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Cluster Headaches: An Overview
Cluster headaches, though excruciating painful, are fortunately quite rare. They involve severe headaches of sharp, piercing pain over one eye or near one temple that can last for 15 minutes up to three hours. Getting their name by occuring in clusters over a period of a few weeks or months, cluster headaches can be debilitating, but don’t cause permanent damage.
What They Feel Like
Those who’ve had cluster headaches compare them to everything from a “brain freeze” headache caused from rapidly ingesting something very cold to a headache with pain severe enough to rival childbirth. The pain occurs on one side of the head, often behind one eye, and is of a stabbing, sharp sensation. The pain intensifies quickly, usually within five to ten minutes, and leaves the person with the cluster headache extremely restless, and severely agitated. Some people find relief by kneeling, walking, or even jogging in place. Lying down, however, is known to increase the pain.
Cluster headaches are the most punctual of all headaches, usually occurring at the same time of night or the same time of day for a cycle of a week, up to a few months. They occur with some frequency in the middle of the night, waking a person from sleep. Though being sensitive to light and vomiting are usually cornerstones of a migraine, these two afflictions can happen during cluster headaches, but their presence is rare.
What Causes Them
Classified in the family of vascular headaches, headaches that are caused by the swelling of blood vessels, cluster headaches occur when the blood vessel dilation occurs in a way that places extraordinary pressure on the cranial nerve responsible for sensation in the face. While this pressure is the cause of the pain, the cause of the pressure has yet to be fully determined by medical science.
There is strong speculation that a problem with a person’s hypothalamus, the part of the brain that regulates processes, systems, and hormones of the body, may be an underlying cause of cluster headaches. Genetics, however, also seem to play at least a partial role. This is based on the discovery that people who have first degree relatives with cluster headaches are much more likely to have them as well.
There are also external factors that are thought to trigger cluster headaches. These include use of alcohol, stress, exhaustion, exposure to certain chemicals or perfumes and ingestion of certain medications such as nitroglycerin and histamines. Smoking cigarettes and eating processed meats are also thought to have a triggering affect. Location is also a factor: cluster headaches appear to be less common near the equator and more common near the North and South poles.
While cluster headaches can affect anyone, those in the highest risk factor are men between the ages of 30 and 40 with a family history of cluster headaches.
Types of Cluster Headaches
The two types of cluster headaches are episodic and chronic. Episodic cluster headaches are those that occur on a daily schedule, usually at the same time each day. This cycle tends to last for several weeks until a remission of a month or several months sets in. People who have more than one cycle of cluster headaches within a year, and also have a remission of at least a month within that same year, are considered to have episodic cluster headaches.
Chronic cluster headaches are less common, affecting between ten and fifteen percent of the cluster headache population. People with chronic cluster headaches can have cluster headaches every day for years and years. If the cluster headaches last for over a year and no remission is present, the condition is considered to be chronic.
A person with cluster headaches can switch between the two types, going from chronic to episodic and vice versa. They can also have remission periods that last for decades at a time.
Treatment of Cluster Headaches
While cluster headaches have no cure, there are several types of treatment options aimed at alleviating pain and making cluster headaches less debilitating. However, some conventional treatment options, such as the use of Aspirin and Ibuprofen, do not stop the pain from a cluster headache. Along these lines, biofeedback, a relaxation technique known to help some types of headaches, also has no affect. Some people have minor relief by taking narcotic pain killers, but because the pain is often too intense for even narcotics to eliminate, and because the cluster headache is often prevalent for a lengthy cycle, narcotics are not a good choice. Because of this, other treatment options must be sought.
The best treatment medications for cluster headaches are abortive medications or prophylactic (preventive) medications. The most effective form of abortive treatment is the inhalation of oxygen. When a person with a cluster headache inhales pure oxygen before the cluster headache peaks, the headache can be aborted quickly. Drinking strong cups of coffee when an attack first hits has also proven to be a successful form of abortive treatment.
Oxygen and coffee, however, do not abort an attack that is already full blown. When an attack is at its peak, abortive medications such as sumatriptan and zolmitiptan, medications that relieve the dilation of blood vessels, must be administered. Because of the painful intensity of the cluster headaches, these medications are usually injected instead of taken orally.
Other things that may help abort cluster headaches, or at least take away some of their intensity, include taking a cold shower, breathing cool air, drinking large amounts of water, and strenuous exercise.
While abortive treatments aim to stop a cluster headache before it peaks, prophylactic, or preventive, treatment intends to stop a cluster headache from occurring at all. However, prophylactic treatments, because its hard to prevent a condition with an unknown cause, aren’t as successful as abortive treatments, with patient response varying greatly.
There is some speculation that calcium channel blockers, particularly verapamil, may be helpful while there is other speculation that high doses of steroids given over a span of five days may prevent cluster headaches. Muscle relaxants and anti-psychotic drugs have also been effective in some cases.
Nearly half of those inflicted by cluster headaches have found that magnesium supplements are particularly beneficial while others have come to the same conclusion about melatonin. There have also been cases where a root canal, or extraction of a bad tooth, have made cluster headaches go away altogether.
While not all cluster headaches have triggers, some of them do. This makes staying away from things that can trigger them – certain foods, alcohol, particular odors – extremely important. Along these lines, because the large majority of those with cluster headaches are either present or former tobacco users, maintaining a lifestyle void of tobacco products may also keep cluster headaches from forming.
About us: The Center for Osteopathic Medicine in Boulder, Colorado believes in The Osteopathic Difference. In a medical industry focused on treating symptoms, The Center is more focused on finding the cause of these symptoms. The Osteopathic Difference is the application of "Hands on Therapeutics" for both the diagnosis and treatment of complaints, disorders, and pain. The Osteopathic Difference will apply the time proven osteopathic fact that function is directly related to structure, and poor structure will lead to poor function.
While The Center tries to focus on health, and above all else, prevention for all those who cross into its threshold, sometimes the best that can be done is to recognize the source of the “DIS-EASE," and to teach every individual how to manage their symptoms. Believing that it is the most important aspect of any treatment regime, and that it is the primary job of the health care practitioner, The Center works to empower the patient in the maintenance of their own health.
Achieving health is also an elusive place, and The Center will work tirelessly to create a path to health which, when embraced by the patient over time, will allow the patient to enjoy a positive return on their rehabilitation investment. The Center teaches a Mindfulness Yoga Program that aims to educate the patient in the power of the mind to minimize, if not rid the body of, aches and pain. Although the ultimate goal of health is to live without the use of drugs, natural or otherwise, The Center for Osteopathic Medicine recognizes the importance of medicinals and their appropriate use. All styles of "Hands on Manipulation" are practiced at The Center. By combining these Manipulative techniques with Structural Integration, massage, meditation and Western Medicine, The Center for Osteopathic Medicine helps people to identify disease before it manifests, quiet pains that have been previously diagnosed as Chronic, and embrace a holistic mindset to Live in the Present- and wi!
thin that presence, live completely well.
The information discussed in this article is for informational and educational purposes only. If you are experiencing symptoms of a health problem, please visit your doctor. The material discussed on this website is not meant to replace the opinion or diagnosis of a medical professional.
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