Migraine vs Cluster Headache
Your eyes water. Your nose runs. One side of your head really hurts. You may wonder: Is it a cluster headache or migraine attack?
These two neurological conditions have some things in common. They each cause disabling headaches that might make you feel a little sick. And they share triggers such as stress, lack of sleep, and weather changes. But there are some key differences.
It’s possible to have both migraine and cluster headaches, but your treatment depends on which one is causing your pain. Your doctor can help you figure out what’s going on. Here are some questions they may ask.
How Long Does Your Headache Last?
The length of time is a big clue.
A cluster headache is brief, but it comes on fast and strong. It’s sometimes described as “explosive.” The pain may peak within 10 to 15 minutes and vanish within 15 minutes to 2 hours. It may last longer, but that’s uncommon.
Migraines tend to build up slowly and last a long time. If left untreated, it can stick around for up to 72 hours. Symptoms can impact daily life, but migraines are considered less intense than a cluster headache.
When and How Often Do You Get Headaches?
Cluster headaches tend to happen around the same time every day for weeks or months, usually in spring or fall. During a cluster, you could have a headache every other day or up to eight in 1 day. Some may wake you up at night. But then you can have pain-free periods for weeks or years.
Migraine pain may go up and down throughout the day. But it’s rare to have more than one headache a day. And unlike cluster headaches, migraines are more likely to happen during the day and don’t seem to follow a seasonal pattern.
What Area of Your Head Hurts?
A cluster headache is unilateral. That means it only affects one side of your head. You may feel like it’s right behind your eye or on the side of your forehead. The pain may switch sides in another attack, but it won’t cross over during an episode.
One-sided head pain is also common with migraines. But you can have a headache that’s behind your eye, by your temple, on both sides, or in the front or back of your head.
How Do You Feel During Your Headache?
Cluster headache and migraine have some of the same symptoms. That’s one reason they’re easy to mix up. But there are some factors that set them apart.
Cluster headaches often give you a sense of restlessness. You may feel better if you walk around. Your face or forehead may also start to sweat.
A cluster headache also causes continuous pain. And you’ll usually have some symptoms on the same side as your headache. That may include:
- Watery or red eye
- Nasal congestion
- Runny nostril
- Puffy eyelid
- Droopy eye
Migraine headaches usually give you the urge to lie down and rest. In fact, your pain may get worse when you’re active.
A migraine may cause some constant pain, but it usually throbs. It may feel like your heartbeat is pulsing in your head. Other symptoms include:
- Nausea
- Throwing up
- Light or sound sensitivity
- Visual, speech, or sensory changes (aura)
How to Treat Migraine vs Cluster Headache
Make a note of what you’re doing when you get a headache. You may be able to keep an attack from happening if you know what’s causing it. Certain factors may trigger either a migraine or cluster headache. These include:
- Mental stress
- Changes in your sleep routine
- Too much alcohol
- Bright light
- Travel to high altitudes
Your doctor will likely approach each condition in a different way. You may need therapy to ease single attacks. That’s called acute or “rescue” treatment.
If you get headaches a lot, you may need medication to lessen how serious they are or how often you have them in the future. That’s called preventive or “prophylactic” treatment.
Treatment for migraine may include:
Over-the-counter medication. Painkillers like acetaminophen and ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDs), may help with mild pain.
Injectables and nasal sprays. These drugs target brain chemicals and blood vessels that cause migraine pain and symptoms such as nausea. You can only get them with a prescription from your doctor. They work best when you take them at the start of your attack.