This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.
Related guides: Hemicrania continua, Hypnic headache.
What it is
Cluster headache is the most common of a group of headaches that affect one side of the head and cause eye and nose symptoms on the same side. It usually starts in people in their 30s or 40s.
Episodic cluster headache
Bouts last from a week to a year, usually 2 weeks to 3 months, with pain-free gaps of 3 months or more in between. Bouts often come at the same time of year.
Chronic cluster headache
Attacks continue for over a year with no break, or with breaks shorter than 3 months. It affects about 1 to 2 in 10 people with cluster headache.
Symptoms
- Severe, boring, burning or stabbing pain around or behind one eye
- Pain that peaks within 5 to 10 minutes
- A watery or red eye, drooping or swollen eyelid, or small pupil on the same side
- A runny or blocked nostril, or a sweaty or flushed face, on the same side
- Feeling restless, pacing or rocking, rather than lying still
- Attacks at the same times each day, often at night
During a bout, alcohol can set off an attack within minutes. Strong smells, heat and exercise can also trigger attacks.
Treatment
Ordinary painkillers and triptan tablets work too slowly. Cluster headache needs treatments that act fast.
High-flow oxygen
Prescribed by your GP or specialist
Breathing 100% oxygen through a special mask for 15 to 20 minutes can stop an attack. Your doctor arranges oxygen at home through the NHS. Never smoke, or use oxygen near a flame.
Triptan injection or nasal spray
Prescription
A sumatriptan injection works within about 15 minutes. Nasal sprays are an alternative.
Bridging treatment
Specialist or GP
A short course of steroids, or a nerve block at the back of the head, can calm a bout while preventive medicine starts to work.
Preventive medicines
Specialist or GP
Verapamil is usually tried first and needs a heart tracing (ECG) before you start and after each dose increase. Lithium, melatonin and topiramate are other options.
gammaCore
NHS for cluster headache
A handheld device that stimulates the vagus nerve in the neck. NICE supports its use for cluster headache, so a specialist can prescribe it on the NHS, although availability varies by area. It is continued only if it helps within 3 months.
When to get urgent help
Call 999 if you have
- a sudden, extremely bad headache that isn't like your usual attacks
- weakness, numbness or slurred speech
Call NHS 111 if
- you're having attacks and have no treatment
- your oxygen or medicine isn't working
See your GP if
- you think you have cluster headache and haven't been diagnosed
- you don't yet have oxygen at home
- a new bout has started
Work and your workspace
Migraine can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland) if it has a substantial, long-term effect on your everyday life. Conditions that come and go still count, and the law looks at how you would be without treatment. If it applies, your employer must make reasonable adjustments.
Cluster headache attacks often wake people at night, so bouts can leave you exhausted at work. Planning ahead for bouts with your employer can help.
Adjustments that often help
- Somewhere private to use oxygen or treatment at work
- Flexible start times during a bout
- Working from home during bouts
- Leave to attend urgent appointments
- Flexibility over absence during bouts
A migraine-friendly workspace
- A chair with good lumbar and neck support
- A desk big enough to put your screen at arm's length
- Screen raised so the top is at eye level
- A flicker-free monitor with an anti-glare or blue-light filter
- Lighting without flicker or glare, and blinds to control daylight
Access to Work can pay towards equipment and support. Acas and Citizens Advice give free advice on your rights.
How The Beyond Pain Foundation can help
If NHS waits are too long, or the help you need is not available to you on the NHS, we may be able to fund:
- A private consultation with a headache specialist for faster diagnosis and treatment
- Nerve blocks from a qualified specialist when the NHS wait is too long
- Equipment that lets you work from home during a bout
- Travel to specialist appointments
Every award depends on your situation and the funds we have that month. A letter from your doctor, a headache diary and a written quote all help your application.
Support and sources
OUCH (UK)
Cluster headache charity
Support and information for people living with cluster headache and their families.
ouchuk.orgThe Migraine Trust
Information and support service
Information on every type of migraine, a free information and support service, and advice on treatment and work.
migrainetrust.orgNational Migraine Centre
Charity headache clinic
Specialist appointments in person and online, including routine appointments for a voluntary donation, plus free factsheets.
nationalmigrainecentre.org.ukSources for this guide
Written in our own words from the sources above. Last reviewed: October 2026. Figures can differ between sources; where they do, we give the range.