As a North Wales Chiropractor I see lot of people suffering headaches in the Conwy, Gwynedd and Anglesey regions on a daily basis with headaches being the most common new neurological symptom seen by general practitioners and neurologists in the UK¹. Thankfully cluster headaches are not a common headache to experience by people in the Conwy, Gwynedd and Anglesey areas. Cluster headaches were termed the ‘suicide headache’ by American neurologist Dr. Bayard Horton. Remember though a cluster headache is not a migraine headache. So read on to find out more about cluster headaches.
Cluster Headaches Symptoms
Cluster headaches are classified as a primary headache disease. Cluster headache symptoms are identified as:
‘Excruciating, one-sided, recurrent but short-lasting, pain around the eye region’
It is characteristically associated with ‘autonomic’ nervous system signs, such as tearing, nasal stuffiness, redness of the eye and occasionally, drooping of the eyelid and short-sighted vision. Young males are predominately affected with a ratio of 3:1 male to female. Cluster Headache attacks usually occur on a daily basis, in clusters of 6-12 week periods, hence the name of ‘cluster’. Typically headache attacks are rapid onset, lasting from 30 mins to 2 hours. Attacks occur more commonly at night time, the most common times noted as 1a.m., 4a.m. and 7 a.m. Headache bouts may last from 6-12 weeks and then abate for long periods.
What Causes Cluster Headaches
In practice as a Chiropractor in Conwy, Gwynedd and Anglesey I have found that commonly cluster headaches occur around the same time each year. In Conwy, Gwynedd and Anglesey Headaches are most prevalent in the months of December, January and February.
Alcohol is the most recognised trigger for cluster headaches. Although strong odours (cigarette smoke and solvents) and frequent napping, have also been noted as aggravators of headache symptoms. However, when the bouts of headaches are not present it is not unlikely to find that these triggers may not be effective during this time.
CASE STUDY: A patient presented to The North Wales Spine Clinic recently complaining of cluster headache symptoms of several years duration. The problem of headaches was starting to affect daily living and sometimes the headaches were so excruciating work had to be aborted. After a full and thorough history ruling out any traumatic or other concerning components contributing to the headaches our North Wales Chiropractor performed a physical exam. It became apparent that anxiety and stress were underlying the headaches in the form of tightness in the cervical or neck muscles. The patient had already sought out medication but found very little effects on the frequency of headaches, although the severity of the headaches was reduced somewhat. After some Chiropractic and Acupuncture we found that the patient from Gwynedd was able to report a reduction in the frequency of the headaches and some positive affects on the severity of the headaches. The headache medication was maintained but the chiropractic and acupuncture worked well in conjunction to reduce the headache symptoms in this case.
What Does a Cluster Headache Feel Like?
The patient with cluster headaches usually recalls the symptoms of a rapid onset headache that starts with a tingling sensation around the eye and nostril. Within minutes these symptoms worsen to a severe pain, usually described as acid in the eye, or a hot poker put up the nose. The affected eye rapidly begins to water and turns bloodshot, with the nose becoming congested and a watery nasal discharge carrying on throughout the attack. Following each attack the eye and cheek feel bruised and tender. This feeling may persist until the next attack begins.
Cluster Headaches Treatment
Treatment for cluster headaches begins at an acute symptomatic level, trying to stop the pain, due to its severity. To date, no curative treatment exists. Evidence based guidelines for the treatment of cluster headaches have been developed by the European Federation of Neurological Societies (EFNS)².
Cluster Headache Medication
Medication to help the immediate cluster headache pain is typically the subcutaneous administration of the drug sumatriptan (serotonin agonist) and inhalation of high-flow oxygen. Prophylactic or preventative treatment to help decrease the length of the bout of cluster headache attacks typically revolves around the calcium channel blocker, verapamil, and administration of lithium, methysergide and prednisone.
Reading:
- Latinovic R, Gulliford M, Ridsdale L. Headache and migraine in primary care: consultation, prescription, and referral rates in a large population. J Neurol Neurosurg Psychiatry. 2006 Mar;77(3):385-7.
- May A., Leone M., Afra J., Linde M., Sándor P.S., Evers S., Goadsby P.J. EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias. Eur J Neurol. 2006 Oct;13(10):1066-77.