The pain of cluster headaches is described as one of the worst pains ever experienced. It starts quickly, without warning, and reaches a crescendo within fifteen minutes. It is deep, non-fluctuating, and explosive in quality. In addition, 10 to 20 percent of patients can have paroxysms of stabbing, icepick-like pain around the eye that lasts for a few seconds. The symptoms resolve in one to two minutes. This pain is usually described very eloquently by patients: “It feels like a hot poker pushing into my eye,” or “It feels like someone is stabbing my eye with a sharp knife.” The pain is always on one side, and generally affects the same side in subsequent bouts. Typically, this type of headache may cause you to awaken suddenly from the pain.
- Cluster headaches predominantly affect men.
- Cluster headaches occur in clusters of intense pain almost daily for a period of one to two months.
- The pain of the headache can be severe and excruciating.
- The most effective treatment of cluster headaches is inhalation of 100 percent oxygen.
- Administration of lidocaine in the nostrils is also an effective treatment for this type of headache.
The best treatment for acute pain relief in the majority of cluster headache sufferers is the inhalation of 100 percent oxygen via a tight-fitting mask at a flow rate of eight to ten liters per minute for ten to fifteen minutes. This treatment can dramatically reduce the intensity of the pain in about 80 percent of patients. This mode of therapy has recently been substantiated by controlled studies. Oxygen inhalations may be repeated up to five times per day. The exact mechanism by which oxygen treats the headache is not clear, although oxygen stimulates the synthesis of serotonin in the central nervous system (CNS).