Cluster Headache Treatment and Management Melbourne | Keilor Road Physiotherapy
▫️Written by John Keller
✅ Reviewed by Dr. Jenny Hynes on April 4, 2025
Cluster headaches represent the most intense and debilitating form of headaches, often regarded as one of the most severe pain conditions a person can endure. Cluster headaches are rare, affecting between 0.12% of the population, with men being three times more likely to suffer from them than women. The onset typically occurs between the ages of 20 and 25, though many sufferers experience significant delays in receiving a proper diagnosis. At Keilor Road Physiotherapy, we recognise the profound impact that cluster headaches can have on your quality of life and are committed to offering effective, personalised treatment strategies to help you manage and alleviate these excruciating episodes.
What are cluster headaches?
Cluster headaches are part of a group known as Trigeminal Autonomic Cephalalgias (TACs), characterised by severe, unilateral pain typically concentrated around the eye or temple. Cluster headaches are among the most intense and debilitating types of headaches. Unlike migraines or tension-type headaches, cluster headaches occur in repetitive cycles, with sufferers experiencing frequent, severe attacks that can last for weeks or months. The pain is typically sharp and stabbing, often concentrated around one eye, and is accompanied by symptoms such as eye watering, nasal congestion, and restlessness.
If you're suffering from cluster headaches, seeking effective treatment is vital for managing the pain and reducing the frequency of these episodes. While the exact cause of cluster headaches remains unclear, it is believed that the condition is related to the hypothalamus, the part of the brain responsible for regulating biological rhythms.
When it comes to cluster headache management, early intervention and a personalised treatment plan are essential. At Keilor Road Physiotherapy, we offer a range of treatments tailored to your specific needs. Our team of expert physiotherapists in Melbourne provides physiotherapy for cluster headaches, using techniques such as manual therapy, posture correction, and targeted exercises to alleviate pain, minimise symptoms, and prevent future episodes.
If you're experiencing recurrent, severe headaches, it's crucial to seek professional help for a proper assessment. Early diagnosis and treatment can significantly improve your quality of life and provide long-lasting relief from cluster headaches. Let us help you find the right treatment plan for effective pain management and recovery.
Cluster headaches are part of a group known as Trigeminal Autonomic Cephalalgias (TACs), characterised by severe, unilateral pain typically concentrated around the eye or temple. Cluster headaches are among the most intense and debilitating types of headaches. Unlike migraines or tension-type headaches, cluster headaches occur in repetitive cycles, with sufferers experiencing frequent, severe attacks that can last for weeks or months. The pain is typically sharp and stabbing, often concentrated around one eye, and is accompanied by symptoms such as eye watering, nasal congestion, and restlessness.
If you're suffering from cluster headaches, seeking effective treatment is vital for managing the pain and reducing the frequency of these episodes. While the exact cause of cluster headaches remains unclear, it is believed that the condition is related to the hypothalamus, the part of the brain responsible for regulating biological rhythms.
When it comes to cluster headache management, early intervention and a personalised treatment plan are essential. At Keilor Road Physiotherapy, we offer a range of treatments tailored to your specific needs. Our team of expert physiotherapists in Melbourne provides physiotherapy for cluster headaches, using techniques such as manual therapy, posture correction, and targeted exercises to alleviate pain, minimise symptoms, and prevent future episodes.
If you're experiencing recurrent, severe headaches, it's crucial to seek professional help for a proper assessment. Early diagnosis and treatment can significantly improve your quality of life and provide long-lasting relief from cluster headaches. Let us help you find the right treatment plan for effective pain management and recovery.
Why cluster headaches happen
Cluster headache causes are believed to result from an overactive trigeminal nerve, which transmits sensations from the face to the brain. During a cluster headache, this nerve becomes hypersensitive, triggering intense pain and activating autonomic symptoms such as red, watery eyes, nasal congestion, and sweating on the affected side of the face. The hypothalamus, which regulates the body’s internal clock, is also implicated, explaining the regular timing of attacks, often occurring at the same time each day or during specific seasons.
Kandel et al. (2023) suggest that changes in circadian rhythms and sleep cycles, particularly transitions from slow-wave sleep to REM sleep, can be potent triggers for these headaches. However, why cluster headaches happen remains elusive, with the trigeminal nucleus at the base of the brainstem playing a central role in generating the pain signals associated with cluster headaches.
The role of the neck in cluster headaches
At Keilor Road Physiotherapy, we explore the possibility that the upper cervical spine (the neck) may contribute to the overstimulation of the trigeminal nucleus, exacerbating cluster headache symptoms. The connection between the neck and the trigeminal nerve is significant, as irritation or stiffness in the upper cervical spine can amplify the pain signals and potentially trigger or worsen cluster headaches. Through a thorough assessment and targeted physiotherapy treatment, we aim to reduce this neural irritation, providing relief from cluster headaches.
Recognising the symptoms of cluster headaches
Cluster headaches are known for their excruciating pain and distinctive symptoms. About 10-15% of individuals suffer from chronic cluster headaches, with little to no remission periods, making early and accurate diagnosis critical for effective management. Recognising cluster headache symptoms early is essential for proper diagnosis and treatment. According to the International Classification of Headache Disorders (ICHD-3), the following are key symptoms to look out for:
Severe, Unilateral Pain
The pain experienced during a cluster headache is typically severe and occurs on one side of the head, often around or behind the eye. The pain can be sharp, stabbing, or burning and can radiate to other areas such as the face, neck, and temple. Unilateral pain is a defining characteristic, with each attack typically affecting only one side of the head. This is in line with the ICHD-3 criteria, which specify that the pain should not be bilateral (on both sides of the head).Eye Watering and Redness (Lacrimation and Conjunctival Injection)
One of the hallmark cluster headache symptoms is eye watering (lacrimation) on the side of the headache. The eye may also appear red and inflamed due to conjunctival injection, which occurs as blood vessels in the eye dilate. This is a common and distinctive symptom of cluster headache relief, providing an important clue for diagnosis.Nasal Congestion or Rhinorrhoea
Nasal symptoms such as nasal congestion or a runny nose (rhinorrhoea) are also frequently experienced during cluster headaches. This occurs due to the autonomic nervous system's response, leading to swelling of the nasal passages. Often, these symptoms occur on the same side of the face as the headache, which helps differentiate cluster headaches from other types of headaches.Restlessness and Agitation
Unlike other types of headaches, individuals suffering from cluster headaches often feel restless or agitated during an attack. Rather than seeking rest in a quiet, dark room, people with cluster headaches may pace, rock back and forth, or move around in an attempt to alleviate the pain. This physical restlessness is a distinctive feature that helps set cluster headaches apart from migraines or tension headaches.Duration and Frequency of Attacks
Cluster headache attacks are typically short but intense, lasting between 15 minutes and 3 hours. However, the frequency of these headaches is much higher compared to other types of headaches. A person may experience up to eight attacks per day during a cluster period, which can last anywhere from several weeks to several months. This high frequency of attacks is another reason why cluster headache management is crucial for improving quality of life.Additional Symptoms
Other signs of cluster headaches that may occur during an attack include:Ptosis (drooping eyelid)
Miosis (constricted pupil)
Sweating on the forehead or face on the affected side
Eyelid oedema (swelling of the eyelid) These symptoms are part of the autonomic dysfunction that occurs alongside the headache, further aiding in the diagnosis of cluster headaches.
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Recognising these cluster headache symptoms early is essential for obtaining the right diagnosis and starting effective treatment. If you experience any of these signs, it's important to consult a healthcare professional for a proper assessment and to discuss cluster headache treatment options. At Keilor Road Physiotherapy, we offer targeted cluster headache relief with physiotherapy, manual therapy, and other personalised solutions.
How are cluster headaches diagnosed?
At Keilor Road Physiotherapy, diagnosing cluster headaches involves a detailed assessment, including patient history, physical examinations, and, when necessary, imaging tests to rule out other potential causes.
Patient History
Our physiotherapists begin by reviewing your headache history, including the frequency, intensity, and duration of attacks. We also discuss symptoms such as eye watering and nasal congestion, using the ICHD-3 criteria to determine if your symptoms align with cluster headaches. This step helps ensure we accurately identify your condition.Physical Examination
During your consultation, we conduct a thorough physical examination, checking for autonomic symptoms like ptosis (drooping eyelid), miosis (constricted pupil), and sweating on the affected side. These signs are crucial in confirming a cluster headache diagnosis and distinguishing it from other headache types.Imaging Tests
While imaging tests are not always necessary for diagnosing cluster headaches, if required, we may refer back to your GP for a CT scan or MRI to exclude other conditions, such as brain tumours or neurological issues.
Best treatment cluster headache relief Melbourne.
The best treatment for cluster headaches
Finding the right treatment for cluster headaches is crucial for providing relief and preventing future attacks. At Keilor Road Physiotherapy, we offer a comprehensive approach to cluster headache treatment that includes medical treatments, physiotherapy for cluster headaches, and lifestyle adjustments. This multi-faceted approach ensures effective pain management and long-term relief.
Medical treatments for cluster headaches
Cluster headache medication is often the first line of treatment to manage the acute pain and reduce the frequency of attacks. The following medical options are commonly prescribed:
Triptans: These are a class of medications that help alleviate the intense pain associated with cluster headaches by targeting serotonin receptors in the brain. Triptans, often administered as injections or nasal sprays, provide rapid relief from pain during an attack.
Oxygen Therapy for Cluster Headaches: One of the most effective treatments for acute cluster headaches is oxygen therapy. By inhaling pure oxygen at the onset of a headache attack, many individuals experience significant pain relief. This treatment works by improving blood flow and reducing the constriction of blood vessels in the head, helping to relieve the pain caused by the headache.
Preventative Medications for Cluster Headaches: For individuals experiencing frequent cluster headaches, preventative medications are often prescribed. These medications, such as verapamil (a calcium channel blocker), corticosteroids, or lithium, help reduce the frequency and severity of cluster headache attacks over the long term. Preventative medications are particularly useful for people who are in the midst of a cluster period.
Supplemental Regimen: Emerging evidence supports the use of certain supplements, such as Vitamin D3, Omega-3 fatty acids, and magnesium, in reducing the frequency and intensity of cluster headaches. We can work with you to develop a safe and effective supplement plan tailored to your needs.
At Keilor Road Physiotherapy, we work closely with your healthcare provider to ensure that your cluster headache medication is tailored to your specific needs and complements the physiotherapy treatments we offer.
Physiotherapy for cluster headache relief
While medical treatments are essential for managing the acute pain of cluster headaches, physiotherapy for cluster headaches can help address underlying issues that contribute to the severity and frequency of attacks. Tension in the neck, shoulders, and upper back can exacerbate cluster headache symptoms, making neck and shoulder tension relief a crucial part of your treatment plan. Here’s how physiotherapy can help:
Manual Therapy: Joint mobilisation of the upper cervical spine and soft tissue therapy can relieve muscle tension and improve blood flow to the neck and head. By addressing the tension in the upper neck and upper body, we can help alleviate the discomfort that often triggers or worsens cluster headache pain.
Targeted Exercises: Physiotherapists at Keilor Road Physiotherapy guide you through exercises designed to strengthen and stretch the neck, shoulders, and upper back muscles. This helps to improve posture, reduce tension, and prevent the recurrence of cluster headaches. Stronger, more balanced muscles can also provide better support for the cervical spine, reducing the likelihood of pain and tension-related triggers.
Posture Correction: Poor posture can contribute to neck tension, which may exacerbate cluster headache symptoms. Physiotherapists can teach you proper ergonomic practices to reduce neck strain throughout the day, helping to prevent headaches from being triggered by muscle imbalances or poor posture.
By incorporating cluster headache physiotherapy treatment into your care plan, we can address the root causes of your pain and help prevent future attacks, providing a holistic approach to managing your condition.
Lifestyle adjustments for managing cluster headaches
In addition to medical treatments and physiotherapy, making lifestyle changes is an important part of cluster headache prevention. At Keilor Road Physiotherapy, we help you adopt lifestyle modifications that reduce headache frequency and intensity:
Stress Management for Headaches: Stress is a known trigger for many types of headaches, including cluster headaches. Learning effective stress management techniques, such as relaxation exercises, meditation, and breathing techniques, can significantly reduce the likelihood of headache attacks. Regular stress management helps to calm the nervous system, reducing the physiological triggers that lead to cluster headaches.
Diet and Hydration: Certain foods and drinks, such as alcohol, caffeine, and processed foods, may trigger cluster headaches in some individuals. By making dietary changes in collaboration with a dietitian and avoiding known triggers, you can reduce the risk of attacks. Staying well-hydrated is also important, as dehydration can be a common headache trigger.
Regular Exercise: Engaging in regular physical activity can improve overall health, reduce stress, and promote better sleep. Exercise helps to improve circulation and release endorphins, natural pain relievers that may reduce the severity of headaches. A physiotherapist can guide you in selecting exercises that are safe and beneficial for headache management, especially focusing on neck and upper back strength and flexibility.
Sleep Improvement: Poor sleep patterns and poor sleep posture can trigger cluster headaches, so maintaining a consistent sleep schedule and getting your pillow checked is essential. Ensuring you get adequate rest each night can help regulate your biological rhythms and reduce the frequency of headaches and a good pillow can minimise excessive stiffness in the upper neck.
Our physiotherapists work with you to develop a personalised plan that incorporates stress management for headaches, proper exercise, and sleep improvement strategies including a pillow assessment.
Why choose Keilor Road Physiotherapy for cluster headache treatment?
At Keilor Road Physiotherapy, we specialize in providing cluster headache treatment in Melbourne that is both effective and personalised to meet your individual needs. Our team of skilled Melbourne physiotherapists for cluster headaches has extensive experience in diagnosing and managing this painful and often debilitating condition. We understand how intense cluster headache pain can be and the impact it has on your daily life, which is why we adopt a tailored approach to treatment.
We begin with a comprehensive assessment to understand your specific symptoms and triggers. Based on this, our physiotherapists create a customised treatment plan, which may include manual therapy, posture correction, targeted exercises, and lifestyle modifications. Our goal is not just to alleviate the acute pain of cluster headaches but also to reduce their frequency and intensity over the long term.
With our evidence-based physiotherapy techniques and ongoing support, we help you manage cluster headaches effectively and prevent future episodes. At Keilor Road Physiotherapy, our holistic approach ensures you receive the best care for cluster headache treatment in Melbourne, helping you return to a pain-free lifestyle.
Book your consultation with our expert physiotherapists today for a personalised treatment plan for cluster headaches and start your journey towards lasting relief.
Tips for preventing cluster headaches
Preventing cluster headaches can be challenging, but there are several lifestyle changes and strategies that can help reduce the frequency and intensity of attacks. Here are some tips to prevent cluster headaches naturally:
Avoid Triggers: Identifying and avoiding known triggers, such as alcohol, smoking, or strong smells, can help prevent attacks. Keeping track of your headache patterns and triggers will help you manage your condition more effectively.
Maintain Regular Sleep Patterns: Irregular sleep or insufficient rest can trigger cluster headaches. Establish a consistent sleep schedule and ensure you’re getting enough quality sleep each night. A good night’s sleep can help reduce the likelihood of an attack.
Stress Management: Stress is a common trigger for cluster headaches. Incorporating relaxation techniques such as deep breathing, meditation, or yoga into your daily routine can help lower stress levels and reduce the risk of an attack.
Regular Exercise: Physical activity promotes overall health, reduces stress, and increases circulation, all of which can help prevent cluster headaches. Focus on exercises that strengthen the neck and upper back muscles to improve posture and relieve muscle tension, both of which can contribute to headache relief.
Healthy Diet and Hydration: Staying hydrated and eating a well-balanced diet can support overall health and reduce headache frequency. Avoid foods and drinks that are known to trigger headaches, such as alcohol and caffeine.
By making these lifestyle changes for cluster headaches, you can significantly reduce the frequency and severity of attacks. Our team at Keilor Road Physiotherapy is here to help you create a personalised prevention plan that fits your specific needs.
Cluster headache relief
Cluster headaches are painful and often debilitating, but with the right treatment and consistent management, you can significantly reduce their impact. Seeking professional help from experienced physiotherapists is essential for managing cluster headaches effectively. At Keilor Road Physiotherapy, we offer comprehensive, tailored cluster headache treatment that addresses the underlying causes and provides long-term relief.
If you're struggling with cluster headaches, contact Keilor Road Physiotherapy for a personalised treatment plan that works for you. Our expert physiotherapists are ready to help you find lasting relief and improve your quality of life.
References
Kandel SA, Mandiga P. Cluster Headache. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544241/
Article by
John Keller
Clinical Director | Sports & Musculoskeletal Physiotherapist
John graduated as a Physiotherapist from the Auckland University of Technology with the John Morris memorial prize for outstanding clinical practise in 2003. John has since completed Post Graduate Diplomas in both Sports Medicine and Musculoskeletal Physiotherapy with distinction, also collecting the Searle Shield for excellence in Musculoskeletal Physiotherapy.
Reviewed by
Dr. Jenny Hynes FACP
Clinical Director | Specialist Musculoskeletal Physiotherapist
Jenny sat extensive examinations to be inducted as a fellow into the Australian College of Physiotherapy in 2009 and gain the title of Specialist Musculoskeletal Physiotherapist, one of only a few physiotherapists in the state to have done so.