What Is a Cluster Headache? Symptoms, Causes and When to Get Help

A cluster headache is a rare and particularly intense kind of headache, named for the way attacks tend to arrive in a series over a short span of time. They are characterised by very sharp, shooting pain, often concentrated near the eye or on one side of the head.

Below we cover what cluster headaches feel like, what causes them, how they differ from migraines, and where physiotherapy does and does not fit in. If your head pain is ongoing and you are not sure what type you are dealing with, our headache and migraine treatment team can help you work through it.

What Does a Cluster Headache Feel Like?

A cluster headache feels like a sharp, burning or piercing sensation, typically very concentrated around the eye or temple. Attacks often start and stop without warning, and can arrive as a rapid-fire series of headaches with short intervals between them. They can happen multiple times a day, and a cluster period can persist for months at a time.

Cluster headaches are also often accompanied by other symptoms, such as:

• A red and/or teary eye on the same side the headache is concentrated
• Feeling nauseous or feverish
• Miosis (pinpoint pupils)
• Sweating
• Nasal congestion

Cluster headaches tend to last anywhere from 15 minutes to 3 hours. Although the symptoms are well established, researchers are still working to fully understand why cluster headaches occur in the first place.

What Causes Cluster Headaches?

The exact cause of cluster headaches is not fully understood, but some research points to abnormal activity in the hypothalamus — the part of the brain that helps regulate your body’s internal clock. This may explain why cluster headaches often occur at the same time each day, and during particular periods of the year.

Researchers also believe the trigeminal nerve plays a central role, since it is likely what triggers the uniquely intense pain. Genetics may play a part as well, although the research does not currently show a consistent family history among people who experience cluster headaches.

Cluster headaches are neurological in origin. They are not triggered by muscular issues, unlike tension or cervicogenic headaches.

Known Triggers During a Cluster Period

Triggers vary from person to person. Some commonly reported triggers for cluster headaches include alcohol, smoking, strong smells such as perfumes or nail varnish, altitude, and intense exercise.

It is worth noting that these triggers generally only apply during an active cluster period, so they are less likely to affect people in day-to-day life. If you experience recurring cluster headaches, keeping a headache diary can help you identify and avoid your own triggers.

Cluster Headache vs Migraine: What’s the Difference?

Although migraines and cluster headaches are both notable for their acute effects, they differ significantly in duration, pain location, and physical response.

You can read our 5 tips for instant migraine relief for more on managing that condition.

How Are Cluster Headaches Diagnosed?

Only a medical professional can diagnose cluster headaches. While there is nothing wrong with reading informative pieces like this one, self-diagnosis is strongly discouraged, as several headache conditions share similar symptoms but call for very different approaches.

Diagnosis happens in a clinical setting, where a physician will take a detailed history of your symptoms. They will usually ask about the location, severity, duration and frequency of your headaches, along with any associated symptoms and potential triggers. They may also use neuroimaging to rule out other underlying causes. Once other conditions have been excluded, your doctor can recommend an appropriate management plan.

Treatment and Management Options

There is no single treatment that resolves cluster headaches permanently, but a combination of acute and preventive approaches can make attacks far more manageable.

For acute relief during an attack, high-flow oxygen therapy is one of the most widely used treatments, often easing symptoms within minutes. Fast-acting triptans, given as an injection or nasal spray, are also commonly prescribed, as oral medications tend to act too slowly to be useful during a short, intense attack.

For those in an active cluster period, preventive medications and pain relief may be used to reduce how often and how severely attacks occur. These are typically prescribed at the onset of a cluster and tapered off once the period ends.

Frequently Asked Questions