What kind of headache is it? Busting the cluster.....

It's rare that I can't cure a headache or greatly reduce its severity and pain in the clinic. In fact, it's only happened once. In my usual experience, acupuncture can be practically miraculous in its ability to resolve headaches quickly. And then, as I learned recently, there can be an exception to the usual.


Kerry, a 48 year old woman, came to see me complaining of three days of severe headaches in the prior week. Each one caused a visual disturbance, and one was accompanied by vomiting. They began upon the completion of a big work project. The last time she'd ever recalled having a headache this bad was when she was in her early teens.


As she laid on the table, she described a 2/10 headache in the right temple. As I inserted specific acupuncture points related to the channel her pain was on, this actually triggered a severe headache that increased in severity over the next 20 minutes. I removed all the points and allowed her to stay on the table, in the dark. She was clearly unable to drive.


Five hours later, she was well enough to leave my clinic and be on her way. I followed up with her the next day and urged her to get some imaging (an MRI) to rule out any possibility of something pressing on her temporal or orbital lobe, namely a tumor or other growth. This is really important, any time you have acute and sudden pain in the head that is not resolving it's important to rule out deeper pathology. She was able to get into a walk-in clinic, where they ruled out any brain pathology and diagnosed her with cluster headaches.


What are cluster headaches? Headaches are diagnosed as "cluster" when they are periodic and paroxysmal. Periodic mean they have periods of pain, with times of remissions. A headache every other day for a week, as example. Some people with cluster headaches experience no remission at all. Paroxysmal refers to the sudden and uncontrollable nature of this kind of headache.


It's interesting that these headaches occur more often in the spring and the fall and more commonly (5x) affect males. The pain sensation is excruciating, constant, boring or searing, "like a knife cutting through my head." They are usually severe, on one side of the head, either behind the eye, above the eye and radiating towards the front and side of the head.

They typically last 15-180 minutes with a frequency of 1 every other day to 8 in one day. An average episodic cluster can last 6-8 weeks, with remissions of 9-12 months, or in the case of Kerry - years.


Some associated symptoms include: tearing of the eye on the same side as the headache, nasal congestion, swelling or drooping of the eyelid (same side) , facial sweating, dilated pupils, agitated mood and nasal drainage.


So...what to do?? Beyond conventional treatments which include triptan and NSAIDS or analgesics which may or may not be effective (up to 30% of people with cluster headaches don't respond to conventional treatment) here are some tried and true effective naturopathic methods to try. If you experience cluster headaches, DO go see a health care practitioner who can help you and use the tips offered here as an adjunct to proper good care.


Dietary Guidelines

eating principles:

• short fasts are recommended to rid the body of toxins (5-7 day fasts)

• elimination/rotation diet, rotation diet, rotation diet expanded

• anti-inflammatory diet

• gluten-free diet

• fish oils; flax seeds and oil


therapeutic foods:

chrysanthemum flowers, mint, green onions, ginger, oyster shells, buckwheat, pearl barley, carrots, prunes, celery

• smell a whole apple (anecdotal report!)


avoid:

food intolerances

• animal fats (as arachidonic acid metabolites mediate cerebral ischemia)

• spicy foods, alcohol, excess stimulation, coffee, caffeine, chocolate, fried foods,

stimulating foods

• avoid foods containing tyramine (bananas as example)


Supplements

• 5-HTP- in doses of 100-300 mg for prevention of migraines (without SE)

esp. in children very helpful if also sleep problems

may help to improve mood and relieve feelings of depression

• omega-3 fatty acids (for migraine HA)

omega-6 fatty acids

• riboflavin- 400 mg daily as a preventive

magnesium 400-800 mg q.d. helps those with low magnesium tissue levels

ask 5 questions? chocolate? crowds? cramps? sleep? ticklish? GGT < 15?

IV magnesium of 1-3 gm over 10 min for acute

• vitamin B6- 50- 100 mg for those with histamine problems (wine, dyes, alcohol, excessive protein)

• vitamin B-complex IM every 2-10 days

vitamin B3- 500 mg at onset

• choline (cluster HA)

quercetin 500 mg/day



Physical Medicine

Exercise

relaxation breathing

• decrease frequency of migraines by regular aerobic exercise


Hydrotherapy

cold wet packs: to head, forehead and back of neck

rub fingertips on head after dipping in ice water

hot footbath: with apple cider vinegar and peppermint

severe H/A: alternate hot and cold fomentation(s) to head and face

migraine: at beginning use water flow

hot sitz bath, alternating sitz

ice pack to head

constitutional hydrotherapy

castor oil packs


Manipulation

spine: check and align: cervical- C1, C2 for occiput pain

C2, C3 for forehead pain

C6-T3 for thyroid stimulation

• Spondylotherapy: sine or concussion to C7

• Bowen, cranial-sacral, orthobionomy



Botanicals - there are lots of different herbs that can be effective for your headaches, this is where a trained herbalist can really be of help.


Homeopathy can also be quite effective with the four top common remedies being Aconiutm napellus, Anthracinum, Apis mellifica and Argentum metallicum.