Cluster Headache
Cluster headache is one of the most painful conditions known, producing intense burning or stabbing pain around one eye or temple. Attacks last 15 minutes to three hours and typically recur at the same time each day during an active cluster period, which can run for weeks to months before remitting.
Key points
- Bouts of attacks tend to strike at a consistent hour daily for a run of weeks to months before easing off.
- Restlessness and pacing during an attack, rather than lying still, is a feature that helps distinguish it from migraine.
- Injectable or nasal-spray sumatriptan and high-flow oxygen inhalation are the two established ways to abort an attack quickly.
- Preventive medicines with a longer action are typically introduced once a cluster period starts, to shorten how long it lasts.
Recognising an attack
The pain is always one-sided and reaches full intensity within minutes. On the affected side, the eye may water and redden, the eyelid can droop, and the nostril becomes congested or runny. Restlessness during an attack is characteristic; most people pace rather than lie still, which distinguishes cluster headache from migraine.
Aborting attacks quickly
Because attacks peak fast and resolve within hours, fast-acting treatments matter most. Triptans, particularly injectable or nasal-spray sumatriptan, are the established first-line option for aborting an acute attack. High-flow oxygen inhalation is another widely used acute approach. Longer-acting preventive medicines are usually added during an active cluster period to shorten its overall duration. For a broader view of treatments relevant to headache and neurological conditions, see the neurology category.
If you experience your worst-ever headache, sudden onset “thunderclap” pain, or head pain with fever and stiff neck, seek emergency care immediately.