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ONSEN® BLOG / About health

Cluster headache – symptoms, causes, treatment

4 lutego 2022
Cluster headache, types of headaches, sudden headache
Contents
Cluster headache symptoms
Cluster headache causes
Diagnosis and recognition of cluster headaches
Treatment for cluster headaches
The role of psychotherapy in cluster headaches
The phenomenon known as cluster headaches is a relatively rare but very distressing type of headache. It is characterized by sudden and extremely intense headache attacks that are very specific. These attacks are most often unilateral, and in the majority of cases, they are located around the eye or temple. The key feature of cluster headaches is their cyclical nature, occurring in clusters.

Clusters, or cluster headache attacks, can also be accompanied by specific symptoms characteristic of this condition, such as tearing, redness of the eye, and a stuffy nose, particularly on the side affected by the pain. Patients often describe these attacks as some of the most painful experiences, impacting their daily functioning.

Although cluster headaches are a rare condition, their impact on patients can be significant. It is estimated that they mainly affect men, especially those between the ages of 20 and 40, although cases also occur in women and other age groups, which is becoming more common. The characteristic feature is the occurrence of attacks at specific times of the year, forming the so-called cluster seasons.

While it is not a life-threatening disease, its impact on the quality of life for patients is considerable, and diagnosis and treatment require special attention from specialists. Research on the epidemiology of cluster headaches is still ongoing to better understand the mechanisms of this condition, allowing the development of more effective treatment strategies for the benefit of patients.
Headache, tearing, red eyes, stuffy nose

Cluster headache symptoms

Cluster headache is characterized by a unique set of symptoms, making it easy to distinguish from other types of headaches. The most prominent symptom is intense pain, often described as the worst to experience. Cluster headache attacks are typically unilateral and concentrated around the eye, temple, or forehead. They are also accompanied by a feeling of tension and sometimes intense burning in the area affected by the pain.

During cluster headache attacks, patients often experience additional symptoms that increase the difficulties in daily functioning. Most notably, tearing, redness of the eye, and a stuffy nose on the side affected by the pain are typical. These symptoms result from the activation of the trigeminal nerve, which is involved in the pain initiation process. Many patients also report restlessness during attacks, leading them to prefer calmness and isolation.

It is the cyclic nature that distinguishes cluster headaches from migraines or tension headaches. Attacks occur in periods called cluster episodes, lasting for several weeks or months, after which the patient enters a remission period, sometimes lasting several years, before attacks reappear. This specific timing of attacks strongly impacts the patient's life, both during the episode and in remission.
Cluster headache, trigeminal nerve, neuralgia

Cluster headache causes

Unfortunately, the causes of cluster headaches are still largely unclear. However, there are several factors considered as potential triggers for this troublesome condition. One important aspect is a genetic predisposition, as it is observed that individuals with relatives suffering from cluster headaches are more susceptible to developing this condition.

Significant roles are played by environmental factors that can also trigger cluster headaches. This includes, above all, smoking and alcohol consumption, but much data also indicates that the risk of an attack is increased by exposure to chemical substances, especially harmful ones. There is also a connection between hormonal changes and cluster headaches, suggesting the influence of hormones on the neurological processes associated with them.

Dysfunctions of the nervous system, especially involving the hypothalamus, also underlie cluster headaches. The hypothalamus plays a crucial role in regulating the circadian rhythm, explaining the cyclical nature of attacks. When the hypothalamus is activated, there is a release of chemical substances, mainly neuropeptides, which affect blood vessels, triggering the characteristic pain.
Headache and genetics, the influence of chemistry on headaches, health advice

Diagnosis and recognition of cluster headaches

The diagnosis of cluster headache remains a challenge for both patients and doctors due to the specific nature of symptoms and their cyclic course. A crucial element of the diagnostic process is taking a medical history, including the characteristics of pain and the frequency of attacks. It is essential for the doctor to inquire about triggering factors and accompanying symptoms.

As early as 2004, the International Headache Society developed comprehensive diagnostic criteria for cluster headache, commonly known as ICHD-3 (International Classification of Headache Disorders). To make a diagnosis, the doctor must consider parameters such as intensity, unilateral nature, episodes, and accompanying symptoms in a patient suspected of having cluster headache. The diagnosis is based on clinical observations while excluding other causes.

Although the diagnosis of cluster headache is primarily based on clinical examination, the doctor may order additional tests to rule out other conditions. These mainly include imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI), which can help identify changes in brain structures. Blood and urine tests are also conducted to exclude other diseases.

Cluster headache needs to be differentiated from other types of headaches, such as migraine or tension headaches, which are much more common. Each type of headache has its characteristic features, making it sometimes challenging to make a clear diagnosis. Therefore, a precise diagnosis of cluster headache is crucial for effective disease management.
Cluster headache, intense headaches, headache treatment

Treatment for cluster headaches

For many years, the treatment of cluster headaches has been a significant challenge for specialists due to its exceptionally sudden nature and the need for effective relief from intense pain. In the therapy of cluster headaches, a crucial role is played by a visit to the doctor, who can recommend pharmacotherapy and supportive therapies aimed at managing attacks.

In the treatment of an active cluster headache attack, various analgesic medications are often used, as well as other effective therapies such as oxygen or triptans, which help rapidly alleviate symptoms. For some, oxygen inhalation, especially with a mask, is necessary. Triptans also provide relief, known primarily for their use in migraines, but they can also bring relief in the case of cluster headaches, although the effects depend on the patient.

The goal of effective prevention of recurrent cluster headache attacks involves the use of supportive therapies. Typically, this includes verapamil, antiepileptic drugs, or corticosteroids designed to act preventively. These therapies are always adjusted to the individual needs of the patient considering side effects. In addition to pharmacotherapy, there is also growing interest in behavioral therapies such as biofeedback or psychotherapy, aiming to manage stress better to cope with pain.

In preventive care, lifestyle changes are essential, including avoiding factors that trigger pain, such as alcohol or tobacco smoking. Besides, introducing regular sleep and relaxation rituals proves to be extremely helpful. This should be accompanied by social support from close individuals, and considering participation in support groups for those suffering from headaches.
Tryptans, headache medication, headache pills

The role of psychotherapy in cluster headaches

As indicated by MSc Mateusz Nesterok, an experienced health and rehabilitation psychologist, in the treatment of cluster headaches, psychotherapy often plays a significant role. This may involve various therapeutic approaches aimed at supporting the patient in dealing with pain and effectively managing the emotional aspects of the disease. In addition, psychotherapy can be an effective complement to other forms of treatment, helping patients better understand the impact of cluster headaches on their lives.

Most commonly, cognitive-behavioral therapy (CBT) is applied, which works well for patients with cluster headaches. This widely used psychotherapy approach focuses on identifying and then appropriately changing negative thoughts and behavior patterns related to pain, leading to improvement in the patient's psychological and physical well-being. During psychotherapy, patients learn more effective coping strategies for pain, including developing stress response mechanisms.

Another approach used in cluster headaches, which is becoming increasingly popular, is biofeedback based on electroencephalography (EEG). It allows for increased control over physiological functions, such as muscle tension or heart rate. In the case of cluster headaches, biofeedback can help reduce muscle tension and stress, impacting the intensity of pain and sometimes the frequency of attacks. Additionally, relaxation techniques are applied, including autogenic training or meditation, which support overall health.

Psychotherapy for cluster headaches also includes standard psychoeducation, aiming to improve the quality of life for each client. During sessions, the patient should share their experiences, concerns, and coping strategies, allowing for the development of healthier adaptive mechanisms. An essential element is also to help the patient understand how this condition affects their daily life and social relationships, contributing to their well-being.

We also encourage you to explore other articles on the best sleep and health blog, as well as the Encyclopedia of Healthy Sleep prepared by the ONSEN® team of specialists. For those who care about spine health, we recommend a set of spine exercises prepared by our physiotherapist.
Mattress for back pain, spine pain, foam mattresses

FAQ: Cluster headache

What is cluster headache?

Cluster headache is a relatively rare but very intense type of headache characterized by sudden bouts of pain. Typically, these are unilateral headaches located around the eye, temple, or forehead. Cluster headache attacks occur cyclically, in periods called cluster episodes or clusters. They are often accompanied by tearing, eye redness, and a stuffy nose on the side affected by pain.

How long does a cluster headache last?

Cluster headache attacks are short-lived. They usually last from 15 minutes to 60 minutes, although in some cases, the discomfort may be longer. Their characteristic is their occurrence at specific times of the day and cyclicality within cluster episodes, which last from a few weeks to several months. A remission period follows these episodes.

Is cluster headache dangerous?

Although cluster headache itself is not a life-threatening condition, its intensity and cyclical nature can significantly impact the patient's quality of life. The attacks are very painful and can lead to significant difficulties in daily functioning. In case of suspected cluster headache, it is always recommended to consult a doctor to determine the diagnosis and treatment plan.

What to do when experiencing cluster headache?

In the case of a cluster headache attack, it is essential to consult a doctor to determine an appropriate treatment plan. Acute treatment includes the use of triptans and oxygen therapy, and less frequently, nonsteroidal anti-inflammatory drugs. It is also important to stay calm, isolate from light and noise stimuli, and use relaxation techniques.

How to break a cluster headache?

Interrupting a cluster headache attack, known as a cluster, requires consulting a doctor to adjust an appropriate treatment plan. They may recommend the use of triptans or antiepileptic drugs that act quickly on symptoms. Additionally, biofeedback or psychotherapy may be beneficial in managing pain and preventing recurring attacks. A holistic approach, considering lifestyle changes and psychosocial support, is crucial in dealing with cluster headache.

Contents
Cluster headache symptoms
Cluster headache causes
Diagnosis and recognition of cluster headaches
Treatment for cluster headaches
The role of psychotherapy in cluster headaches
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