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Cluster headaches

Cluster headaches are severe attacks of pain that can last for long periods. You may get them for years, but they're not usually serious and there are treatments that can help.

Check if it's a cluster headache

Cluster headaches are severe headaches that can happen multiple times a day and continue for weeks or months. They may stop for a while (weeks, months or years), or there may be no gap between headaches.

The main symptoms of a cluster headache include:

  • a sharp, burning or piercing pain, usually on 1 side of the head, around the eye
  • headaches that happen at the same time of year or at set times of the day
  • headaches that start and stop quickly, without warning
  • pain that can make you feel restless, you may want to walk around or move your body
  • headaches that last between 15 minutes and 3 hours

You may also get other symptoms, such as:

  • a red and watering eye on the same side as the pain
  • feeling sick
  • drooping and swelling in the eyelid on the same side as the pain
  • a smaller pupil in the eye on the same side as the pain
  • face sweating
  • a blocked or runny nose

Cluster headaches are rare but some of their common symptoms can be the same as other conditions, such as migraine.

Find out about migraines

Non-urgent advice: See a GP if:

  • you think you might have cluster headaches
  • your headaches keep coming back
  • painkillers such as ibuprofen and paracetamol do not help your headaches
  • your headaches are so painful they make you restless and agitated
  • you've been diagnosed with cluster headaches and they're getting worse, lasting longer than usual, or your usual treatments are not helping

Urgent advice: Get an urgent GP appointment or call 111 if:

You have a severe headache and:

  • jaw pain when eating
  • blurred or double vision
  • a sore scalp
  • other symptoms, such as numbness or weakness in the arms or legs

These could be symptoms of temporal arteritis.

You can call 111 or get help from 111 online.

Immediate action required: Call 999 or go to A&E now if:

You have either of these symptoms for the first time (even if you've already been diagnosed with cluster headaches):

  • 1 of your eyelids is drooping
  • the pupil in 1 of your eyes is smaller than the other

Find your nearest A&E

What happens at your appointment

There are no specific tests to diagnose cluster headaches. A GP will ask you about the pain, location and frequency of your headaches. They’ll also ask about any other symptoms you’re having.

Other conditions can have similar symptoms to cluster headaches. A GP may refer you to a specialist for a brain scan to rule out other possible causes of your symptoms.

Treatments for cluster headaches

There’s no cure for cluster headaches, but a specialist may recommend treatments to help ease and prevent symptoms.

Painkillers, such as paracetamol and ibuprofen, do not work.

Treatments that help during a cluster headache

If a cluster headache has already started, the main treatments include:

  • medicines called triptans, given as an injection or a nasal spray
  • oxygen, which is breathed through a mask
  • using a device to give mild electrical pulses to the back of the neck

Rarely, when other treatments have not worked, you may be offered surgery. This involves implanting a small device to help treat your headaches.

Treatments to prevent a cluster headache

Your GP may prescribe medicines that can help to prevent a cluster headache before it starts.

These can include corticosteroids, verapamil or lithium.

Ask a GP for advice about common triggers. Understanding this may help you to avoid a cluster headache

Causes of a cluster headache

It’s not known what causes cluster headaches.

They’re more common in men in their 30s and 40s, or if you have a close family member who gets them.

Some people find certain triggers can cause cluster headaches, such as:

  • smoking
  • drinking alcohol
  • perfume
  • the smell of paint, nail varnish or petrol
  • exercise

Keeping a headache diary may help you to understand your triggers.

Find out more

Page last reviewed: 18 August 2023
Next review due: 18 August 2026