Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2005;72(9):1821-1822

What is a cluster headache?

A cluster headache is a rare type of headache that is more common in men. Cluster headaches start suddenly. The pain is usually behind or around one eye and is very bad. If you have a cluster headache, your nose and eye on the same side as the pain may get red, swollen, and runny. Cluster headaches also can make it hard for you to sleep.

Most cluster headaches last for about 30 to 45 minutes. Sometimes, though, they can last only a few minutes or several hours. Cluster headaches usually happen at the same time each day for several weeks, until the “cluster” is over. Clusters usually last four to eight weeks.

What causes cluster headaches?

No one is sure what causes cluster headaches. They don’t seem to be related to other illnesses, and they don’t seem to run in families.

How can I tell if I have cluster headaches?

Your doctor will decide whether you have cluster headaches based on your symptoms. The time and pattern of headaches are very important, so keep a diary of your pain. Family members or others who see you during a headache can help by telling the doctor how you look and act. Don’t be embarrassed to tell your doctor about things you have done to try to help the pain (such as banging your head against furniture). This is common, but will not help. Talking about them will help your doctor decide how bad the headaches are.

Your doctor also will give you a physical exam. He or she might want you to have tests to rule out other illnesses.

Can I do anything to keep from getting headaches once a cluster period has started?

During a cluster period, it is important to keep to your usual routine and try to stay calm. Do not change the times you wake up and go to sleep during a cluster period. This might bring on a headache. Drinking alcohol also will give you headaches during cluster periods. This can happen very quickly—even before you finish the first drink. Stress also may bring on headaches.

How are cluster headaches treated?

There are several ways to treat cluster headaches. It is important to talk to your doctor about the side effects of different medicines. He or she can help pick the right treatment for you and set up times for you to take your medicines.

Your doctor will probably want you to take two medicines. One medicine is taken during a cluster period to reduce the number of headaches. The second medicine is taken to help you feel better when you get a headache. Cluster headaches start too quickly for you to get medical help. You must be ready to take this medicine as soon as a headache starts. You might want to teach family members about your headaches and medicines so that they will be able to help you when you get a headache.

Medicines taken by mouth work too slowly to help with cluster headaches. Instead, your doctor might want you to take a medicine that you breathe in or take as a shot or put into your rectum. Other treatments that work for some people are breathing oxygen through a mask or using a numbing medicine in the nose.

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