Essential Oils For Cluster Headaches

How to get rid of cluster headaches? Until now, there’s no permanent cure for cluster headaches. There are three goals of cluster headache treatment: prevent the attacks, ease the severity of pain, and make the attacks shorter. This article will discuss the symptoms, possible causes, and preventive and symptomatic treatments of cluster headaches. 

What Is A Cluster Headache?

A cluster headache is a primary headache that causes pain on one side of the head and above the eye of the affected side. It comes in groups of brief headache attacks, hence the name “cluster,” which lasts for several weeks or months and followed by a headache-free period. The attacks typically happen at the same time each day and year.

Compared to other primary headaches, the pain in a cluster headache is the most severe. That’s why it earned the nickname “suicide headache.” It’s so painful that sufferers consider taking their own lives to stop the pain. In the United States alone, the suicide rate due to cluster headaches is twenty times its national average. ^[1]

Timing, Duration, and Frequency

A cluster headache happens at the same time each day. Generally, it could strike between 9 p.m. and 10 a.m. and could peak between 1 p.m. and 3 p.m. ^[2] The pain starts dramatically–peaking in about 5 minutes–around the eye and spreads to other parts of the head, like the temple, cheek, neck, and shoulders. Then, the pain rapidly decreases in intensity at the end of the attack.

Cluster headache pain is nonstop, overwhelming, sharp, burning, and penetrating. It could last for 15 minutes or 3 hours for each attack.

Two types of cluster headaches:

• Roughly 80% to 90% of people suffer from an episodic cluster headache. ^[3] This might happen once to thrice daily for a period of around two months. Then, it could disappear for several weeks, months (at least a month), or even years. There are cases when a cluster headache may shift from episodic to chronic, or vice versa.
• A chronic cluster headache behaves similarly to an episodic cluster headache. But, it happens regularly, with multiple headaches every day, for years with only brief pain-free periods. Compared to an episodic cluster headache, it’s more difficult to treat.

Prevalence and Risk Factors

Cluster headaches are rare. They affect 53 in every 100,000 adults in the United States. ^[4] The following are at greater risk for cluster headaches: 

• Unlike migraine headaches, they’re more common in men than women.
• They typically start between the age of 20 and 40. ^[5]
• When it comes to ethnicity, African Americans are more likely to suffer from this condition than Caucasians.
• Also, a person’s risk is higher if he or she has a first-degree relative, like a sibling, child, or parent, who has a cluster headache.

Signs and Symptoms

Symptoms could strike fast and without warning. Aside from the excruciating pain, a cluster headache might also cause the following symptoms:

• Eyes are red, watery, and swollen on the affected side of the head
• Congested or runny nose on the side of pain
• Constricted pupil (the dark-colored hole in the center of the eye)
• Eyelid drooping
• Restlessness
• Pale skin
• Sweaty face

The Possible Causes

The cause of cluster headaches is still unknown, but there are theories. Some clinical experts say that they begin in the trigeminal nerve, a nerve that sends sensation in the face and is responsible for motor function (chewing and biting). Others say that blood vessels located deep within the human head are responsible for cluster headaches, not the trigeminal nerve. ^[6]

The Difference between Migraine and Cluster Headaches

Some people often mistake cluster headache for migraine headache. But, the two have many differences. For starters, people who are experiencing a cluster headache attack are often restless. They might walk around, can’t sit down, or can’t find in relief by sleeping during an attack. The pain in migraine is described as throbbing, while it’s continuous with a cluster headache. And unlike migraine, a cluster headache happens several times daily.

Also Read: How To Get Rid Of A Migraine Fast And Naturally.

Other Ways To Get Rid Of Cluster Headaches

Prevention is the first and most important step

Preventing another attack is highly important since the pain in cluster headaches is debilitating and can affect your quality of life. If the attacks are constant, you should see your doctor as soon as possible. Fortunately, medications generally work well in reducing attack frequency and duration.

The following medications are the most effective in preventing cluster headaches during cycle of attacks:

Calcium Channel Blockers

Research shows that calcium channel blockers, particularly verapamil, are effective in preventing migraine and cluster headache. ^[7] These medications are not approved by the FDA as a prophylaxis for cluster headaches. They work by blocking the entrance of calcium into the muscle cells of blood vessels to prevent them from dilating , which causes severe pain.

Verapamil is used for the treatment of high blood pressure (hypertension), chest pain, and heartbeat irregularities, but it’s also effective in reducing the number of cluster headaches you get. The downside to this medication is it doesn’t work immediately and is only effective at high dosages (120 to 160 milligrams daily). Your doctor may prescribe other medications, like steroids, to give you faster relief.

Possible side effects:

• Nausea
• Extreme tiredness
• Constipation
• Low blood pressure when standing
• Swollen ankles
• Heart beat abnormalities

Note: Constant monitoring of your ECG (electrocardiogram) is important to ensure there are no abnormalities in your heart’s electrical conduction system, which controls your heartbeat timing.

Steroid Injections

Steroids are used for a wide range of inflammatory conditions. As preventive medications, they’re highly effective in reducing cluster headache attacks by up to 90% during active therapy. In one study (2011), result showed that steroid injections were able to rapidly decrease the average number of cluster headache attacks (two or fewer for each day) on the second, third, and fourth days of treatment. ^[8]

Doctors give steroids for patients who need fast and effective relief from cluster headache pain. Sufferers may experience relief 2 to 4 days after starting the therapy. These medications are typically combined with other preventive and abortive (medications that shorten attacks and ease symptoms) medications during a headache cycle.

Although they work well, steroids are not appropriate for long-term preventive therapy because of their serious side effects. Your doctor has to weigh the benefits against the risks.

Possible side effects:

• High blood pressure
• Clouding of the lens of one or both eyes
• High blood sugar
• Aggravation of diabetes
• Increased susceptibility to infections
• Osteoporosis
• Fractures

Lithium Carbonate

Lithium carbonate, a mainstay treatment for Bipolar Disorder, is used mainly for the treatment of chronic cluster headaches. The appropriate dosage depends on different factors, but doctors may prescribe one to three 300mg tablets (per day) for this condition. ^[9] Lithium may be combined with other cluster preventive medications, like cortisone and verapamil.

Lithium is well tolerated in small doses. It’s important to submit yourself to regular blood tests to check the development of serious side effects.

Possible side effects:

• Drowsiness
• Weakness
• Lack of coordination
• Nausea or vomiting
• Upset stomach
• Dry or thinning hair
• Itchy skin
• Mood swings
• Diarrhea
• Mild tremor
• Increased thirst
• Kidney damage

Melatonin

Melatonin is a hormone that controls your sleep-wake cycles. An imbalance of this hormone may trigger migraine or cluster headaches, according to WebMD.com. Generally, people find it more effective for chronic cluster headache.

The typical dose of melatonin ranges from 9 to 10 mg. Small studies suggest that 10 mg of melatonin at bedtime could lower the incidence of cluster headaches. ^[10]

Melatonin is probably the only preventive medication for cluster headaches that you can purchase over-the-counter. And it seems to be safe, even if you take it for more than a year. However, it can cause side effects, like stomach cramps, irritability, dizziness, excessive daytime sleepiness, and headache. ^[11]

If these medications don’t prevent or reduce the symptoms of your headache, your doctor may suggest another category of preventive medications, including:

Methysergide

Methysergide is a medication used to ease the pain and/or frequency or severity of migraine and cluster headaches. However, because of its side effects, doctors generally prescribe it if other medications, like calcium channel blockers, fail to work or when a headache becomes severe and persistent.

Possible side effects:

• Hair loss
• Numbed or cold extremities
• Backache
• Sleep difficulty
• Weakness and fatigue
• High body temperature
• Swollen or painful leg
• Breathlessness
• Rash
• Urination problems
• Dizziness
• Sleepiness
• Lack of coordination
• Gastrointestinal problems (nausea, vomiting, heartburn, constipation, and diarrhea)

Valproate

Valproate is a bipolar disorder and epilepsy medication, but it can also help in preventing cluster headaches in some people. In a small pilot study, researchers gave patients with chronic and episodic cluster headaches 600 to 2000 mg (divided into two doses) of valproate daily. Result showed that the patients experienced marked improvement in their condition. In fact, nine out of the fifteen patients was completely free from pain. ^[12]

Possible side effects:

• Ringing or buzzing in the ear
• Changes in your weight
• Restlessness
• Hair loss
• Gastrointestinal problems (heartburn, vomiting, and nausea)

Triptans

Triptans are effective treatments for acute migraine and cluster headaches. They work by reducing inflammation and constricting certain blood vessels within the brain. They come in different preparations: tablet, nasal spray, and injection.

Don’t use triptans if you have a medical history of, or are predisposed to, the following health problems:

• High blood pressure
• Angina (chest discomfort or pain due to insufficient oxygenation of the heart muscle)
• Impaired liver function
• High blood sugar
• Stroke
• High cholesterol
• Blood vessel problems
• Heart or coronary artery disease

The side effects of triptans are usually mild. Here are some of them:

• Sleepiness
• Dizziness
• Mouth dryness
• Headache
• Skin tingling
• Numbness
• Nausea

Other second-line preventive medications for cluster headaches are ergonovine (also known as ergometrine), Indocin (indomethacin), and injection of a steroid around the occipital nerves. If these medications still don’t work, your doctor can prescribe another line of preventive medications, which include cocaine drops (taken through the nose) and intravenous dyhydroergotamine (DHE).

Use fast-acting symptomatic treatment to markedly reduce symptoms

Symptomatic treatment refers to any medical therapy that treats only the symptoms, not the root cause. Oxygen therapy and injectable sumatriptan are the first options when it comes to the symptomatic treatment of cluster headaches. But if you smoke cigarettes or suffer from any heart disease, oxygen therapy is the more appropriate treatment.

Oxygen Therapy

Oxygen therapy has been a standard treatment of acute cluster headaches for decades. This procedure involves inhaling 100% oxygen through a face mask at a rate of at least 7 liters per minute for about 15 minutes.

It’s still not clear how oxygen therapy works, but insufficient oxygen supply is a known headache trigger. When there’s a lack of oxygen to the brain, caused by airway obstruction or breathing difficulty, the blood vessels widen and bring on cluster headaches or migraines.

Clinical studies show that high-flow oxygen offers faster relief. One study suggested that patients who received 100% oxygen by face mask at a minimum rate of 12 liters per minute for 15 minutes at the beginning of a cluster headache attack were more likely to be pain-free within 15 minutes. ^[13]

Oxygen therapy is generally effective, safe, and has no contraindications. The only side effect it has is rebound headache. The downside is it’s inconvenient and impractical because you’ll have to carry around an oxygen tank and regulator with you.

Injectable Sumatriptan

Sumatriptan is usually used for migraine, but it may also help with the pain caused by a cluster headache. However, it doesn’t prevent or reduce the number of cluster headache attacks. It’s injected under the skin, specifically on your upper arms, thighs, or midsection.

It works by stimulating serotonin receptors called 5HT receptors, causing the blood vessels in your brain to constrict. The pain in headaches, like migraine and cluster headache, is believed to be caused by dilated blood vessels.

Sumatriptan is generally effective in treating cluster headaches and migraine. In one study, researchers found out that sumatriptan 6 mg (subcutaneous) is well-tolerated, effective, and works fast in reducing cluster headache attacks (74%). Also, it markedly improved the functional disability associated with this condition. Increasing the dose to 12 mg doesn’t provide greater relief to patients. Instead, it may increase their risk to side effects. ^[14]

Injectable sumatriptan has mild and short-term side effects, which include:

• Lightheadedness
• Mouth dryness
• Nausea
• Feelings of pressure in certain parts of the body, like the chest, arms, legs, and face.

Note: People who have a history of, or at risk for, stroke and diseases that affect the heart and blood vessels should avoid using sumatriptan.

Other drugs for the symptomatic treatment of cluster headaches:

Lidocaine

Lidocaine is a numbing agent that healthcare professionals use in minor surgeries. Some people get this by prescription to treat cluster headaches, especially when other medications fail to work. You use it by placing it into your nostril of the affected side. Side effects include numbing or a burning sensation in the nose.

Injectable Octreotide

Octreotide is a synthetic version of somatostatin, which is a hormone that regulates the release of certain brain hormones. A small double-blind study shows that synthetic somatostatin was able to markedly ease the intensity and duration of pain compared to placebo during 72 cluster headache attacks. The dose researchers used was 25 μg (microgram) per minute for 20 minutes via intravenous infusion. ^[15]

Seek medical advice immediately

As soon as you experience a severe type of headache–the kind that’s so painful that you can’t sleep or sit still–see your primary doctor immediately. Your doctor may perform a brain scan to rule out other conditions, but in most cases, he or she will make the diagnosis based on your symptoms. Generally, brain scans will show up normal in people with cluster headaches.

Once your doctor diagnoses you with a cluster headache, he or she may refer you to a doctor (neurologist) that specializes in health problems that affect the brain and nerves to discuss your treatment options. Fortunately, the condition itself is non-life-threatening and manageable.

Aside from medications, invasive procedures, and other medical therapies, patients are also encouraged to avoid things that might trigger cluster headaches.

Here’s a list of conditions and substances that may trigger cluster headaches:

• Smoking cigarettes – Most people who suffer from cluster headaches are smokers. Smokers with episodic cluster headache have a higher risk of having a more severe form of the condition. Unfortunately, quitting smoking rarely helps. ^[16]
• Nitrite-containing foods (bacon, hot dogs, salami, sausages, and corned beef) – These foods cause your blood vessels to dilate, setting the stage for a cluster headache attack.
• High-altitude locations (around 8,500 feet above sea level) – High altitudes cause intense headaches because the body can’t get enough oxygen from the air. If you experience intense and persistent headache accompanied by other symptoms (confusion, breathing difficulty, coughing, or inability to walk properly), you should go down to a lower elevation immediately and get medical attention.
• Changes in the weather
• Exertion or physical activities
• Bright lights
• Medications
• Certain smells
• Cocaine
• Alcohol consumption

Sticking to a fix sleep schedule–even on weekends or holidays–may help prevent a cluster headache attack. The relationship between sleep and headaches, like migraine and cluster headaches, is poorly understood. However, headaches are common complaints of people who have sleep difficulties or disorders.

Here are 3 tips to get better sleep every night:

Sleep and wake up at the same time every day

When choosing your wake-up time, it’s important to consider how much sleep you think you need. Aim for 7 to 8 hours of sleep every night for longevity. You don’t have to make drastic changes to your sleep-wake schedule. Try to make small and slow adjustments.

For instance, if you want to sleep at 9 p.m. instead of 11 p.m., you can go to bed at 10:50 p.m. for four to five nights. Then, you can go to bed at 10:40 p.m. for the succeeding days. Keep adjusting your sleep schedule in 10-minute increments until you reach your desired time.

Find ways to relax before going to bed

You can take a hot shower, listen to soothing music, meditate, or eat a carb-loaded meal. Eating foods rich in carbohydrates, especially four hours before going to bed, is an effective way to fall asleep faster because they quickly raise your blood sugar.

Avoid using your gadgets (smartphone, laptop, tablet, or desktop computer) because they emit blue light, which can disrupt normal sleep patterns and worsens insomnia. This type of light keeps you awake because it tricks your brain into thinking that it’s still daytime.

Get some sunshine first thing in the morning

Sunlight tells your brain it’s time to wake up. Go for a morning walk after getting out of bed. Having adequate amounts of vitamin D in the body will help you get adequate and timely sleep and wakefulness behavior. And one way to keep your vitamin D within normal levels is to have adequate sun exposure.

Also Read: How To Get Rid Of A Headache At School or At Work.

Join a support group

Living with cluster headache is difficult and scary. It will eventually severely affect the quality of your life and your relationships. It’s important to have at least one person in your life who knows the effect of this condition and the effective treatments for it. You can also talk to a therapist or join a support group in your area to help you deal with the effects of cluster headache. Ask your doctor for recommendations.

If you feel suicidal, there are many ways to find help, such as the following:

• You can call National Institutes of Health crisis prevention hotline at 1-800-273-8255 or The National Hopeline Network at 1-800-784-2433. Try browsing through your phone directory to get the contact number of your local crisis center.
• Other online resources that could help you find healthcare professionals who specialize on headaches are the American Headache Society (AHS) and National Headache Foundation.

What do you think? Do you have any other tricks that have helped you with your cluster headaches?

References:

[1]  http://medcraveonline.com/JNSK/JNSK-03-00092.pdf

[2] http://www.nytimes.com/health/guides/disease/cluster-headaches/print.html

[3] http://www.nytimes.com/health/guides/disease/cluster-headaches/print.html

[4] https://www.ncbi.nlm.nih.gov/pubmed/18422717

[5] http://www.aafp.org/afp/2013/0715/p122.html

[6] http://www.emedicinehealth.com/cluster_headache/article_em.htm

[7] http://www.aafp.org/afp/2005/0215/p717.html

[8] https://www.acep.org/content.aspx?id=82253

[9] http://chicagoheadacheclinic.com/archives/preventivemeds.html

[10] http://www.mhni.com/headache-pain-faq/cluster-headaches/cluster-headache-sleep

[11] http://www.webmd.com/vitamins-supplements/ingredientmono-940-melatonin.aspx?activeingredientid=940

[12] http://onlinelibrary.wiley.com/doi/10.1046/j.1468-2982.1989.0903195.x/abstract

[13] https://www.ncbi.nlm.nih.gov/pubmed/19996400

[14] https://www.ncbi.nlm.nih.gov/pubmed/8749244

[15] http://www.sciencedirect.com/science/article/pii/0304395984900484

[16] https://www.ncbi.nlm.nih.gov/pubmed/23742010