Cluster headaches

Cluster headaches are severe attacks of pain that can last for long periods. They're not caused by another illness. They can have a real impact on your life, but there are treatments that can help.

Symptoms of a cluster headache

Cluster headaches are severe headaches that can happen multiple times a day and continue for weeks or months. They may stop for a while (weeks, months or years), or there may be no gap between headaches.

The main symptoms of a cluster headache include:

• a sharp, burning or piercing pain, usually on 1 side of the head, around the eye
• headaches that happen at the same time of year or at set times of the day
• headaches that start and stop quickly, without warning
• pain that can make you feel restless, you may want to walk around or move your body
• headaches that last between 15 minutes and 3 hours

You may also get other symptoms, such as:

• a red and watering eye on the same side as the pain
• feeling sick
• drooping and swelling in the eyelid on the same side as the pain
• a smaller pupil in the eye on the same side as the pain
• face sweating
• a blocked or runny nose

Cluster headaches are rare but some of their common symptoms can be the same as other conditions, such as migraine.

Find out about migraines

See a GP if:

• you think you might have cluster headaches
• your headaches keep coming back
• painkillers such as ibuprofen and paracetamol do not help your headaches
• your headaches are so painful they make you restless and agitated
• you've been diagnosed with cluster headaches and they're getting worse, lasting longer than usual, or your usual treatments are not helping

Get an urgent GP appointment or call 112 if:

You have a severe headache and:

• jaw pain when eating
• blurred or double vision
• a sore scalp
• other symptoms, such as numbness or weakness in the arms or legs

These could be symptoms of temporal arteritis.

Call 112 or go to A&E now if:

You have either of these symptoms for the first time (even if you've already been diagnosed with cluster headaches):

• 1 of your eyelids is drooping
• the pupil in 1 of your eyes is smaller than the other

Find your nearest A&E

What happens at your appointment

There are no specific tests to diagnose cluster headaches. A GP will ask you about the pain, location and frequency of your headaches. They’ll also ask about any other symptoms you’re having.

Other conditions can have similar symptoms to cluster headaches. A GP may refer you to a specialist for a brain scan to rule out other possible causes of your symptoms.

Treatments for cluster headaches

There’s no cure for cluster headaches, but a specialist may recommend treatments to help ease and prevent symptoms.

Painkillers, such as paracetamol and ibuprofen, do not work.

Treatments that help during a cluster headache

If a cluster headache has already started, the main treatments include:

• medicines called triptans, given as an injection or a nasal spray
• oxygen, which is breathed through a mask
• using a device to give mild electrical pulses to the back of the neck

Rarely, when other treatments have not worked, you may be offered surgery. This involves implanting a small device to help treat your headaches.

Treatments to prevent a cluster headache

Your GP may prescribe medicines that can help to prevent a cluster headache before it starts.

These can include corticosteroids, verapamil or lithium.

Ask a GP for advice about common triggers. Understanding this may help you to avoid a cluster headache

Causes of a cluster headache

It’s not known what causes cluster headaches.

They’re more common in men in their 30s and 40s, or if you have a close family member who gets them.

Some people find certain triggers can cause cluster headaches, such as:

• smoking
• drinking alcohol
• perfume
• the smell of paint, nail varnish or petrol
• exercise

Keeping a headache diary may help you to understand your triggers.