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Cluster headaches are amenable to treatment. However, chronic cluster headaches are quite resistant even to medical therapy. Since these headaches can prove to be quite disabling, impacting the victim's life in all aspects, it is essential that all the treatment options for this disorder be explored.
The treatment may be either abortive which is administered during the attack to cut short its duration and intensity. Or it may be prophylactic to prevent the attacks from happening in the first place itself.
Abortive treatment:
The attack of cluster headaches sets in quite rapidly and what the patient immediately seeks is relief from the excruciating pain. The most successful treatment to cure cluster headaches is inhaling pure oxygen with the help of a facial oxygen mask. This has been found to be really helpful for cluster headache attacks that occur at night.
Triptan drugs like Sumatriptan and Zolmitriptan can be taken nasally or by a subcutaneous injection. Both these provide instant relief because a cluster headache attack sets in quite rapidly. In fact, the injectable form of Sumatriptan can be self-administered. Tablet forms of these triptans are also available, but they are not as fast-acting as the other two methods.
Ergotamine preparations can be used at the onset of the symptoms. But their dosage has to be limited as they may cause some side-effects like nausea. Ergotamine can also be a prophylactic treatment.
A lidocaine nasal spray which acts as a local anesthetic agent can also be prescribed by the doctor.
In addition to these, some natural methods have also been classified under abortive treatment as they have been found to be effective during an attack. These include ice, cold showers, breathing cold air, caffeine, drinking copious quantities of water during the start of the attack and even vigorous exercise. But these methods might not work for all the people.
Prophylactic treatment:
Prophylactic treatment has been found to be especially useful in the case of patients with episodic cluster headaches. The prophylactic treatment aims to prevent an attack in the first place itself
Prophylactic treatment is available in the form of a wide variety of prophylactic medications. These include some corticosteroids like prednisone which are prescribed if the attacks have started recently, muscle relaxants and ergot compounds. Anti-seizure medicines like topiramate and even atypical anti-psychotics are recommended. Their doses are gradually reduced as the headaches disappear
Lithium and calcium channel blockers have also been reported to be beneficial, especially in chronic sufferers. However, if the chronic sufferers do not respond to these methods, then histamine desensitization and surgery to kill the pain receptors of the trigeminal nerve may be considered. Radiofrequency heating may be done to kill these pain sensitive cells. But this is used only when all the other methods have failed.
In some cases, magnesium supplements are also recommended. A chemical called melatonin has also been reported to help some by reducing the severity and frequency of headaches. A few cases were reported where a bad tooth was the cause of the headache. Removal of the tooth by root canal served to make the symptoms disappear.
Natural treatments include the use of kudzu, a flower found in Japan and China and feverfew which is a herb used in the treatment of migraine to treat cluster headaches. Unfortunately, no specific dietary treatments are known till now, just as in the case of migraine.
Other therapies which have not shown consistent results but which may be tried are acupuncture, herbal treatments, homeopathy, hypnosis, reflexology, aromatherapy, yoga and massage.
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