Tension headache and cluster headache: how they differ

Tension-type headache tends to feel like pressing or tightening across the head and may be linked with neck or shoulder tension. Cluster headache presents with intense pain on one side, commonly around or behind an eye, and may cause tearing, a blocked or runny nostril, eyelid swelling, or marked restlessness on that side. Attacks often follow a repeated pattern over a period, but symptoms overlap with other headache disorders. A clinician diagnoses the pattern rather than relying on pain intensity alone.

Record the start time, duration, side, location, associated eye or nose symptoms, and whether attacks occur at similar times. During a possible cluster attack, do not drive yourself if the pain affects vision or concentration. Arrange medical assessment promptly because cluster headache often needs prescription treatment and a plan for future attacks. Avoid alcohol if it appears to trigger episodes, and do not borrow another person's medicine.

Get urgent help for a first or sudden severe headache, new weakness, confusion, fainting, seizure, fever with a stiff neck, or a painful red eye with vision change. Seek prompt assessment for repeated one-sided attacks, facial or eye symptoms, or a headache that is changing in character. These features need evaluation even when previous headaches were mild.

Ask whether the timing and one-sided symptoms fit cluster headache, migraine, or another cause, and which treatment should be used at the start of an attack. Share your diary, alcohol or sleep links, eye and nose symptoms, and any medicines already tried.