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If you have "sinus" symptoms which
bulletoccur more than once a month,
bulletlast more than three hours, and
bulletare not accompanied by a fever or greenish nasal discharge

 You probably don't have a sinus problem.  An estimated 90% of "sinus problems" are really migraine or cluster headaches which haven't been properly diagnosed.  See Is It Sinusitis?

Do you have some or all of the following sinus/allergy problems your doctor can't solve? 

Symptom Cluster Headache Migraine Headache
Attacks often ... awakens sufferer from sleep after about an hour of going to bed start with visual aura (flashing or multi-colored lights, or zigzag lines)
Pain is ... steady, severe to excruciating, always on the same side, beneath, behind or above one eye throbbing, moderate to severe
Pain located ... in and around one eye; may have tearing eye, drooping eyelid, stuffed or runny nostril, sweating over the eyebrow of affected side on one side of head
Light and sound ... distracts from pain worsens pain
When having an attack, sufferer... is active, and craves distraction from pain (such as radio or TV) doesn't want to move, and craves dark, cool, quiet
Nausea, vomiting? No Sometimes
Attacks last ... 45 min. - 2 hrs, in clusters of 1 - 3 per day for 4 - 8 weeks, then none for months or years 4 - 72 hrs
Sufferers are usually ... men (90%) women

Cluster Headache Symptoms

Severe pain, always on the same side, beneath, behind or above one eye (as though caused by a sinus problem)
Pain preceded by nasal stuffiness and/or drainage
Nose and eye on that side swollen, red and runny, eyelid may droop
Doctors only find clear discharge, and medications for sinus problems don't change your symptoms. True sinus infections have colored mucous discharge; clear discharge means no infection.
Attacks sometimes awaken you after you've been asleep for an hour or so
Pain lasts 45 min - 2 hours
Pain so severe you have thought of (or actually did) cause yourself pain elsewhere to distract you from the pain (like hitting your head on the wall)
You have an urge to move around while you're in pain (can't sit still)
You seek a distraction while you're in pain (TV, radio, etc.)
Attacks occur for some period of weeks or months, then can disappear for long periods of time (months or years)
reappear the same time of year, but not be related to seasonal allergies
You are probably a male (although some females are also affected)

You may not have a sinus problem; you may be suffering from cluster headaches.

Cluster headaches are related to migraine headaches; in general men get clusters, women get migraines.
bulletCluster headaches are the most severe pains known; individuals have been known to commit suicide to end the pain.  A headache expert described cluster headaches as "the mother of all headaches, the suicidal headache."
bulletThey're rare, affecting about 0.04% of the population
bulletA recent study showed that men who suffer chronic headaches are up to four times more likely to have a stroke than men who do not have headaches (women's results were statistically insignificant.)

You don't have to suffer!  See a neurologist and tell him or her you have symptoms consistent with cluster headaches (print this page and take it along).

bulletPrescription medications exist to reduce or eliminate the pain for both migraine and cluster headaches.  Imitrex (sumatriptan) is available in tablet form, along with newer members of the triptan family (but never for people with a previous history of strokes, heart attacks or uncontrolled hypertension.)  Other drugs are also helpful.  A recent study showed that intranasal Zolmitriptan provided significant relief; 61% who took 10 mg. had headache relief, while 42% who took 5 mg. were also pain-free after 30 minutes.
bulletOxygen therapy can stop an attack in minutes.  100% oxygen at 8-10 liters/minute for no longer than 10 minutes.  Stop after 10 minutes; longer does no good and can cause lung damage.
bulletObstructive sleep apnea may be a factor in up to 44% of cluster headache patients.  If the apnea is treated, the cluster headaches may disappear.

Tips to alleviating migraine and cluster headaches.

bulletKeep a diary of your symptoms, the foods you eat and your activities.  Examination of the results may show relationships which can lead to reduction of attacks.
bulletAvoid the "trigger" foods and products listed below.  This alone may be enough to alleviate your problem.  Attacks which tend to occur seasonally may be due to consumption of trigger foods during that season (such as hot dogs with sauerkraut and beer or cola during ball games in the summer.)
bulletMagnesium has been found to help some sufferers.  Take up to 500 mg daily (more can cause diarrhea), it's cheap and you may not have to do anything more.  The citrate version may cause less digestive upset than oxide.
bulletAvoid cigarette smoke.  If you smoke, stop or at least cut down to  pack/day, which can cut headaches by 50% without any medication; however use of a nicotine substitute prevents the improvement.  Progress may take some months to appear.
bulletRiboflavin (vitamin B2) 400 mg. daily may also be helpful.
bulletFeverfew leaf (a herb) can also help (often used in combination with the above).  Check your local health-food store.
bulletMelatonin and/or butterbur might help.  A recent study of migraine sufferers found that 3 mg. of melatonin taken 30 min. before bedtime reduced half the headaches in 78% of subjects.  Also, 75 mg. of butterbur twice daily reduced headache frequency by 48%.  While no study has been done regarding clusters, there may be similar results since migraines and clusters are closely related.

A 2003 study in the Netherlands showed that the average time to reach a correct diagnosis for cluster headaches was 3 years, but extended all the way back to 48 years!  I suffered with "sinus" pain for about 25 years, with assorted medications (sprays and pills), even sinus surgery.  I thought that my current ear, nose and throat doctor was crazy when he referred me to a neurologist for my "sinus" complaint, but the neurologist listened to my troubles, examined me, gave me a list of foods and products to avoid, and prescribed a headache medicine, Imitrex autoinjectors, which stopped the pain in 15 minutes!  I resisted injecting myself (being "needle-phobic") but the pain drove me to it, and the relief was amazing. It didn't solve the problem right away, but it was the beginning.  I now know what to expect, and what foods to avoid when I feel a series of cluster headaches may be starting; I've been able to avoid them for years but I do get occasional ocular migraines which are not nearly as bad.


Use the links below to help find answers to your problem.

bulletFamily Doctor - Cluster Headaches
bulletCluster Headaches Worldwide Support Group
bullet National Institutes of Health MEDLINEplus Medical Encyclopedia: Cluster headaches
bullet Michigan Head Pain And Neurological Institute - Cluster Headache and other Headache Types & Causes
bullet Mayo Clinic article on cluster headaches
bullet Google Search: cluster headaches
bullet InteliHealth list of headache foods
bulletAnother site concerning cluster headaches


 Cluster and Migraine Trigger Foods and Products

Food and drink

bulletCaffeine, most commonly found in the following:
bulletcaffeinated sodas (read the labels) such as colas, Mountain Dew, 7-UP Red, Sunkist Orange, Barq's root beer,  Red Fusion, dnL, Red Bull, Mello Yello, Mr. Pibb, Dr. Pepper Venom
bulletnon-decaffeinated coffee, iced coffee, coffee milk-flavoring (Coffeetime)
bulletnon-decaffeinated tea, iced tea
bullethot cocoa
bulletchocolate, chocolate syrup, chocolate ice cream, other foods containing chocolate
bulletcoffee ice cream, coffee-flavored yogurt
bulletweight-loss and food supplements which list caffeine as an ingredient
bulletFoods and beverages containing Aspartame
bulletNitrited meats (ham, bacon, hot dogs, kielbasa, coldcuts, etc.)
bulletAged and ripened cheeses such as brie, gouda, cheddar, etc., and foods containing cheese (American, Velveeta, cottage cream and fresh mozzarella cheeses are OK).
bulletMonosodium glutamate (MSG, often used in Chinese cooking, also sold as Accent and often included in seasoned salt)
bulletPickled foods, pickles
bulletMarinated foods
bulletFermented foods (which include sour cream, yogurt [including frozen], buttermilk and sourdough bread)
bulletNuts and peanut butter
bulletCertain fruits and vegetables:
bulletbeans (broad, lima, fava, snow peas)
bullet> cup daily of citrus fruits, figs, raisins, papayas, avocados, red plums.
bullet> banana daily
bulletSulfited food (this includes most wines; read the labels)
bulletSalty foods and excess salt.  Many processed food contain loads of salt; read the labels.
bulletSmoked fish
bulletSoy sauce
bullet>two eggs per week
bulletChicken livers
bulletCanned figs
bulletRed wine
bulletBeer, lager, ale, stout, porter (darker drinks are often worse)
bulletMost dark-colored hard liquor

Other Products

bulletPerfume & fragrance products
bulletScented soaps & detergents
bulletFabric softeners & softener sheets
bulletRoom deodorizers
bulletScented deodorants
bulletScented anything

Note: what you want is "fragrance free" products, which have no scent added.  "Unscented" products may have a fragrance added to mask the product's natural odor.

bulletTobacco smoke


If you found this page to be helpful to you, please let me know by sending to .  I suffered for many years with this, and hope that others will be helped by my publishing this information.

Copyright 2001-07 by Ralph G. Johnson; all rights reserved.