What is a Cluster Headache?
Cluster Headache (CH) is a neurological condition1 with a variety of autonomic symptoms such as nasal congestion, swelling and tearing of the eye typically accompanied by short attacks of severe disabling pain on one side of the head2.
CH derives its name from the fact that episodes typically present in a headache cluster or multiples, sometimes on a daily basis for a week or a month, often followed by a remission period (e.g. months or a year) without headache. Typical attacks last from 15 to 180 minutes but they have been known to last longer.
Unlike most other headache and migraine types where women have a higher incidence, CH more often affects men, in a 3:1 ratio. CH belongs to the third group of primary headache disorders collectively called Trigeminal Autonomic Cephalalgias.
Cluster headaches that demonstrate many migraine features (like nausea/vomiting, aura, light and noise sensitivity) are often referred to as Cluster migraine. However, unlike typical migraineurs, 83% report feeling of intense restlessness during cluster attacks, rather than being bed ridden (which is common in typical migraine).
What is the cause of Cluster Headache and Cluster Migraine?
On the surface, the cause may be attributed to stress, tension, fatigue, certain foods, chemical or hormonal imbalances, but in reality these are more accurately triggers and not “the” cause. Others blame genetic or inherited causes alone, but clinical wisdom says “genetics may load the gun but environment pulls the trigger” – so even though a genetic cause may be postulated, there must be other key (and thus treatable) factors?
So what is the real cause of Cluster Headache?
Thankfully, research is now revealing what every chronic headache and migraine sufferer knew all along, namely it’s not “all in your head!” (or just “bad genetics” for that matter!). In fact, what is emerging is the fact of a common pathway or “headache headquarters” in the brainstem where multiple neurons converge. This specific region is called the Trigeminocervical complex (TCC) and is a “holy grail” of sorts for both researchers, clinicians and sufferers alike. Furthermore, recent studies have revealed that one of the most powerful causes of brainstem sensitivity is the upper neck or Cervical spine4,6,7.
Even between an episode or attack, research shows that chronic headache and migraine sufferers exhibit a sensitized brainstem. This explains why even normal stimuli is registered by a migraineurs nervous system as a stressor or trigger for an attack…it is normal everyday stressors activating an already sensitized brainstem.
During an attack an already sensitized brainstem (by the neck or other causes) is activated by a trigger, which then sets off an explosive positive feedback loop from the brain cortex and back to the brainstem. The already “cranky” hyper sensitized brainstem fires and the cortical brain cells respond with cortical spreading depression causing inflammation of the blood vessels, dura and local tissues in the face, head and neck.
The trigeminal nerve (a nerve that supply’s sensory and some motor control to the face, head, jaw, upper teeth) then picks up this amplified signal and becomes inflamed and sensitized itself lighting up pain and the unique autonomic symptoms of Cluster Headache that present in the head, face, sinuses and eyes which then sends powerful signals back to the brain stem and the pain neuromatrix…and the vicious cycle continues amplifying and causing intense pain and multiple attacks.
The good news is this brainstem sensitivity can be treated with an integrated and combined therapy approach, with a critical step being expert screening of the upper neck as a primary contributor of sensitivity in the brainstem3,4.
Our unique combined therapy approach is logical and evidence-based and aimed at decreasing the sensitivity in the brainstem at the “headache headquarters” with a number of safe treatment options individualized to your headache type.
Click the links for more information on how we perform Our Assessment or Our Treatment or to learn more about our revolutionary 4 phase S.T.E.P. into FREEDOM TM program to help you live life headache free!
- Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2163–2196
- Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2013; 33: 629–808.
- Watson D, (2015) “Sensitive New Age Migraine”; video lecture
- Goadsby, P,J, (2009) The vascular theory of Migraine. A great story wrecked by the facts. Brain, 132 (1), pp 6-7.
- Steiner TJ, Birbeck GL, Jensen R, et al. Lifting The Burden: The first 7 years. J Headache Pain (2010); 11: 451–455.
- Watson D. and Drummond (2014). “Cervical Referral of Head Pain in Migraineurs: Effects on the Nociceptive Blink Reflex””Cephalalgia. 54: 1035-1045. Doi 10.1111/head.12335.
The Headache + Migraine Clinic
Telephone: 1300 HOPE 4 YOU (1300 467 349)
Brisbane West (Springfield Central)
Suite 3, Level 1, Orion Springfield Central
1 Main Street, Springfield Central QLD 4300