Spending a bit of time on Twitter lately, I’ve noticed that there still seems to be quite a bit of confusion over what migraine is, as opposed to what cluster is.
Sometimes in the past the two have been used interchangeably. Or sometimes, just based on imprecise information. For example, sometimes people think of any bad headache as a "migraine headache", or think of certain types of pain as a "cluster headache".
In reality, these two are very different, and require different types of treatment. Let’s take a quick look at cluster and migraine, and see if we can clear up a few misconceptions.
You’ll see right away that I used terms like "usually" and "typically" a lot, and I probably could have used them more. There is a lot of variation from person to person, so we’re just hitting on some of the more common, typical traits of each. But just a reminder – either of these can include pain that’s not just on one side, sometimes there is no pain in migraine, sometimes it’s not throbbing pain, etc.
You can see highlighted some of the key differences between migraine and cluster. Cluster headaches come on faster and leave quicker than migraine attacks. It’s unusual for a migraine attack to last less than 4 hours, and unusual for a cluster attack to last more than 3 hours.
Another key difference – migraine patients tend to avoid light and movement. They’ll often go lie down in a dark room.
That’s the last thing a cluster patient wants to do – good luck getting them to lie down! They become restless and may rock or pace.
But the last highlighted item is especially key. Clusters get their name not from where the pain is or what it feels like, but from the cycles of pain.
You’re not going to get just one cluster headache. You’ll get several in a series – maybe one a day, or several a day, regularly. This can go on for weeks and even months, but then completely disappear for months or years.
Sad to say, there are also chronic cluster headache sufferers who have no periods of remission (as this recent news story on cluster headache illustrates).
Hopefully that clears up some misconceptions, especially regarding cluster. Cluster is an incredibly painful condition. There is treatment for cluster, but the treatment has had limited success in many people. Much more research needs to be done to fight what has been rightly called the suicide headache.