Imagine you get a strong, penetrating, burning pain around your eye (orbital pain) that may radiate to your face, neck and shoulders. It makes you teary-eyed involuntarily… and after several intense short-lived bouts that repeat themselves over and over again, you wear down, you voluntarily cry. Just when you think they are gone, they come back again to visit a few weeks or months later. Sounds like fun? They are cluster headaches.
Whereas cervicogenic and tension headaches had no gender bias, migraine headaches are mostly suffered by females, cluster headaches have a male predilection. They are typical of middle-aged men. You may have several of them the same day, with the majority occurring at night (so much for restful sleep). They last an average of 30 excruciating minutes, but may last up to two hours. They cluster over days or weeks and then end. They can be seasonal in nature. They are described as the most painful pain the patient has ever felt as if a hot poker being inserted in the eye. Lacrimation (tearing), redness of the eye, reduced pupil size, drooping eyelid, and runny nose, are common symptoms on the same side as the headache. So patients will often look as if they are or have been crying. Of all headaches they are the ones that have driven patients to commit suicide the most. This patient is highly animated during the attacks and sometimes beat their head against the wall attempting to relief the pain. Fortunately, there are good news: They tend to decrease in frequency and intensity with age.
What causes them? Nobody knows for certain. However, There is a history of alcohol abuse and/or smoking in many of these patients. Many of them would not describe themselves as alcoholics. Also, some foods might trigger these headaches. So keeping a journal, like I suggested at the beginning of this series, is very important.
Scientists who have hypothesized about the physiological cause of these cluster headaches mention serotoninergic central inhibitory system dysfunction (similar to migraines), blockage of the cavernous sinus and veins that puts pressure on sympathetic nerve fibers (this explains lacrimation and runny nose) and sudden activation of some hypothalamic and other brain areas. No conclusive theory has emerged yet.
Chiropractic treatment might or might not be effective to treat these headaches. There’s a lack of scientific studies on this matter, but due to the similarity in mechanism to other headaches, particularly migraines, a trial of chiropractic treatment during the cluster period might be effective for some. The allopathic medical community treats them with migraine medication, 100% oxygen, intranasal cocaine or lidocaine.
You must contact your primary care physician if you think you have these kinds of headaches or if they have suddenly started. Any new kind of headache must be examined by a professional to rule out any life-threatening condition.
If your headache gets substantially worse; changes in nature, frequency or severity or if you have had any kind of head trauma, you must consult with your physician. If your physician is not available, go to the emergency room. Go to my introduction to the headache series to find out more red flags at https://nuchiro.wordpress.com/2011/05/16/from-mere-headache-to-a-life-threatening-emergency/
NEXT UP: Migraines