What’s the Difference Between Cluster Headache vs Migraine?

By Sarah Tran
Medically reviewed checkmarkMedically reviewed
June 21, 2022

It can be hard to tell the difference between a cluster headache vs migraine.

Both are painful headaches that can feel paralyzing, putting a halt to all your plans for the day.

But there are several differences that can help differentiate between the two, including location and associated symptoms.

The defining difference between a cluster headache vs migraine, though, is time.

A cluster headache is a short event, lasting no longer than 90 minutes.

A migraine, however, can last for an entire day, and sometimes even several days. 

One reason that the two can be confused: Multiple cluster headaches can take place over the course of a single day. There are pain-free periods that take place in between the clusters, though.

Migraine pain level can waver in severity, but the pain does not completely resolve as it does between cluster headaches.

If you’re experiencing pain from a cluster headache or migraine, talk to your doctor to receive a proper diagnosis. 

In this article, I’ll talk about different types of headaches, including cluster headaches and migraine.

I’ll explain more about the differences between cluster headache vs migraine, and how each can be prevented and treated.

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What Is a Headache?

Types of headaches 

There are two broad classifications for all types of headaches: primary and secondary.

A primary headache is when the headache is the main problem and not a symptom of an underlying condition.

A secondary headache is when the headache is a symptom of an underlying condition.

It includes headaches from simple problems, like sinusitis, to more concerning conditions, like aneurysms or tumors. 

The common types of primary headaches are:

  • Tension headaches: The pain of a tension headache feels like pressure or tightness that wraps around the head like a band. Tension headaches are fairly common and can last from a few minutes or up to a few days. There are multiple factors that can trigger a tension headache, but stress is the most common cause.
  • Migraine headaches: Migraines are usually felt on one side (60-70% of the time) and come on gradually, building to a moderate to severe intensity. Migraine attacks can cause nausea, sensitivity to light and sound, and throbbing, pulsating pain. Most sufferers need to lie down in the dark and rest to ease the pain. Migraine headaches can last from a few hours up to a few days.
  • Cluster headaches: Cluster headaches are so named because they arrive in clusters, or cycles. The pain is always on one side, beginning around the eyes or temple, and grows quickly to severe pain. Cluster headaches can last 15 minutes to a few hours.

What is a Migraine?

A migraine is a disorder in which one experiences a moderate to severe headache along with symptoms like nausea, light sensitivity, or sound sensitivity.

It’s estimated that around 12 percent of the population—one in eight people—suffers from migraine.

There are 4 different stages to a migraine, though not everyone experiences every stage.

The prodrome stage is the first stage, and it’s experienced by 75% of individuals having a migraine.

During the prodrome stage, symptoms include light and sound sensitivity, fatigue, mood changes, cravings, and poor concentration.

The second phase of migraine is aura, which only occurs in about one in four patients.

Aura is a neurological disturbance that can cause changes to vision, hearing, or motor problems.

If you’re experiencing an aura for the first time though, see a doctor in person for evaluation to ensure there are no other neurologic causes to these symptoms.

The next phase is the headache, or attack, phase of migraine. The pain is throbbing, pulsating, or pounding, and usually occurs on one side of the head.

It can last up to several days. Lastly, there is a postdrome stage, in which the pain has ended but lingering symptoms can be felt, like fatigue.

Migraine triggers

The causes of migraines are not fully understood.

Genetics are believed to be involved, as migraines are more likely to occur if you have a family history of migraine.

Migraine is also more common in people who were female at birth.

For the cause of migraine episodes, it’s believed that a trigger causes a wave of changes to nerves and blood vessels that release pain signals to the brain.

Here are some common triggers that may be responsible for migraine: 

  • Stress
  • Hormone changes
  • Smoking
  • Alcohol 
  • Caffeine (changes to your normal intake) 
  • Bright lights or loud noises
  • Lack of sleep 
  • Skipping a meal
  • Different types of foods (aged cheeses, preservatives, etc)
  • Changes in weather 

You may have different triggers that set off a migraine.

Keep track of your triggers with a diary or journal so you can remember them and speak to your doctor about them. 

Diagnosis 

If you think you’re suffering from migraine headaches, meet with a doctor to review your symptoms and history (including family history) and have a physical exam.

Together, a plan can be set and treatment options reviewed.

Depending on any concerns for other causes of your headache (any concerns that your headache is actually a secondary headache), testing may be recommended.

Treatment for Migraines

Some nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen (Aleve) or ibuprofen (Motrin, Advil), can help alleviate migraine pain.

However, you should not take NSAIDs if you have kidney problems. 

Excedrin Migraine is a combination pain reliever that can help treat migraines.

The drug contains a combination of caffeine, aspirin, and acetaminophen. 

There are some prescription medications, in addition to over-the-counter pain relievers, that may help reduce the severity of your migraine.

These include tripans, like rizatriptan (Maxalt) or sumatriptan (Zecuity).

Some anti-nausea medications can help if you’re experiencing nausea during your migraine.

Some supplements, like riboflavin and magnesium, have been recommended to treat migraines.

However, you may need to take them for several months to notice a difference. 

Prevention

There are a few steps you can take to prevent future migraine attacks: 

  • Reduce stress
  • Breathing exercises 
  • Increase physical exercise 
  • Eat a healthy diet 
  • Stay hydrated 
  • Stick to a sleep schedule 
  • Cut out alcohol 
  • Avoid environmental triggers such as loud noises, strong smells, or bright lights 

What is a Cluster Headache?

A cluster headache is a painful headache felt in cycles (called clusters), with pain-free periods in between.

You can have up to eight cluster headaches a day, and this cycle can last for weeks.

Cluster headaches occur on one side of the head and are accompanied by symptoms such as tearing of the eye, eye redness, and nasal congestion or runny nose on the side of the face where the headache is occurring.

They’re the most painful form of headache, with the pain described as stabbing, burning, or searing.

Cluster headaches are rare, affecting less than one in 1,000 adults across the world. 

The cause of cluster headaches is not completely understood, but it’s believed to be linked to activation and pressure on the trigeminal nerve, a nerve that carries sensations from your face to your brain.

Episodic cluster headaches are the predominant form, affecting more than 80% of those who experience cluster headaches.

When cluster headaches are episodic, there are alternating pain and pain-free periods.

Pain-free periods last at least 3 months.

If pain-free periods are shorter than 3 months, the cluster headaches are considered to be chronic.

Cluster headaches can take place with little warning.

There is not usually a reason or special trigger for their attacks.

This is different from other types of headaches, where smells or bright lights can be triggering factors.

However, you should avoid any strong smells or alcohol while experiencing a cluster headache. 

Cluster headaches come on suddenly and can last for several hours.

To help with a feeling of restlessness, patients feel the urge to pace or rock back and forth.

If you believe you are experiencing cluster headaches, talk to a doctor. 

Treatment for Cluster Headaches

There is no cure for cluster headaches.

However, there are a few different treatment options to help patients find relief.

Management of acute cluster headache include:

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When to See a Medical Provider

If you experience moments of vision changes, dizziness, severe neck stiffness, or headache with exertion, seek medical attention right away.

See a doctor if headache pain ever becomes inordinately severe, becoming “the worst headache of your life.”

If your migraine or cluster headaches become increasingly frequent and disrupt your daily life, see a doctor. 

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

How does a cluster headache feel?
Cluster headache pain is severe and feels like a sharp, piercing pain on one side of the head. It’s very intense. The pain can feel like a burning sensation.
What is the main cause of cluster headaches?
The cause of cluster headaches is not completely understood. These painful headaches are believed to be linked to pressure on the trigeminal nerve, a nerve that carries sensations from your face to your brain. Some people who are sensitive to strong chemical smells or alcohol might experience them. Additionally, changes in part of the brain called the hypothalamus might be a contributing factor.
What is the most painful type of headache?
There is debate about whether a cluster headache or a migraine is more painful. Migraine pain lasts for longer and happens all at once. Cluster headache pain has been described as excruciating, and can affect the entire upper body.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Sarah Tran

Dr. Sarah Tran is a board certified family medicine physician with 9 years of clinical experience serving the underserved.

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