Cluster Headaches In The Adult Patient

Like tension type headaches, the International Headache Society classifies cluster headaches into episodic and chronic headaches. This is based on the length of the cluster period, and the length of the period between clusters. Episodic cluster headaches occur daily for 1 week to 1 year. This is then followed by an interim period of no pain lasting at least a month In the chronic form of cluster headaches, the headaches occur everyday for more than a year with no interim period or a pain free period of less than a month. 10 to 15% of all headache sufferers are people with chronic cluster headaches.

The attack of a cluster headache is very much that, an attack. It usually occurs rapidly, with very little warning. The pain becomes extremely intense within a matter of a few minutes. The pain is usually one sided and will usually remain on that side throughout the headache sufferers life. Many sufferers describe the pain as a sharp, burning, penetrating type pain, as if someone has stuck a red-hot iron in your eye.

Many cluster headache sufferers are restless during an attack. They may walk around, pace back and forth or curl up to try and get some type of relief. They may massage the painful area with their hand, or place ice packs with pressure on the site, anything that may help relief the pain. Cluster headache sufferers like migraine sufferers generally prefer to be by themselves during an attack. Many patients experience their cluster headaches at the same time, frequently at night. Because of this, some sufferers will try to stay awake as long as possible to delay the headache cycle. This normally does not work, and in some cases can make the headaches worse by adding sleep deprivation to the cycle.

Nasal congestion, eye drooping, contracting of the pupils, excessive tearing and flushing of the face are common symptoms that may accompany cluster headaches. These symptoms are autonomic nervous system responses. The autonomic nervous system controls many of the involuntary activities of the body, such as blood pressure, sweating, heart beat and body temperature. Most of the time these symptoms will disappear when the headache does.

The intense pain of cluster headaches is generally centered around the eye. The trigeminal nerve is responsible for the innervation of this area. It also is a major pathway for pain. Stimulateion of the nerve results in the arteries supplying blood to the head. This results in the arteries becoming dilated, and causing the red-hot pain. Later on, we will show how important the trigeminal nerve is in the treatment of headaches using neuromuscular principles.

2-12 weeks is the normal range for a cluster period headache. Chronic sufferers can have periods lasting longer than a year. In many sufferers, the periods are almost exactly the same time of year from year to year. They can be related to specific seasons, and some belief that they will coincide with the solstices, the longest and shortest days of the year. When a sufferer is going thru a cluster period, they normally have headaches everyday. Attacks occur frequently at night during rapid eye movement (REM) sleep, when dreaming occurs.

Cluster headaches are not usually associated with the normal triggers we see with migraines and tension-type headaches, like foods, hormones or stress. There does seem to be some correlation with cluster headache sufferers and heavy drinking and cigarette smokersing. Many sufferers can trigger a headache by drinking alcohol. Those that are smart, stay away from it. Nitroglycerin, a drug used for angina, has also been cited as a possible trigger. Cluster periods often coincide with changes in sleep patterns, such as with a newborn child, or during a vacation. Like other headaches, reasearch into headache treatments for cluster headaches is improving each day.


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A distinctive approach to the treatment of Headaches using Neuromuscular dentistry. Botox is a temporary fix, Neuromuscular dentistry is a long term headache solution.