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Cluster Headaches

Cluster headaches are one of the most painful health issues humans experience. Symptoms are severe and start fast. An attack may last anywhere from 15 minutes to 2 hours.

Cluster headaches cause burning, piercing pain around your eye or temple on one side of your head.

They're also rare. In the U.S., only 4 people out of 1,000 get cluster headaches.

But the experts at the UPMC Headache Center have vast training in treating cluster headaches.

On this page:

  • Cluster headaches overview
  • Cluster headaches symptoms and diagnosis
  • Cluster headaches treatments

Looking for Cluster Headache Care?

  • UPMC Headache Center

Find a cluster headache doctor

Request an appointment


What Is a Cluster Headache?

A cluster headache:

  • Is a vascular headache, meaning the blood vessels swell in the tissues around the head. This is what causes the throbbing pain.
  • Is one of the least common types of headaches.
  • Gets its name from how the attacks come in groups or clusters over a distinct period.

Doctors define cluster headaches as severe headaches that usually happen at the same time of day for a few weeks.

Cluster attacks don't last as long as migraine headaches. They also don't happen as often. It's common to get 1 to 3 cluster headaches daily, with cluster periods usually in spring and fall.

A person can go months without symptoms. This is the most common type of cluster headache, which only happens a couple of times yearly.

You can get them at any age, but they often start between 20 and 40. They are more common in men.

A small number of people have chronic cluster headaches. Chronic cluster headaches can come back regularly and last for years. A person with chronic cluster headaches may have only a month or less without pain over that stretch.

What causes cluster headaches?

Doctors don't know what causes cluster headaches.

Since they happen more at night, the body's sleep-wake cycle may play a role in triggering cluster headaches.

People with a past head injury are more likely to have cluster headaches.

And, some families are more at risk of cluster headaches. There may be a gene that passes from parent to child.

Even though cluster headaches are more common in the fall, doctors don't think seasonal allergies cause them. Food, hormones, or stress also aren't usual triggers.

What are cluster headache risk factors and complications?

Cluster headache risk factors

You're more at risk for cluster headaches if you:

  • Drink alcohol.
  • Smoke.
  • Are male.
  • Have other family members that have them.

Complications of cluster headaches

Taking over-the-counter (OTC) pain relievers isn't a good cluster headache treatment. This can lead to drug overuse headaches — when pain relievers stop working and the headaches come back.

Overusing these OTC drugs to delay expert headache care could make prescription medicine less effective.

Can I prevent cluster headaches?

At the UPMC Headache Center, we take a whole-person approach to your care.

Your doctor will share healthy ways to prevent headaches, such as to:

  • Keep a set sleep schedule.
  • Eat healthy meals and snacks.
  • Drink plenty of water.
  • Don't skip meals.
  • Work out.
  • Limit stress.
  • Do deep breathing.
  • Limit sugar, alcohol, and caffeine.
  • Don't smoke.

Your doctor may also suggest supplements to help prevent cluster headaches. like:

  • Magnesium.
  • Riboflavin.
  • Vitamin D.
  • Coenzyme Q10.

Most people need to take medicine to prevent future attacks.

UPMC offers the most advanced treatments to stop and avoid cluster headache pain.

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Cluster Headache Symptoms and Diagnosis

What are the signs and symptoms of cluster headaches?

Cluster headaches often wake you up at night. You may have migraine-like visual disturbances and nausea may come before the attack.

Unlike a migraine, you can't lie down with a cluster headache. People pace and can't sit still.

The pain:

  • Peaks 5 to 10 minutes after the cluster headache starts.
  • Stays intense for up to 3 hours.
  • Is only on one side of the head — often at the temple, behind, or around one eye.

Other cluster headache symptoms may include:

  • Heart rate and blood pressure changes.
  • Sensitive to light, sound, or smell.
  • Restless and moody.
  • Redness in the face.
  • Eyelid droop.
  • Swollen, runny nose.
  • Teary.
  • Sweating.

If this describes how you feel, call a UPMC Headache Center specialist. With our advanced treatments and cutting-edge drugs, we can treat your acute pain — and you can avoid the ER.

How do you diagnose cluster headaches?

There are no tests doctors can use to diagnose cluster headaches.

Your doctor will ask about your health history and symptoms and do a physical exam.

You may need imaging scans like a CT or MRI to rule out other causes of your headaches.

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What Are the Treatment Options for Cluster Headaches?

With world-class neurologists board-certified in headache medicine, the UPMC Headache Center has the expertise you need.

Our cluster headache treatment will get you back to doing the things you love pain-free.

Calcitonin gene-related peptide (CGRP) monoclonal antibodies to treat cluster headaches

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 with no serious side effects.

You'll often get 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 for cluster headaches

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 shoot yourself under the skin. It starts working in 5 minutes. It may make you drowsy or dizzy.

It's not for people with heart disease, high blood pressure, liver or kidney problems.

Nerve block shots to treat cluster headaches

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 the scalp.

Nerve block shots are quick, safe, and minimally invasive.

Your doctor will:

  • First inject a numbing solution such as lidocaine or bupivacaine so the shots don't hurt.
  • Then they'll inject the nerve block solution.
  • Add corticosteroids, an anti-inflammatory drug, to the shot if they feel you need it.

In most cases, you'll have shots every three months.

Possible side effects are:

  • Bleeding.
  • Infection.
  • An allergic reaction.
  • Short-term numbness.

Trigger point shots to treat cluster headaches

Trigger point shots can treat cluster headaches, migraines, and sometimes tension headaches.

Trigger shots reduce pain coming from muscles.

When you get the shots, your UPMC headache doctor will:

  • Tailor the dose and placement to your cluster headache pain.
  • Inject a numbing solution so the trigger point shots don't hurt.
  • Give you the trigger point shot. The shots contain a solution to numb the pain and may include a steroid, much like a nerve block.

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 both your nerves and muscles with one treatment.

Cycle breaker medicines to treat cluster headaches

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 for cluster headaches

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.

You can get oxygen therapy and sumatriptan shots together at the UPMC Headache Center for fast pain relief.

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