Migraine and cluster headaches are different types of primary headache. They share some symptoms, but migraine tends to cause throbbing pain, while cluster headaches come on quickly, and the pain is sharp, piercing, or burning.

Both migraine and cluster headache are primary headache disorders, meaning another health condition does not cause the symptoms, and they are conditions in their own right. Both cause significant pain and disruption to daily life.

This article discusses cluster headaches vs. migraine, how to identify each, and treatment options.

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Cluster headache is a primary headache disorder that often begins between the ages of 20 and 40 years. They tend to occur in clusters, with periods of remission between episodes. A change of seasons can trigger cluster headaches, which are more common in the fall and spring.

Episodes often occur overnight and wake people from their sleep. The headaches are severe, lasting between 15 minutes to 3 hours.

People describe them as burning, sharp, or piercing. The pain is usually on one side of the head, behind the eye, and may also cause a red, teary eye, runny or stuffy nostril, and facial flushing.

A person may find it difficult to stay still and lie down during an episode.

Migraine is a primary headache disorder that can cause severe symptoms. The neurological condition affects people of all ages and often runs in families.

Migraine has four phases, but people may not experience all phases. They include:

  • Prodrome: This phase can occur a day or two before the headache and may include changes in mood, appetite, and energy levels. About 7 in 10 people with migraine experience prodrome.
  • Aura: About 1 in 5 people with migraine experience an aura before the headache. This may include visual disturbances such as seeing flashing lights or zigzag lines. Other symptoms may include numbness, weakness, or tingling on one side of the body.
  • A headache: The headache is usually throbbing and can last for hours or even days. The pain is often one-sided but may switch sides during the attack. People often experience nausea and vomiting during this phase.
  • Postdrome: This is the final phase, which can last up to a day after the headache has gone. People may feel drained and exhausted.

There are similarities and differences between migraine and cluster headaches, including:

  • Pain: People with cluster headache often have pain in the area around the eye and experience a sharp, burning, or piercing pain on one side of the head. Migraine causes throbbing pain on one or both sides of the head.
  • Sensory differences: A person may experience light sensitivity with either condition. However, migraine may involve changes to vision, hearing, and speech.
  • Other symptoms: Both conditions can cause nausea, but someone with migraine may also feel dizzy and tired. Conversely, a person with a cluster headache may have a small pupil, a sweaty face, and a blocked or runny nose. Their eyelids may also droop or swell on the affected side.
  • Duration: Migraine episodes last 4–72 hours, while cluster headaches last from 15 minutes to 3 hours.

Doctors do not know the exact cause of cluster headaches but think it involves an area of the brain called the hypothalamus. Custer headache sometimes runs in families, suggesting a genetic link. Additionally, males are three times more likely to develop the condition.

Interestingly, people who smoke have an increased risk of cluster headaches. More than 8 in 10 people that doctors diagnose with cluster headaches are smokers.

People may find drinking alcohol or strong smells such as perfume or petrol can trigger an episode.

Migraine has a strong genetic component, but doctors have not yet identified any inheritance pattern. People living with migraine often find that stress is a trigger, as are hormonal or weather changes, skipped meals, and changes to sleep patterns.

Treatments for both conditions may consist of preventive measures and treatment for acute attacks.

Acute treatment

Doctors may use oxygen therapy to treat cluster headaches, as at least 66% of people respond.

Triptan medications, such as almotriptan (Axert), rizatriptan (Maxalt), or sumatriptan (Imitrex) nasal sprays, may also help with both cluster headaches and migraine.

In addition, people with migraine may benefit from antinausea medication and nonsteroidal anti-inflammatory drugs (NSAIDs) to ease the pain.

Preventive medications for cluster headaches include:

For migraine, preventive options include:

Other conditions may cause symptoms similar to cluster headaches and migraine. These include:

  • Tension headache: This common type of headache usually feels like a tight band around the head.
  • Trigeminal neuralgia: This is a type of nerve pain affecting the trigeminal nerve, which runs from the brain to the face. It can cause severe, sharp, shooting pain in one side of the face.
  • Sinusitis: This is inflammation of the sinuses, which are the cavities around the nose. It can cause pain in the forehead, cheeks, and teeth.
  • Eye conditions: Various eye conditions can cause pain in the face, including infections, ulcers, and glaucoma.

Anyone experiencing regular headaches should consult a doctor for a diagnosis. This is particularly important if other symptoms accompany the headaches, such as weakness, paralysis, or vision changes.

A doctor can help rule out other conditions and work with the person to create a treatment plan that helps them manage their pain.

Cluster headaches and migraine are conditions that often cause severe pain. Although there are some similarities between these primary headache disorders, they are separate conditions.

Both conditions cause pain on one side of the head and may cause nausea and light sensitivity.

However, cluster headache pain is sharp and affects the area around the eye. Migraine causes a dull throbbing pain, often alongside sensory disturbances.

If a person is experiencing regular headaches, they should see a doctor for a diagnosis to rule out any other health conditions and begin a treatment plan.