Hi;

I was wondering about the pain associated with cluster. Does the pain lead to atonomic activation or does the autonomic activation lead to the pain?

Thanks

My guess is neither.
We have pain, we have autonomic activation.  Neither caused by the other but by a messed up hypothalamus.

Bob P wrote on Apr 24^th, 2013 at 7:47am:

My guess is neither. We have pain, we have autonomic activation.  Neither caused by the other but by a messed up hypothalamus.

That would be my guess too...

Joe

I find this a curious question. Autonomic activation, of the type displayed by hypoglycemia, includes sweating, pallor, trembling, etc. I don't experience these at all. I do feel a compulsion to walk or move which is something I think is quite different. blessings. lance

Just read a paper this morning that said that the swelling perceived on CT/MRI associated with clusters happens AFTER pain is noted, which makes me wonder whether the inflammation occurs in response to the pain instead of the other way around.  So does the autonomic system generate neurotransmitters that create pain, then the vascular system responds to that stimulus?  All I can say is, after 30 years of these things, it's so wonderful that medicine is actually getting a bead on these monsters and that I can be confident that as bad as the current episode I'm suffering is, it will be over, hopefully sooner than later!

Interesting.  I do get the pallor, sweating, and trembling.  Not pretty along with my screaming in pain! 

I find this a curious question. Autonomic activation, of the type displayed by hypoglycemia, includes sweating, pallor, trembling, etc. I don't experience these at all. I do feel a compulsion to walk or move which is something I think is quite different. blessings. lance[/quote]

wimsey1 wrote on Apr 24^th, 2013 at 8:35am:

I do feel a compulsion to walk or move which is something I think is quite different.

It is amazing how the thought of not moving during a CH is so common and in complete contrast to a migraine where the opposite is true. Since I get both migraines and CHs my supporter often asks me which it is (no doubt as she really hopes it isn't the start of a new CH cycle). To me it is so obvious, not just from the pain level but from my need to move or not to move.

What got me wondering was I remember reading about a condition called reflex sympathetic dystrophy(RSD). It is a condition in which a person injures the sympathetic nerve in a limb and leads to over-activation of this nerve pathway, leading to pain and autonomic response. The pain is unique in that is is coming from the sympathetic nerve pathway. That got me wondering about the pain mechanism in cluster headache, since it too has a sympathetic component.   

Mike NZ wrote on Apr 24^th, 2013 at 5:12pm:

[quote author=5E40445A4C5018290 link=1366728472/3#3 date=1366806929]Since I get both migraines and CHs

Hi Mike,

I feel sorry for you being “blessed” with both migraines and CH’s :(

I often get the reaction (like many of us I guess) from people suffering from migraines that they too have something “similar” which is very painful, I often wondered: Are migraines really that different?

I mean  I know about  the differences in nausea, having to lay down and getting away from light and noise as opposed to head-banging, dripping nose and eye.  But is the pain-level really that different?

P.

Having learnt to deal with CH gave me a huge head start when learning to deal with migraines. So many of the same things apply to both, like working with a headache specialist (I saw the same one as for my CHs), educating myself about migraines, getting a good preventive / abortive and learning my triggers.

But for the headache itself, they are quite different in many ways. The location of the pain is identical being around my right temple but whilst my CH pain is just pure pain, the migraine pain is more a throbbing pain. The pain levels themselves are a lot lower, with the most painful migraine I've had being around 7 on the Kip scale, this is a whole lot less than many of the CHs I've had. Most migraines I can just keep working through, which isn't something I can do with a CH even at the same Kip scale. There is something about CH pain that just grabs your attention.

I'd have multiple migraines rather than have one CH.

Although I'm lucky with now being pain free from CH for over a year (vitamin D helps a LOT) and with migraines I'm down to one every other month or so.

So they are different, but they can have quite an impact on quality of life.

Hi Mike,

Many thanks for sharing this insight - and glad for you you are PF (at least for CH) for over a year now!

Best regards,

P.