tingling
  • Weakness
  • Difficulty either speaking or listening

After a migraine attack is complete, the patient may have symptoms similar to a hangover, including feelings of exhaustion and confusion. This time period is referred to as the postdrome phase.

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A migraine may be brought on by a variety of factors, including the following:

  • Alterations in the weather
  • Insufficient or excessive amounts of sleep
  • Strong scents
  • Stress
  • Loud sounds
  • Anxiety or depressive symptoms
  • Several pharmaceuticals
  • Caffeine, certain meals, and food additives
  • Hormonal fluctuations

Possible treatment for a cluster headache

Cluster headaches cannot be effectively treated with a single modality; rather, therapy must focus on both terminating existing episodes and preventing new ones from occurring.


Your doctor may suggest high-dose oxygen treatment using a face mask for 15 to 20 minutes in order to halt or at the very least suppress an attack that is currently developing.

In addition, they may recommend that you use a sumatriptan nasal spray in order to alleviate the excruciating pain caused by a cluster headache.

A selective serotonin receptor agonist, sumatriptan, is used to treat migraines. This drug works by narrowing the blood arteries in the brain, which in turn reduces the sensation of pain.

Medications to treat a cluster headache

The use of medication on a regular basis to stave off future attacks is the second step in the treatment for a cluster headache. Several different medications are used in the treatment of cluster headaches:

  • Ergotamine
  • Sumatriptan (Imitrex)
  • Zolmitriptan (Zoming)

Nerve stimulation

Treatment involves electrical stimulation of the occipital nerve. A network of nerves at the base of the skull receives electrical impulses from a device implanted by your doctor.


People who experience cluster headaches constantly may want to consider surgery as a last resort if other treatments have failed.

Can you prevent cluster headaches?

If you want to prevent cluster headaches, you can try to avoid these things:

  • Alcohol
  • Cigarettes
  • Cocaine
  • High elevations
  • Exercise that puts an excessive strain on the body
  • Meals high in nitrates

While cluster headaches are not fatal, no effective treatment exists. Your headaches may get less severe and more infrequent as you continue to use these techniques, and they may even go away entirely.

A headache may be avoided with preventive treatment. Medication, as prescribed by your physician, may shorten the duration of a cluster headache and lessen the severity of episodes. Here are some of the medications that your physician may prescribe:

  • Verapamil
  • Ergotamine
  • Melatonin
  • Capsaicin


Headaches are something that affects almost everyone, and there are a variety of causes for them. However, cluster headaches are not the same as other types of headaches. Talk to your health care provider if you’ve been having severe headaches recently.

You could be experiencing cluster headaches, and your doctor may recommend the best cluster headache treatments for you.

December 28, 2022