Table of ContentsView AllTable of ContentsDifferencesCausesRisks for EachAt-Home CareMedicationsSeeing a Neurologist
Table of ContentsView All
View All
Table of Contents
Differences
Causes
Risks for Each
At-Home Care
Medications
Seeing a Neurologist
Cluster headachesandmigrainesare complex headache disorders associated with significant and sometimes alarming symptoms, although they are not dangerous.
While these two headache types share some features like trigger factors (e.g., alcohol), they are quite different in other elements, namely headache quality (what it feels like), duration, pattern of attacks, and genetic basis.
This article will review the essential differences between cluster headaches and migraines. It will also provide insight into seeking care for a severe headache.
Cluster Headache vs. Migraine: How to Tell the Difference
Features like headache quality, associated symptoms, frequency, and duration are valuable clues when distinguishing a cluster headache from a migraine.
Quality and Symptoms
Cluster headachesalwaysoccur on one side of the head, causing unbearable pain in thetrigeminalnervedistribution (in or around the eye, eyebrow, or temple).
The quality of pain is piercing, stabbing, or burning and is reported as comparable to or more severe than passing a kidney stone, breaking a bone, or having a hot poker penetrate the eye. Restlessness and agitation typically accompany cluster headaches.
Also, at least one of the following cranial autonomic symptoms is present (on the same side as the headache):
The Symptoms of a Cluster Headache
One or both of the following symptoms accompany a migraine headache:
Moreover, in approximately one-third of people with migraine, anauraprecedes the headache.
What Is an Aura?Amigraine auralasts up to an hour and consists of neurological symptoms, like seeing flashing lights, or smelling or hearing things that aren’t there (hallucinations).
What Is an Aura?
Amigraine auralasts up to an hour and consists of neurological symptoms, like seeing flashing lights, or smelling or hearing things that aren’t there (hallucinations).
Some people with migraines also experience prodrome and postdrome phases, which are:
The Symptoms and Stages of a Migraine Attack
Frequency
Cluster headachesoccur between once every other day and up to eight times daily.They tend to follow a circadian pattern (24-hour biological clock), manifesting at the same time each day, often in the middle of the night.
In addition to a circadian pattern, cluster headache cycles usually coincide with changes in the seasons, with episodes peaking in spring and autumn.
Unlike cluster headaches,migraineis not generally a cyclical disorder. One classic exception ismenstrual migraine,which develops around the time of a person’s menstrual period. It stems from the sudden drop in estrogen levels just before menstrual flow.
People withchronic migraineshave at least 15 migraine attacks per month.
Duration
Cluster headachesare short and intense. They last from 15 minutes to three hours, averaging 45 to 90 minutes.
Migraine headacheslast four to 72 hours, although entire attacks—including all four phases (prodrome, aura, headache, and postdrome)—typically last one to two days.
Effect on Quality of Life
Cluster headaches are excruciating and associated with a decreased quality of life. People with cluster headaches commonly reportdepressive symptomsand, compared to the general population, are more likely to reportsuicidal ideation(thoughts or ideas of suicide).
Get Help Right AwayIf you have thoughts of suicide, dial988to contact the988 Suicide & Crisis Lifelineand speak with a trained counselor. If you or a loved one are in immediate danger, call911.
Get Help Right Away
If you have thoughts of suicide, dial988to contact the988 Suicide & Crisis Lifelineand speak with a trained counselor. If you or a loved one are in immediate danger, call911.
Like cluster headaches, migraines negatively impact the quality of life, including family, work, and social relationships.
They are also associated with various mental health conditions, namely depression, anxiety, andpost-traumatic stress disorder(PTSD).
Overlapping but Different Causes
Experts aren’t sure of the exact cause ofcluster headaches. However, thehypothalamus(a gland at the base of the brain) and thetrigeminalnerve pathway are believed to play a substantial role. In addition, various triggers, namely alcohol and strong odors, can trigger cluster headache attacks.
Similarly, the trigeminal nerve is also involved inmigraineattacks. Likewise, alcohol and strong odors are among the triggers that can precipitate a migraine attack. Unlike cluster headaches, which do not tend to run in families, genetics significantly contributes to migraine development.
Researchers Identify New Genetic Risk Factors for Migraines
Who Gets Cluster Headaches vs. Migraines?
Cluster headachesaffect up to 0.1% of the population and are between 2 and 3 times more common in males than females.(Note that the terms for sex or gender in this article are taken from the sources cited.)
They can occur at any age but rarely develop in children. Interestingly, people who smoke are at a higher risk for developing cluster headache disorder.
Causes of Ongoing Cluster Headaches
Migrainesare much more common, affecting around 12% of the population, equivalent to 39 million individuals in the United States.
Unlike cluster headaches, migraines are more common—twofold to threefold—in females vs. males. They also occur in 3% to 10% of children and adolescents.
An Overview of Pediatric Migraines, Symptoms, and Treatment Methods
How to Relieve Cluster Headache and Migraine Pain at Home
There is no cluster or migraine headache cure. However, combined with medication, various home remedies can help soothe such headaches.
Cluster
Since cluster headaches come on exceptionally quickly and severely, carry your medicine (or portable oxygen) with you at all times to immediately manage pain at symptom onset.
Also, because some people find that applying cold water or cooling pads to the painful area is helpful, it’s reasonable to consider carrying a water bottle orinstant cold packin your purse, briefcase, or backpack.
Lastly, avoidcluster headache triggerslike alcohol and strong odors (e.g., petrol, paint fumes, perfume, or bleach) during a cycle of attacks.
Migraine
A crucial difference between migraine and cluster headaches is that sleep can help soothe a migraine headache, whereas, with a cluster headache, a person is agitated, often pacing around a room or rocking back and forth.
Besides sleeping in a dark, quiet room, other migraine home remedies include:
12 Common Migraine Triggers You Should Know
Medications for Each Type of Headache
Medication is often required to abort a cluster or migraine headache.
The primary abortive therapies for cluster headaches are home oxygen therapy and a medication class called triptans.
Oxygen is safe, well-tolerated, and very effective in aborting cluster headaches. Research has found that nearly 80% of people experiencing a cluster headache are pain-free 15 minutes after receiving high-flow oxygen therapy delivered via a face mask.
Triptans are prescription drugs that attach toserotonin(chemical messenger) receptors, altering blood flow and pain signaling within the brain.
The triptans used for cluster headaches are:
Oral preparations of these drugs are not preferred for aborting cluster headaches.
Drawback of TriptansBecause they constrict blood vessels, triptans cannot be used in people with certain underlying health conditions, namelyheart disease,stroke,peripheral artery disease, or significanthigh blood pressure.
Drawback of Triptans
Because they constrict blood vessels, triptans cannot be used in people with certain underlying health conditions, namelyheart disease,stroke,peripheral artery disease, or significanthigh blood pressure.
Other less commonly used abortive therapies for cluster headaches include:
Preventive Cluster Headache MedicationsPreventive cluster headache medications are intended to reduce the number of attacks and the duration and severity of the cluster cycle.Examples include:A heart medicine called verapamilA calcitonin gene-related peptide (CGRP) antibody called Emgality (galcanezumab)
Preventive Cluster Headache Medications
Preventive cluster headache medications are intended to reduce the number of attacks and the duration and severity of the cluster cycle.Examples include:A heart medicine called verapamilA calcitonin gene-related peptide (CGRP) antibody called Emgality (galcanezumab)
Preventive cluster headache medications are intended to reduce the number of attacks and the duration and severity of the cluster cycle.
Examples include:
Migraine headaches that are mild to moderately severe may be alleviated with one of the two over-the-counter (OTC) painkillers:
Is Tylenol or Advil Better for a Headache?
Moderate to severe migraine headaches are usually treated with a triptan, of which seven are Food and Drug Administration (FDA)–approved in the United States.
Which triptan is prescribed for your migraine care depends on factors like associated symptoms, migraine type, and age (some are approved to treat children).
For example, if vomiting accompanies your migraine headaches, a healthcare provider will likely recommend a triptan given through the nose or as a shot.
Other medications that can stop a migraine include:
Medications for Treating Migraine Headaches
Preventive Migraine MedicationsYou may be a candidate forpreventive migraine therapiesif you have frequent or prolonged migraine headaches.Examples include:An anti-seizure drug calledTopamax (topiramate)A high blood pressure drug calledInderal (propranolol)A calcitonin gene-related peptide (CGRP) inhibitor such as Aimovig (erenumab), Vyepti (eptinezumab), or Emgality (galcanezumab-gnlm)
Preventive Migraine Medications
You may be a candidate forpreventive migraine therapiesif you have frequent or prolonged migraine headaches.Examples include:An anti-seizure drug calledTopamax (topiramate)A high blood pressure drug calledInderal (propranolol)A calcitonin gene-related peptide (CGRP) inhibitor such as Aimovig (erenumab), Vyepti (eptinezumab), or Emgality (galcanezumab-gnlm)
You may be a candidate forpreventive migraine therapiesif you have frequent or prolonged migraine headaches.
Seeing a Neurologist for Severe Headache Pain
While the symptoms of cluster headaches and migraines are often alarming, they are not dangerous conditions.
That said, seeing aneurologist(a medical doctor specializing in nervous system conditions) orheadache specialistis important if you think you may be experiencing one of these disorders.
Diagnostic EvaluationAmigraine diagnosisusually requires a thorough medical history and neurological exam, whereas acluster headache diagnosisrequires additional imaging or other tests to rule out mimicking conditions.
Diagnostic Evaluation
Amigraine diagnosisusually requires a thorough medical history and neurological exam, whereas acluster headache diagnosisrequires additional imaging or other tests to rule out mimicking conditions.
Also, see a healthcare provider if you have a new headache and any of the following pertain to you:
Likewise, if you have been diagnosed with cluster headaches or migraines, see a healthcare provider if your headaches occur more frequently or become more severe.
Go to your emergency room or call 911 right away if:
When Should You Worry About a Headache?
Summary
Cluster and migraine headaches are debilitating, although they differ significantly in pain quality and location, duration, and pattern.
Migraine headaches are throbbing, located on one or both sides of the head, and are associated with nausea, vomiting, and light and sound sensitivity. A typical migraine attack may last days and involves four phases—prodrome, aura, headache, and postdrome.
Other differences are that migraine headaches are more common in females, whereas cluster headaches are more common in males. Moreover, while genetics plays a significant role in migraine development, cluster headaches do not usually run in families.
While some drugs treat cluster and migraine headaches, namely triptans, oxygen therapy is the hallmark treatment for cluster headaches.
29 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Al-Karagholi MA, Peng KP, Petersen AS, De Boer I, Terwindt GM, Ashina M.Debate: are cluster headache and migraine distinct headache disorders?J Headache Pain. 2022;23(1):151. doi:10.1186/s10194-022-01504-x
Headache Classification Committee of the International Headache Society (IHS).The International Classification of Headache Disorders, 3rd edition (beta version).Cephalalgia. 2013;33(9):629-808. doi:10.1177/0333102413485658
American Migraine Foundation.The timeline of a migraine attack.
Khonsary SA, Ma Q, Villablanca P, Emerson J, Malkasian D.Clinical functional anatomy of the pterygopalatine ganglion, cephalgia and related dysautonomias: A review.Surg Neurol Int. 2013;4(Suppl 6):S422-8. doi:10.4103/2152-7806.121628
Benkli B, Kim SY, Koike N, et al.Circadian features of cluster headache and migraine: a systematic review, meta-analysis, and genetic analysis.Neurology. 2023;100(22):e2224-e2236. doi:10.1212/WNL.0000000000207240
Nappi RE, Tiranini L, Sacco S, De Matteis E, De Icco R, Tassorelli C.Role of estrogens in menstrual migraine.Cells. 2022;11(8):1355. doi:10.3390/cells11081355
American Migraine Foundation.How long does a migraine attack last?
Grinberg AS, Best RD, Min KM, et al.Cluster headache: clinical characteristics and opportunities to enhance quality of life.Curr Pain Headache Rep. 2021;25(10):65. doi:10.1007/s11916-021-00979-8
National Suicide Prevention Lifeline.The lifeline and 988.
Battista S, Lazzaretti A, Coppola I, Falsiroli Maistrello L, Rania N, Testa M.Living with migraine: a meta-synthesis of qualitative studies.Front Psychol. 2023;14:1129926. doi:10.3389/fpsyg.2023.1129926
Minen MT, Begasse De Dhaem O, Kroon Van Diest A, et al.Migraine and its psychiatric comorbidities.J Neurol Neurosurg Psychiatry. 2016;87(7):741-9. doi:10.1136/jnnp-2015-312233
Sohn JH, Choi YJ, Kim BK, et al.Clinical Features of Probable Cluster Headache: A Prospective, Cross-Sectional Multicenter Study.Front Neurol. 2018 Oct 26;9:908. doi:10.3389/fneur.2018.00908
Chung PW, Kim BS, Park JW, et al.Smoking history and clinical features of cluster headache: results from the Korean Cluster Headache Registry.J Clin Neurol. 2021;17(2):229-235. doi:10.3988/jcn.2021.17.2.229
Burch RC, Buse DC, Lipton RB.Migraine: epidemiology, burden, and comorbidity.Neurol Clin. 2019;37(4):631-649. doi:10.1016/j.ncl.2019.06.001
Antonaci F, Voiticovschi-Iosob C, Di Stefano AL, Galli F, Ozge A, Balottin U.The evolution of headache from childhood to adulthood: a review of the literature.J Headache Pain. 2014;15(1):15. doi:10.1186/1129-2377-15-15
Rossi P, Whelan J, Craven A, Ruiz De La Torre E.What is cluster headache? Fact sheet for patients and their families. A publication to mark Cluster Headache Day 2016.Funct Neurol. 2016;31(3):181-183. doi:10.11138/fneur/2016.31.3.181
Sprouse-Blum AS, Gabriel AK, Brown JP, Yee MH.Randomized controlled trial: targeted neck cooling in the treatment of the migraine patient.Hawaii J Med Public Health. 2013;72(7):237-41.
de Almeida Tolentino G, Lima Florencio L, Ferreira Pinheiro C, et al.Effects of combining manual therapy, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a study protocol for a randomized clinical trial.BMC Neurol. 2021;21(1):249. doi:10.1186/s12883-021-02290-w
Kingston WS, Dodick DW.Treatment of cluster headache.Ann Indian Acad Neurol. 2018;21(Suppl 1):S9-S15. doi:10.4103/aian.AIAN_17_18
Dodick DW, Shewale AS, Lipton RB, et al.Migraine patients with cardiovascular disease and contraindications: an analysis of real-world claims data.J Prim Care Community Health. 2020;11:2150132720963680. doi:10.1177/2150132720963680
National Institutes of Health DailyMed.Emgality - galcanezumab-gnlm injection, solution.
Mo H, Chung SJ, Rozen TD, Cho SJ.Oxygen therapy in cluster headache, migraine, and other headache disorders. JClin Neurol. 2022;18(3):271-279. doi:10.3988/jcn.2022.18.3.271
UpToDate.Acute treatment of migraine in adults.
Office on Women’s Health.How are migraines treated?
The Migraine Trust.Calcitonin gene-related peptide (CGRP) monoclonal antibodies.
May A, Schwedt TJ, Magis D, Pozo-Rosich P, Evers S, Wang S-J.Cluster headache.Nat Rev Dis Primers. 2018;4(1):18006. doi.10.1038/nrdp.2018.6
Phu Do T, Remmers A, Schytz HW et al.Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.Neurology.2019;92(3):134-144. doi:10.1212/WNL.0000000000006697
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
