How to Get Rid of a Cluster Headache

Cluster headache is a rare disorder characterized by “cluster periods” of repeated, severe headaches. About 80% of cases are episodic, meaning there will be a period of daily headaches, often occurring several times a day, followed by a month or more without headaches. The remaining 20% have no such breaks and are considered chronic.

Although there is no known cure for cluster headaches, there are a number of natural treatments, over-the-counter (OTC) and prescription medications, and even surgical approaches that can help relieve symptoms.

This article covers how to get rid of a cluster headache using natural treatments as well as OTC, prescription, and surgical treatment options.

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Natural Treatment for Cluster Headaches

What’s most important to remember about conditions like cluster headaches is that what works for some people may not for others. Still, there is a lot you can do to reduce the frequency of attacks or help ease the intensity of your symptoms:

Sleep schedule: A growing body of research shows that keeping to a consistent sleep schedule can help reduce the frequency of cluster headaches. This regularizes the body’s circadian rhythms, which can help ease the onset of attacks.

Regular exercise: The benefits of exercise cannot be understated, and directly or indirectly, many have found it effective for cluster headaches. Daily fitness activity, even when moderate, has been shown to improve sleep cycles, improve blood circulation to the brain, and reduce stress.

Avoiding tobacco: Among the many negative health effects of smoking cigarettes or using other tobacco products is that this habit has been linked with increases in chronic headache conditions. Though difficult, it’s worth looking into smoking cessation if you experience cluster headaches.

Avoiding alcohol: Alcohol, in any form, is a known trigger for a cluster attack. People experiencing cluster headaches may find it in their best interest to abstain, especially during tougher periods.

Over-the-Counter (OTC) Therapies

Most over-the-counter pain medications like ibuprofen, acetaminophen, and aspirin are rarely able to mediate the severe pain of cluster headache. While they have some efficacy and are worth trying out, they’re rarely a match for the intensity of this condition.

Furthermore, using some of these medications for more extended periods of time can lead to medication overuse headache (MOH), in which the frequency and intensity of headaches can increase. MOH is more common in people with migraines, though it is occasionally reported in people with cluster headaches.

Prescriptions

Prescription drug approaches to cluster headache can be divided into two groups: acute medications (those intended to take on attacks after they’ve started) and preventative ones.

Acute Medications

For those already experiencing attack, here’s a breakdown of acute medications:

Triptans: The migraine medication sumatriptan (Imitrex), a triptan, has been known to work during cluster attacks when injected. For those who don’t tolerate sumatriptan (or other medications), nasal sprays of zolmitriptan (Zomig) can also work.

Zolmitriptan does come with a risk of side effects. Possible side effects of Zomig (oral, nasal, or auto-injectors) include a sensation of chest pressure, dizziness, nausea, and dry mouth. Zomig nasal spray can also cause nasal irritation, an unusual taste, or increased sensitivity to lights, sounds, and smells.

Octreotide: A synthetic version of somatostatin, a brain hormone associated with growth and intercellular communication, can provide quick results if injected. While there are many indications that triptans are more effective, this approach has its utility.

Taking octreotide does carry a risk of side effects, including gallstones (usually only with long-term use), nausea, pain at the site of the injection, abdominal pain, flatulence, constipation, fatigue, flu-like symptoms, dizziness, and headache, among others.

Local anesthetic: When delivered through the nose (intranasally), local anesthetic drugs like lidocaine (similar to your dentist’s novocaine) have effectively managed cluster attacks.

Dihydroergotamine: Especially when injected, dihydroergotamine can be very effective in taking on headache attacks. This treatment is typically reserved for the clinic or hospital and is for more severe cases.

Notably, this injection is not recommended for those who are pregnant or breastfeeding, or those who have a history of heart disease or other cardiac issues, high blood pressure, liver or kidney disease, or hypersensitivity to this type of drug.

Preventative Medications

In addition, many drugs are prescribed to prevent attacks right as they start, including:

Calcium channel blockers: Calcium channel blocking drugs like verapamil (also known as Calan, and Verelan, among others) are considered a top-tier choice for preventing cluster headache attacks and are sometimes prescribed for chronic cases. Side effects do crop up, though; among these are nausea, fatigue, constipation, ankle swelling, and reduced blood pressure.

Corticosteroids: This class of drug is known to be highly effective for reducing inflammation. The drug prednisone (Prednisone Intensol, Rayos) can be very effective as a rapid-acting treatment in cases where there are long periods of remission. Typically, use of corticosteroids for cluster headache shouldn’t last more than a few days because of the risk of side effects, including diabetes, high blood pressure, and cataracts.

Calcitonin gene–related peptide inhibitors (cGRP): Emgality (galcanezumab) inhibits a vasodilator called calcitonin gene–related peptide. This medication is given once a month as an injection. One small study found that around 71% of those who use this medication will have a 50% reduction in the frequency of cluster headache attacks. It is most effective when given at the beginning of a cluster period.

Lithium carbonate: A medication often prescribed for bipolar disorder, lithium carbonate (Lithobid) may be indicated when other medications and approaches haven’t yielded results. Though effective, prolonged use can lead to kidney damage, so patients will have to undergo regular blood testing while taking medications. Other side effects to watch out for are tremors, diarrhea, and increased thirst.

Topamax (topiramate): This medication is sometimes given as a preventative when first-line treatments aren't effective. Because it can cause significant side effects, it is usually given at the smallest effective dose.

Keep in mind that what works for someone else may not work for you. If you find that a drug's side effects are increasing your pain instead of helping, don't hesitate to tell your healthcare provider.

Surgeries and Specialist-Driven Therapies

Healthcare providers have a number of therapeutic options when it comes to cluster headaches. Treatments can be acute or preventative in nature, with surgeries and more invasive options reserved for stubborn and difficult cases. Here’s a quick breakdown:

Oxygen therapy: This fast-acting acute approach is considered the first-line hospital therapy for cluster headaches. Oxygen therapy is typically delivered for 15 minutes at a time through a nasal cannula or face mask. Without any side effects, the only drawback of this approach is its relative inaccessibility; outside the clinic, patients would need to have specialized oxygen tanks with them. 

Nerve block: This treatment involves the injection of a solution that combines an anesthetic (for numbing) and a corticosteroid near the occipital nerves. These nerve clusters run from the top of the spine (at the back of the head) into the scalp, and headache pain is managed when their messaging is blocked. This approach, typically reserved for more severe chronic cluster cases, provides initial relief until longer-acting drugs kick in.

Sphenopalatine ganglion stimulation: This procedure involves surgically implanting a set of specialized electrodes on the sphenopalatine ganglion, a brain region involved with pain processing. These electrodes, when activated by patients with a handheld controller, deliver mild electric shocks, essentially scrambling messages from this brain region. A growing body of research shows this to be an effective approach for difficult cases.

Vagus nerve stimulation: This approach is similar to sphenopalatine ganglion stimulation in that it involves electrical stimulation controlled by a patient’s handheld device. In this case, the electrodes are just beneath the skin and access the vagus nerve, which starts in the brainstem and runs through the neck. While more research is needed, this approach has been found to reduce the frequency of cluster attacks.

Occipital nerve stimulation: Some studies have noted that mild electric shocks to the occipital lobes can also help. A special surgery is employed to implant electrodes in this area, and, as with other stimulation approaches, patients are able to control when treatment is delivered. Early research results show that this approach can help in cases when prescription drugs aren't effective for treating cluster headache attacks.

Deep brain stimulation: Another more novel treatment stimulation approach, deep brain stimulation involves targeting the hypothalamus region with electric signals to scramble pain processing at another of its sources. Notably, studies evaluating this approach have yielded mixed results, though research is ongoing.

Complementary Alternative Medicine

Herbal and non-western approaches to cluster headaches are largely unvetted and are rarely accepted by the medical community. Still, many patients have found them to be quite effective.

Most commonly, 10-milligram doses of melatonin are believed to help, especially when taken at night before going to sleep. In addition, there’s some evidence that taking capsaicin in an intranasal form can work as an acute treatment.  

How to Get Rid of a Cluster Headache While Pregnant

Oxygen therapy is the preferred treatment for cluster headaches during pregnancy, as it is both effective and risk-free. Since it requires a hospital visit, oxygen therapy may only be ideal if your cluster headaches are infrequent. Talk to your healthcare provider if you are unable to access hospital care as frequently as your symptoms require you to.

Summary

There’s a reason that cluster headaches are considered by some to be the worst possible pain. This condition is more than a headache; it’s a serious problem that can get in the way of work, family life, and personal quality of life.

If you experience recurrent headaches, take the issue seriously and seek medical attention. The sooner you’re able to get a handle on this issue, the sooner you’ll be back on track. While not every approach is going to work, there’s no doubt that something will; don’t give up!

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Mark Gurarie

By Mark Gurarie
Mark Gurarie is a freelance writer, editor, and adjunct lecturer of writing composition at George Washington University.