What should you know about cluster and tension headache?

Cluster headache is a neurological headache disorder that can bring intense one-sided pain around or behind an eye, often with a watery or red eye, blocked or runny nose, drooping eyelid or marked restlessness on the same side. Attacks can come in groups over a period of time. Tension-type headache commonly produces a steady, pressing or tightening sensation across the forehead, temples or back of the head. Neck and scalp muscle tenderness may accompany it, but nausea and strong light sensitivity are less typical.

A headache pattern can overlap with other problems, so the location alone does not establish the cause. A clinician considers the timing, duration, symptoms between attacks, medicines and medical history.

Keep a headache diary with the start time, duration, location, intensity, sleep, meals, alcohol, medicines and symptoms such as eye watering or nausea. During an attack, move to a calm environment, drink fluids if you can and avoid taking pain medicine more often than the label or a clinician recommends. Cluster-like attacks need medical assessment because standard self-care may not be enough; a GP can discuss an examination and an appropriate plan.

Seek emergency help for a sudden, severe headache, new weakness or numbness, trouble speaking, confusion, fainting, a seizure, stiff neck with fever, or a headache after a significant head injury. Arrange prompt medical review for a new pattern, steadily worsening headaches, repeated vomiting, visual loss, a painful red eye, or headaches that repeatedly wake you.

Ask whether your pattern fits cluster headache, tension-type headache or another cause; which warning signs should change your plan; which medicines are suitable for an attack; and how to record triggers and response safely.