Estimates show that approximately 15.8% of the world’s population experiences headaches each day. Headaches can vary in type, and understanding the specific kind you have can help you manage it more effectively. Two frequently confused types of headaches are cluster headaches and migraine. Read on to learn more about cluster headaches vs. migraine, how to tell them apart, and the best management options.
Cluster Headache Overview
Cluster headache is a severe recurring headache that occurs in periods of frequent episodes called clusters. The pain affects one side of the head only and lasts anywhere from a few minutes to several hours.
This type of headache is relatively rare; it affects around 0.1% of the population. Although people can develop cluster headaches at any age, it usually begins at the age of 30. Cluster headaches affect men more than women. Given the rarity of cluster headaches, it’s quite difficult to study all the mechanisms involved in its development.
What is Migraine?
A migraine is a type of intense, throbbing headache typically on one side of the head. The difference between migraine and headache is that migraine is a complex neurological disorder accompanied by various symptoms including nausea and vomiting. Migraine occurs in episodes that may last from a few hours to several days.
According to the World Health Organization (WHO), migraine generally affects people between 35 and 45 years. Migraine affects around 12% of the population. This type of headache affects women more than men. Further in this post, you’re going to learn more about cluster headache vs. migraine and how to recognize which one you may have.
What are the Symptoms of Cluster Headaches vs. Migraine?
The best way to differentiate cluster headache vs. migraine is to compare their symptoms side by side. The table below shows how people experience these types of headaches. More precisely, it shows how cluster headaches and migraine make them feel.
| Symptoms side-by-side |
| Severe sharp or stabbing pain usually around one eye (one side of the head) | Nausea and vomiting |
| Pain may spread to other areas of the head and face | Confusion |
| Watery eye | Blurred vision |
| Restlessness | Fatigue |
| Eye redness and/or swelling on the affected side | Mood changes |
| Droopy eyelid on the affected side | Increased sensitivity to sound or light |
| Runny nose on the affected side | Difficulty concentrating |
| Sweat on forehead | Trouble sleeping |
| Changes in skin color on the affected side | Frequent urination |
Symptoms of migraine develop in four stages:
- Prodrome: begins around 24 hours before migraine occurs
- Aura: lasts anywhere from 5 to 60 minutes before or during migraine attack, and refers to sensory, motor, and speech symptoms.
- Headache: throbbing pain in the head
- Postdrome: known as migraine hangover, lasts up to 48 hours.
NOTE: not everyone experiences all four stages.
What is the Duration of Your Headache?
The most significant point of difference between cluster headache vs. migraine is in the duration of pain. A single episode of cluster headache lasts from 15 minutes to three hours while the average duration is from 30 to 45 minutes.
Migraine develops gradually but lasts longer. Headache due to migraine may last four to 72 hours without medical treatment. Sometimes migraine may last longer than that. The duration of migraine depends on the phase of the illness. The prodrome stage may last from a few hours to a few days. Aura lasts five to 60 minutes, headache four to 72 hours, and the postdrome stage lasts 24 to 48 hours.
When Do You Get Headaches and How Common They Are?
When distinguishing between cluster headache vs. migraine, it’s important to consider their timing and frequency. Cluster headaches typically occur at the same time each day and can last for weeks or months. These headaches often begin in the spring or fall, although each person’s experience may vary. Some individuals may have cluster headaches daily while others may have seven or eight episodes throughout the day. After an episode, cluster headaches may not recur for weeks, months, or even years.
The frequency of migraine varies from one person to another. Migraines are most common in the morning and most people experience two to four episodes per month.
Which Area of Your Head is Affected?
Cluster headache affects one side of the head primarily in, behind, or around one eye. Migraine location is a bit different. This type of headache tends to affect one side of the head, but it may occur behind the eye, temple, front or back of the head, and on both sides.
Migraine vs. Cluster Headache Treatment
Cluster headaches currently do not have a cure, but it is possible to alleviate the pain and minimize the recurrence of new episodes. Treatment methods may involve medication or surgery. Effective medications for cluster headaches are oxygen, triptans, and local anesthetics, all of which are fast-acting treatments that stop pain once it begins.
Doctors may also prescribe medications to prevent cluster headaches. These include calcium channel blockers, lithium, corticosteroids, and nerve blocks. Surgery is an uncommon approach and may be recommended only when other approaches fail. Some procedures aim to damage the nerve pathways that cause pain.
Treatment of migraine may depend on the trigger of the headaches. The main goal is to stop symptoms and prevent future episodes. The most common treatment approaches are:
- Pain-relieving medications: taken during migraine attacks to stop symptoms. These include over-the-counter pain relievers such as ibuprofen (Advil) and a migraine shot. The latter blocks pain pathways in the brain. Common shots include triptans such as sumatriptan (Imitrex, Tosymra) rizatriptan (Maxalt), and dihydroergotamine (Migranal). Other pain-relieving medications include oral tablets, nasal sprays, and opioids.
- Preventive medications: prevent frequent migraine episodes. Good examples are antidepressants, anti-seizure drugs, blood pressure medications, and Botox.
In addition to medications, management of migraine may include:
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Dietary supplements: natural products such as Endmigra – migraine relief supplement, rely on herbs to reduce the frequency and severity of migraines, alleviate associated symptoms, and manage common triggers.
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Avoidance of triggers: the doctor may help you identify triggers so you can avoid or reduce exposure to them. Common triggers of migraine are aged cheese, alcohol, chocolate, pickled or fermented foods, processed foods, stress, hormonal changes, weather changes, too much physical activity, exposure to loud noises or bright lights, and missing a meal.
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Acupuncture: an alternative treatment approach for relieving migraine. Evidence confirms that acupuncture can be more effective than medication in reducing the frequency of migraines. Just by stimulating certain points in the body, it’s possible to improve the flow of energy and reduce the pain. The same can be achieved by massaging the migraine relief pressure points such as Hegu or LI-4 found at the base of the thumb and index finger.
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Relaxation techniques: biofeedback and other types of relaxation can help with stressful situations and decrease the number of migraines.
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Regular exercise: physical activity may decrease tension and prevent migraine.
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Bottom line
The main focus of this post was to compare cluster headache vs. migraine and highlight their differences. While both types of headaches can cause severe pain that significantly impacts quality of life, they are fundamentally different. Cluster headaches and migraines differ in duration, areas of the head they affect, as well as their symptoms, frequency, and treatment approaches. If you are experiencing the symptoms discussed in this post, it is important to consult a doctor. Your doctor can diagnose whether you are experiencing a cluster headache or a migraine and recommend the most suitable treatment approach.
References
1] https://pubmed.ncbi.nlm.nih.gov/35410119/
2] https://www.ncbi.nlm.nih.gov/books/NBK544241/
3] https://www.who.int/news-room/fact-sheets/detail/headache-disorders
4] https://pubmed.ncbi.nlm.nih.gov/31563224/
5] https://www.medicalnewstoday.com/articles/migraine-timeline#timeline
6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606388/
Celeste Small
Medicine has always been a passion ever since she was young so it was no surprise when Celeste decided to pursue pharmacy. Celeste Small was born in South Florida and raised in Melbourne, FL. She graduated from Rockledge High School in 2010 and received both her Bachelor of Science (in 2014) and Doctor of Pharmacy (in 2018) degrees from the University of South Florida in Tampa, FL. Celeste has worked at in an independent pharmacy in Titusville, FL for three years after graduating from pharmacy school and currently is working at the Patrick Space Force Base in Cocoa Beach, FL as a contract pharmacist. Celeste is also currently a freelance medical writer on the side and has written content for blogs, presentations, and for educational material. She also manages a website called Pharmacistconsult.com where she and other pharmacy colleagues post informative medical information for both healthcare professionals and consumers alike. In her free time, she enjoys traveling, going to theme parks, listening to music and enjoying the Florida sun.
