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The pain of cluster headache is its defining and most dramatic feature. This pain comes on without warning (no forewarning symptoms such as the aura in classic migraine) and may begin as a burning sensation on the side of your nose or deep in your eye.

The pain peaks in just a few minutes. People describe the feeling as having an ice pick driven through your eye. They use words such as "excruciating," "explosive," and "deep." This stabbing eye pain carries with it a rapid electrical-shocklike element, which may last for a few seconds, and a deeper element that continues for a half-hour or longer. The pain almost always begins in your eye and always on 1 side of your face. Interestingly, for most people the pain stays on the same side of the face from cluster to cluster, while in a small minority the pain switches to the opposite side during the next cluster.

In addition to its one-sidedness, other characteristics separate cluster headaches from other headaches.

• The headaches commonly come on just after you go to sleep.
  
  
• Often the eye on your affected side will tear.
  
  
• Your eyelid on the affected side will droop.
  
  
• You will experience one-sided nasal stuffiness and runny nose.
  
  
• Cluster headaches have seasonal variations. Most attacks occur in January and July, where the days are in turn the shortest and longest.

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