How to Get Rid of a Cluster Headache

Cluster headache is a rare but extremely debilitating disorder that affects about 0.1 percent of the population. Characterized by “cluster periods” of repeated, severe headache attacks of 30 or so minutes at a time, about 80% of cases are episodic—meaning a month or more time may pass between attacks—while the remaining 20% have no such breaks and are chronic. Treatments of this condition can be subdivided into those that are preventative in nature and those that take on headache and other symptoms after they start.

Because the exact mechanism of cluster headache is not fully understood—and due to the condition being relatively rare or often confused with migraine—there’s no singular, gold-standard treatment. That said, there are a number of lifestyle, over-the-counter, prescription medication, and even surgical approaches to this condition. If you suffer from this condition, you may find the need to tailor an individualized approach with the help of your healthcare provider.

Home Remedies and Lifestyle

What’s most important to remember about conditions like cluster headache is that what works for some sufferers may not for others. Still, there is a lot you can do to reduce the incidence of attack or help ease its intensity:

• Breathing exercises: One of the first-line clinical treatments for cluster headache is the application of oxygen, which is known to reduce the severity of an attack. With this in mind, some sufferers have found deep breathing exercises to be effective in managing symptoms. This approach has the added benefit of relieving stress.
• Sleep schedule: A growing body of research shows that keeping to a consistent sleep schedule can help reduce the incidence of cluster headaches. This regularizes the body’s circadian rhythms, which can help ease the onset of attacks.
• Regular exercise: The benefits of exercise cannot be understated, and directly or indirectly, many have found it effective for cluster headache. Daily fitness activity, even when moderate, has been shown to improve sleep cycles, improve blood circulation to the brain, and reduce stress.
• Yoga: Because this practice combines breathing techniques with stretching, it’s been linked with reducing recurrent head pain problems like a cluster headache. Typically, sufferers should aim for five sessions a week of about 60 minutes each, though novices may want to start with a more modest regimen before scaling up.
• Avoiding tobacco: Among the many negative health effects of smoking cigarettes or using other tobacco products is that this habit has been linked with increases in chronic headache conditions. Though difficult, it’s worth looking into smoking cessation if you suffer from cluster headache.
• Avoiding alcohol: Alcohol, in any form, is a known trigger for cluster attack. Sufferers of cluster headache may find it in their best interest to abstain, especially during tougher periods.

Over-the-Counter (OTC) Therapies

Most over-the-counter pain medications like ibuprofen, acetaminophen, and aspirin are rarely able to mediate the severe pain of cluster headache. While they have some efficacy and are worth trying out, they’re rarely a match for the intensity of this condition. Furthermore, the use of some of these medications for more extended periods of time can lead to medication overuse headache (MOH), where pain actually gets worth when medications are taken.

Prescriptions

Prescription drug approaches to cluster headache can be divided into two groups: acute medications (those intended to take on attacks after they’ve started) and preventative ones.

Acute Medications

For those already experiencing attack, here’s a breakdown of acute medications:

• Triptans: The migraine medication sumatriptan (Imitrex), a triptan, has been known to work during cluster attacks when injected. For those that don’t tolerate sumatriptan (or other medications), nasal sprays of zolmitriptan (Zomig) can also work. This class of drug does have some side effects, including dizziness, muscle weakness, nausea, sleepiness, and tingling or pain at the site of injection. They also should be avoided if patients have a history of heart problems. 
• Octreotide: A synthetic version of somatostatin, a brain hormone associated with growth and intercellular communication, can provide quick results if injected. While there are many indications that triptans are more effective, this approach has its utility. Taking this drug does carry the risk of side effects, including gallstones (usually only with long-term use), nausea, pain at the site of the injection, abdominal pain, flatulence, constipation, fatigue, flu-like symptoms, dizziness, and headache, among others.
• Local anesthetic: When delivered through the nose (intranasally), local anesthetic drugs like lidocaine (similar to your dentist’s novocaine) have effectively managed cluster attacks.
• Dihydroergotamine: Especially when injected, dihydroergotamine can be very effective in taking on headache attacks. This treatment is typically reserved for the clinic or hospital—intranasal use has shown only mixed results—and is for more severe cases. Notably, this injection is not recommended for those who are pregnant or breastfeeding or those who have a history of heart disease or other cardiac issues, high blood pressure, liver or kidney disease, or hypersensitivity to this type of drug.

Preventative Medications

In addition, many drugs are prescribed to prevent attacks right as they start, including:

• Calcium channel blockers: Calcium channel blocking drugs like verapamil (also known as Calan, and Verelan, among others) are considered a top-tier choice for preventing cluster headache attacks and are sometimes prescribed for chronic cases. Side effects do crop up, though; among these are nausea, fatigue, constipation, ankle swelling, and reduced blood pressure.
• Corticosteroids: This class of drug is known to be a highly effective inflammation suppressant, and the drug, prednisone (Prednisone Intensol, Rayos) can be very effective as a rapidly acting treatment in cases where there are long periods of remission. Typically, though, use of corticosteroids for cluster headache needs to be carefully monitored and shouldn’t last more than a few days because of the risk of side effects, including diabetes, high blood pressure, and cataracts.
• Lithium carbonate: A medication often prescribed for bipolar disorder, lithium carbonate (Lithobid) may be indicated when other medications and approaches haven’t yielded results. Though effective, prolonged use can lead to kidney damage, so patients will have to undergo regular blood testing while taking this regimen. Other side effects to watch out for are tremors, diarrhea, and increased thirst.

As your healthcare provider will tell you, should you undergo a prescription approach to cluster headache, what works for some may not for others. Patients will be advised not only to stick carefully to prescription plans but to be vigilant about side effects. If anything seems off, don’t hesitate to seek out medical help.  

Surgeries and Specialist-Driven Therapies

Healthcare providers have a number of therapeutic options when it comes to cluster headache. Treatments can be acute or more preventative in nature, with surgeries and more invasive options reserved for more stubborn and difficult cases. Here’s a quick breakdown:

• Oxygen treatment: The first-line approach to cluster headache in the hospital, the delivery of pure oxygen is known to be a fast-acting acute approach. This is typically delivered for 15 minutes at a time through a nasal cannula or face mask. Without any side-effects, the only drawback of this approach is its relative inaccessibility; outside the clinic, patients would need to have specialized oxygen tanks with them. 
• Nerve block: This treatment involves the injection of a solution that combines an anesthetic (for numbing) and a corticosteroid near the occipital nerves. These nerve clusters run from the top of the spine (at the back of the head) into the scalp, and headache pain is managed when their messaging is blocked. This approach, typically reserved for more severe chronic cluster cases, provides initial relief until longer-acting drugs kick in.
• Sphenopalatine ganglion stimulation: A more recently developed approach to extreme cases of chronic cluster headache, this involves surgically implanting a set of specialized electrodes on the sphenopalatine ganglion, a brain region involved with pain processing. These electrodes, when activated by patients with a handheld controller, deliver mild electric shocks, essentially scrambling messages from this region. A growing body of research shows this to be an effective approach for difficult cases.
• Noninvasive vagus nerve stimulation: This approach is similar to sphenopalatine ganglion stimulation in that it involves electrical stimulation controlled by a patient’s handheld device. In this case, the electrodes are just beneath the skin and access the vagus nerve, a nerve that starts in the brainstem and runs through the neck. While more research is needed, this approach has been found to reduce the frequency of cluster attacks.

• Occipital nerve stimulation: Some studies have noted that mild electric shocks to the occipital lobes can also help. A special surgery is employed to implant electrodes in this area, and, as with other stimulation approaches, patients are able to control when treatment is delivered. Research is ongoing, but early results show that this approach can help in cases where cluster headache attacks aren’t effectively managed pharmaceutically.
• Deep brain stimulation: Another more novel treatment stimulation approach, deep brain stimulation involves targeting the hypothalamus region with electric signals to scramble pain processing at another of its sources. Notably, studies evaluating this approach have yielded only mixed results, though research is ongoing.

Complementary Alternative Medicine

Herbal and non-western approaches to cluster headache are largely unvetted and are rarely accepted by the medical establishment. Still, many patients have found some of these approaches to be quite effective. Most commonly, 10-milligram doses of melatonin are believed to help, especially when taken at night before going to sleep. In addition, there’s some evidence that taking capsaicin in an intranasal form can work as an acute treatment.  

A Word From Verywell

There’s a reason that cluster headaches are considered by some to be the worst possible pain. This condition is more than a headache; it’s a serious problem that can get in the way of work, family life, and personal quality-of-life. If you suffer from recurrent headaches, make sure to take the issue seriously and seek out medical attention. The sooner you’re able to get a handle on this issue, the sooner you’ll be back on track. While not every approach is going to work, there’s no doubt that something will; don’t give up!