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Cluster headaches are a rare type of headache that occurs suddenly and is often severe. They cause intense burning or piercing pain around one eye or temple on one side of your head.
Cluster headaches last from 15 minutes to three hours and occur daily or almost daily around the same time each day for several weeks or months, earning their name from the “cluster” of attacks that happen during a specific timeframe.
At UPMC, our headache experts offer a full range of treatments for cluster headaches. After diagnosing your condition, our headache experts will develop a comprehensive treatment plan to manage your acute pain — reducing the need to visit the emergency department for care and improving your quality of life.
Cluster headaches are rare, sudden, and severe headaches that cause intense burning or piercing pain around the eye or temple on one side of the head.
Cluster headaches last from 15 minutes to three hours and occur daily or almost daily around the same time each day for several weeks or months, earning their name from the “cluster” of attacks that happen during a specific timeframe.
Cluster headaches don't last as long as migraine headaches. They also don't happen as often. It's common to get 1-3 cluster headaches daily, with cluster periods usually happening in spring and fall.
There are two types of cluster headaches, including:
Doctors don't know what causes cluster headaches. However, they occur when blood vessels swell in the tissues around your head, resulting in throbbing pain. They may be related to:
Other triggers for cluster headaches may include:
You may be at higher risk of developing cluster headaches if you:
Although cluster headaches are not life-threatening and do not cause permanent damage to your brain, they can cause intense pain that interferes with everyday activities, such as school, work, or caring for your family.
People with cluster headaches may also develop drug overuse headaches when over-the-counter (OTC) pain relievers stop working and the headaches return. It is advisable to seek expert care rather than overusing OTC drugs, as overuse may reduce the effectiveness of prescription medications.
Avoiding cluster headache triggers may help to prevent attacks. Your doctor may recommend keeping a headache diary to track details about your attacks, which could help you better understand your triggers. Your doctor may also prescribe medications or other treatments to prevent cluster headaches.
Other ways to prevent headaches may include:
Your doctor may also suggest supplements to help prevent cluster headaches, including:
Cluster headaches affect approximately 1 of 100,000 people, making them an uncommon type of headache. They are more common in men. Although they can happen at any age, they most commonly start between age 20 and 40.
Cluster headaches often wake you up at night. You may have migraine-like visual disturbances and nausea before the attack.
Unlike a migraine, you can't lie down with a cluster headache. You may pace and feel like you can't sit still.
The pain:
Other cluster headache symptoms may include:
Yes. In some cases, cluster headache symptoms may disappear suddenly and not return for months or years. However, most people need treatment to manage their cluster headaches.
If you have symptoms of cluster headaches, you should schedule an appointment with your doctor right away. Getting fast treatment can help you feel better sooner, improve your quality of life, and reduce needing emergency care when cluster headaches happen.
If you have already been diagnosed with cluster headaches, you should contact your doctor if:
Sometimes, a more serious condition, such as a stroke or another brain disorder, can be mistaken for cluster headaches. You should dial 911 if:
Your doctor will review your health history, ask about your symptoms, and do a physical exam.
When you arrive at your appointment, your doctor will:
There are no tests doctors can use to diagnose cluster headaches. You may need imaging scans like a CT or MRI to rule out other causes of your headaches.
With treatment, most people are able to manage cluster headaches and reduce their impact on quality of life. Cluster headaches may also occur less frequently with age.
The goal of cluster headache treatment is to reduce the pain, improve your quality of life, and prevent future headaches. OTC and narcotic medications don’t work well for cluster headaches.
You may need a combination of treatments to manage your cluster headaches, including:
CGRP is a compound in the brain that causes intense inflammation. Doctors use the medicine to treat cluster headaches. It blocks the peptide, reducing inflammation and pain without serious side effects.
Your doctor may give you three CGRP shots at the start of the cluster period. You'll get another shot once per month until the end of the cluster period.
Triptans are a type of medicine called a serotonin agonist. These drugs balance chemicals in the brain and block pain pathways. They may leave you feeling flushed and warm, with chest tightness and a rapid heartbeat.
You can take triptans as a tablet, nasal spray, or shot. They're not for people who smoke or have heart issues.
Sumatriptan is a common triptan. It narrows blood vessels to reduce headache pain.
When a cluster attack starts, you use a pre-filled medicine pen to give yourself a shot. It starts working in five minutes. It may make you drowsy or dizzy, and it's not for people with heart disease, high blood pressure, liver, or kidney problems.
Nerve block shots are a long-lasting way to stop nerve pain signals. To treat headaches, nerve blocks target the seven main branches of the pericranial nerves in your scalp.
Nerve block shots are quick, safe, and minimally invasive. Your doctor will:
In most cases, you'll have shots every three months.
Possible side effects include:
Trigger point shots can treat cluster headaches, migraines, and sometimes tension headaches. They reduce muscle pain.
When you get the shots, your doctor will:
Often, your doctor may use the same solution and do both nerve block and trigger point shots in one visit. This can relieve pain from your nerves and muscles in one treatment.
A cycle breaker medicine stops a prolonged headache. There are various cycle breaker drug options. Your doctor may prescribe different ones for you to try.
Oxygen therapy reduces blood flow to the brain and works quickly to stop the pain of cluster headaches. Your doctor may prescribe an oxygen tank and face mask to use at home when you get a cluster headache. Some people use oxygen therapy and sumatriptan together for fast pain relief.
If your cluster headaches are severe and do not improve with other treatments, your doctor may recommend a neurostimulator. Neurostimulation involves using a device that sends electrical signals to your nerves. These signals disrupt pain pathways, reducing the intensity and frequency of your pain.
Several types of noninvasive and surgically implantable neurostimulation devices are available. Your doctor will let you know which device is right for you based on your symptoms and overall health.
When you choose UPMC for cluster headache care, you will receive:
By UPMC Editorial Staff. Last reviewed on 2025-02-25.
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