The pattern of cluster headache attacks earn their name: episodic cluster headaches consist of active periods that may last days or even months, during which headaches occur in “clusters” every other day or as frequently as eight times per day. Headache-free remissions can last months or years.

During active periods, factors that may trigger attacks include alcohol, high altitude, air travel, bright sunlight, exertion or foods, especially foods high in nitrites. Drugs that dilate the blood vessels, such as nitroglycerine and various blood pressure medications, can also set off an attack. When the cycle is inactive, these triggers usually have no effect.

Cluster headache pain generally resides on one side, behind or around the eye or in the temples, and may be accompanied by hyperactivity, congestion, swelling and eyelid drooping or swelling. The pain may fluctuate before it subsides. Care focuses on controlling pain in acute attacks, preventing recurrences and minimizing the impact on daily functioning. Treatment usually consists of pain relief and headache prevention medications, but may include nerve injection, radio-frequency therapy or oxygen therapy.

Cluster Headaches most commonly occur in men from 20 to 40. People with cluster headaches tend to be sociable, active and responsible, so cluster headaches are sometimes called “the executive headache.” Because these headaches can be very disruptive, patient education and support groups are often helpful and comforting.

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Consider the possibilities:

Seemingly unrelated problems sometimes bring headaches on. Dental disorders like cavities or abscesses, eyestrain or infections are common culprits. When your head hurts, consider whether the ache could have started somewhere else.

De-Stress your life:

95% of headaches are brought on by tension, research shows. In most cases, its not a tense situation, but how you respond to it. Attempt to manage your stress to keep those pesky headaches at bay.

Go with the flow:

One technique found to be particularly useful in dealing with headaches is visualization exercises in which you “go with the flow” of pain. Most people by fighting it. This may make the pain worse. If you flow with the pain, instead of fighting it, you give it the opportunity to flow right out of your body. Try this easy method: In a quiet room, lie on a carpeted floor or a bed. Close your eyes. Imagine yourself standing at the top of a stairway looking down into a beautiful, peaceful place. Slowly count backward from 10 to one. On each count, take a deep breath and imagine yourself descending one step. Go ahead and notice the pain, but continue walking down the steps.

As you take the last step down, notice that you have entered a beautiful garden filled with fragrant flowers, beautiful trees and a sparkling stream. Continue to breathe deeply, walk slowly toward the stream. Stand or sit by its side while you watch and listen to the gently rippling waters. Now imagine your headache pain connecting to and flowing into those waters. This may hurt, but just try to casually notice the hurt.

As the pain begins to flow, notice how the river gently washes it away.

Don’t drink too much:

Alcohol constricts the blood vessels in your brain. More than a drink or two can constrict them to the point of pain. And excessive drinking, of course, often leads to the mother of all headaches, the hangover.

Don’t smoke:

Smoking constricts your blood vessels and fills your lungs with carbon monoxide instead of oxygen. If that doesn’t give you a headache, some of the numerous other poisonous ingredients may do the job. Smoking injures your air channels, which can make you prone to sinus headaches.

Brush it away:

A simple scalp brushing can help treat and even prevent headaches. Use a brush with firm bristles. Start at the front of your head. Instead of long brush strokes, move the brush in little circles in one spot, then move it down to the next spot and repeat until you’ve brushed your entire scalp.

Sleep just enough:

No two people are exactly the same. For some, too much sleep can sometimes cause headaches. In fact, midday naps are notorious for bringing migraines. On the other hand, for some people sleep is the best antidote for a headache.

Stand up straight:

Poor posture, especially in your shoulders and neck, can scrunch up muscles and give you a headache. Practice good posture. Throughout the day, pay attention to how you’re sitting or standing and correct yourself if necessary.

Stretch your face:

A little muscle action can counteract tension in your head. Act like a kid: make weird faces to stretch your mouth, cheeks and forehead.

Take herb and homeopathic medications:

A nice, warm cup of rosemary tea can relieve a headache. For something more medicinal yet altogether natural, a homeopathic pharmacist or physician can prepare you a special concoction. Natrum muriaticum is said to relieve throbbing. China officinalis is used to treat light-or odor-induced headaches.

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Pain centered in the nerves and muscles running throughout the face and neck, as well as poor habits the discomfort may cause, can trap sufferers in a painful feedback loop, with head pain triggering jaw and neck pain and vice versa.

“Headaches and toothaches all transmit through the trigeminal nerve, the largest sensory nerve in the head that supplies the external face, scalp, jaw, teeth and much of the intra-oral structures,” Clark says. “Pain in one branch of the nerve has the potential to activate other branches of the nerve, and when that pain is chronic and sustained, it is more likely to trigger a sequence of events that might lead to a headache. In people who have headaches, a continuous, sustained toothache can easily trigger one of the episodic headaches such as migraines.”

Besides the close anatomical links between head, face and jaw pain, reflexive behaviors caused by pain and tension such as jaw clenching and muscle tightening can exacerbate and transfer pain.

“There is a good deal of interconnectivity between the orofacial and craniocervical systems; for example, when you clench your teeth you contract your neck muscles inadvertently,” Clark says. “When patients have an acute neck injury they often start holding tension in their teeth, and jaw muscle pain will occur. When you have a chronic toothache or bad temporomandibular joint, this may also cause bracing and guarding in the muscles on the same side of the jaw and in the neck.”

When head and face pain spring from tooth or jaw joint injury, such as when a patient unknowingly clenches or grinds their teeth for long periods of time and damages tissue inside and below the teeth, it can be difficult for a physician to decipher the cause of the pain, he says. That’s where a dentist with a trained eye for the medical and behavioral causes of orofacial pain comes in.

“In general, headaches don’t have physical signs, and diagnosis is all related to the history and pattern of the pain,” Clark says. “If the patient is being treated for the migraines, tension headaches or sinus pains and the medications or other methods of treatment given by the physician are not effective, they are often referred to a dentist for evaluation. At the Orofacial Pain and Oral Medicine Center, we actually receive a number of patients from physicians who want us to check the teeth and the jaw joints for problems.”

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