Migraine vs. Cluster Headache: Pain Patterns and Treatment

Both are primary headache disorders causing severe pain, but they differ fundamentally. Migraines produce unilateral throbbing pain with nausea and light sensitivity, lasting hours to days. Cluster headaches cause excruciating, stabbing pain around one eye in shorter but more intense attacks.

Key Differences at a Glance

Pain Location
Migraine
One side of head, temple, or forehead
Cluster Headache
Strictly around or behind one eye
Duration
Migraine
4-72 hours
Cluster Headache
15 minutes to 3 hours
Behavior
Migraine
Patient lies still in dark, quiet room
Cluster Headache
Patient is agitated, pacing, restless
Autonomic Signs
Migraine
Nausea, photophobia, phonophobia
Cluster Headache
Tearing, nasal congestion, eyelid drooping on affected side
Gender
Migraine
3x more common in women
Cluster Headache
3-4x more common in men

Shared Symptoms

  • Severe unilateral head pain
  • Sensitivity to light

Unique Indicators

ONLY Migraine
  • Aura (visual disturbances)
  • Nausea/vomiting
  • Worse with movement
  • Long duration
ONLY Cluster Headache
  • Restlessness/agitation
  • Eye tearing and redness
  • Nasal congestion on one side
  • Clockwork regularity of attacks

Professional Diagnosis

Both are diagnosed clinically based on ICHD-3 criteria. The behavioral response to pain (lying still vs. pacing) and autonomic symptoms are key distinguishing features.

Treatment for Migraine

Acute: triptans, gepants, NSAIDs. Preventive: CGRP antibodies, topiramate, beta-blockers.

Treatment for Cluster Headache

Acute: high-flow oxygen (100% at 12-15L/min), injectable sumatriptan. Preventive: verapamil, galcanezumab, short courses of corticosteroids.

When to See a Doctor

See a headache specialist if headaches are severe, frequent, or not responding to OTC medication. Seek emergency care for any new severe headache pattern.

Not sure which one you have?

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Medically Reviewed for Accuracy

Medical Advisory Board
Last reviewed: March 20, 2026

Content is aligned with established clinical guidelines from authoritative medical institutions, including MedlinePlus (U.S. National Library of Medicine), the CDC, the NIH, and the NHS. All content is reviewed by our medical advisory board for accuracy and safety.