Just in case we need further evidence that painkilling medication doesn't help CH sufferers -- Ten days ago I had shoulder (rotator cuff) surgery.  The few days immediately afterwards were very, very painful.  On the 3rd night after surgery, fully doped up on oxycontin, I had a major KIP 8 attack (I am in cycle) which broke right through the pain meds like they weren't even there.  No pain in the shoulder, just the CH.  So oxycontin does a great job on shoulder pain, but can't lay a hand on a good ole KIP 8 CH.

You've just re-affirm whats been discuss here many, many,
times in the past. We all know when blood vessels dilate in
the head, you need medication to constrict them, to get any relief. Painkillers will never achieve this. Therefore your CH
pain will remain.

Hoppy.

Note that there's no proof that vasodilation is the source of pain. Actually, there is evidence accumulating that it isn't and a change in nerve sensitivity and pain mechanisms is. Triptans and other abortives do other things besides constricting blood vessels.

Hmmm...  Just an observation mind you... but saying vasodilation is, or isn't the source of pain or that one triggers the other, obviates the possibility that they're mutually exclusive... i.e., which comes first, the chicken or the egg, vasodilation or the pain... or neither? 

There are some who opine they can occur at the same time which obviates precedence...  In other words, it's entirely possible that one may not trigger the other...

That leaves open the notion that it's also possible that something else triggers both of them.

Just a thought... Logic can be so challenging...

V/R, Batch

Hi shooky,
Their is research into the cause of CH's going on all the
time somewhere in the world, with new theories on CH's.
But in the main it all boils down to the same thing. CH's
are caused by the dilation of blood vessels which cause
the extreme pain that we clusterheads have to suffer. I
spent the best part of my adult life with the beast
paying me quaterly visits, and the only thing that would
send him packing were Migral and Cathagot both in the 
Ergotamine family of drugs, and later Imigran. These drugs
were prescribed for the sole purpose of constricting blood
vessels in both Migraine and CH sufferes to abort the pain.

Hoppy.

It's actually not as simple as classifying migraine and CH as being vascular headaches.

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

The vascular theory of migraine—a great story wrecked by the facts - Peter J. Goadsby

Whilst the article is about migraine, there is likely to be a degree of overlap with CH.

So for now this needs a lot more research to understand the true origins of CH, how it really works to result in the pain we experience and how the various medications work.

G'day Mike,
I was'nt comparing Migraine headaches with CH's. I was
just saying that Ergots and Triptans work well in treating
both Migraine and CH's.

A migraine headache is a common form of headache that is believed to occur as a result of complex interactions between the nervous system and the vascular system as well as alterations in brain chemicals. It was formerly believed that migraine headache was simply caused by vasodilatation (enlargement of blood vessels) that caused the release of chemicals from nerve fibers that coil around the large arteries of the brain. While these blood vessels do indeed enlarge, advanced imaging studies of blood flow in the brain have shown that changes in blood flow cannot be solely responsible for all features of migraine. Instead, complex processes within the nervous system are believed to initiate the development of migraine headache. For example, it is known that certain neurological pathways become sensitized and are stimulated more easily during a migraine headache, and chemicals that promote inflammation are secreted by nerves around the blood vessels.

Cheers, Hoppy.

I can see how this topic is very intriguing and important to research scientists, but for many if not most who come to this site, the question is: how can I make this pain stop? I'm a fairly bright guy who can tie my own shoes without looking, but I gotta say my real concern is what works to stop the pain and what doesn't. Why it does or doesn't work means little when I'm getting wrecked and wracked with a KIP 8. Know what I mean? blessings. lance

As far as I know, the use of steroids to treat CH was due to a theory of it being of an inflammatory source - which was never actually proved. Prior to that, it was thought that CH is kind of an allergic response - which it probably isn't.

During cycles our body does tend to produce more histamines and substances related to inflammation and vascular vassodilation (such as CGRP and nitric oxide), but it also produce more cortisol and less melatonin and testosterone. This doesn't make CH a hormonal disorder and we don't attribute the pain to any of these phenomenon.

I don't think the chicken&egg analogy fits here, because we don't know for a fact that substantial vassodilation occurs or that it is in any way connected directly to the pain and not a secondary side effect.

Before I was formally diagnosed and visiting my Primary Dr's office and E.R. I remember being prescibed Hydrocodone, Midrin, Darvocet, and those wouldn't even touch it. I too have had 3 knee surgeries and shoulder surgery and yep while those deal with that pain well, those narcotics don't scratch the surface of a CH.  I don't know why but frustrating they don't.

wimsey1 wrote on Dec 2^nd, 2013 at 8:09am:

I can see how this topic is very intriguing and important to research scientists, but for many if not most who come to this site, the question is: how can I make this pain stop? I'm a fairly bright guy who can tie my own shoes without looking, but I gotta say my real concern is what works to stop the pain and what doesn't. Why it does or doesn't work means little when I'm getting wrecked and wracked with a KIP 8. Know what I mean? blessings. lance

Well said.  The collective knowledge, reason, experience, and intuition represented by the folks who are this site is unrivaled, IMHO.  Humble as it may be, I am more than a casual observer of human nature.  Take a bow, everyone.  During PF times, I tend to 'ride the wave' and deeply enter my denial stage, oddly comfortable in the knowledge that the unwelcome guests will again revisit - just not tonight.  During cycle, however, I ponder more on this peculiar mystery of life called CH.  As for "painkillers", my considered opinion is that marketing has surpassed cogent explanation in the description of these chemicals.  Many of these are not pain killers, but pain signal attentuators, many acting to de-intensify (is that a word?) the significance of the signal at its terminal/interpretive point.  That doesn't make them bad, it's just that meaningful conversation is difficult to have, even (especially) among those who have attained some measure of notoriety which qualifies them to some designation of "expert".  Lost, I fear, is the civility of conversation among such "experts", whose objective, it seems to me, is often to elevate his/her own significance by dismantling the impact of others.  A bit overstated, maybe. In this forum, we are truly blessed to have a group that does not care to whom credit goes, only that our member sufferers get some direction in the reduction of the pain while those involved in research and treatment protocols gain understanding that leads to some improvements in treatment. 

Gads, I'm wordy.  BTW, did anyone guess that I had my first PF night's sleep in 2 and a half months?  Oh, yeah.  Ride the wave, baby.  Thinking of you all,

TJ

Beautifully written TJ, hope it's the start of a LLOONNGG pain free wave for you.

Joe

I wrote, #4.
I spent the best part of my adult life with the beast
paying me quaterly visits, and the only thing that would
send him packing were Migral and Cathagot both in the 
Ergotamine family of drugs, and later Imigran.

I wrote, #6

G'day Mike,
I was'nt comparing Migraine headaches with CH's. I was
just saying that Ergots and Triptans work well in treating
both Migraine and CH's.

Hoppy.

For the past 3 years I've had headaches, it seemed one thing would work and then it didn't.  Verapimil barely worked, I low calorie, high calorie, low salt, high caffine, high exercise, no exercise, moving, vacations to different parts of the world, meditation, yoga, swimming, walking, breathing exercises, oxygen, anti-depressants, redbull, coffee, no alcohol, no coffee,....  the only thing that dulls the pain until the cluster cycle has ended and brought relief 95% of the time within an hour was hyrocodon-ibuprophen and cortosterois together.  Just 1 of each and headache was gone, sometimes for months.  I don't take anything if I don't have the headache.  I know one day I won't ever have a severe headache like this again.  Right now I have the headache every day at 3am until about 5am or 9am since Monday and I have nothing to take.  I can't keep my 3 part-time jobs if I'm exhausted from lack of sleep.  It took a whole year trying different meds, differnt things nothing worked, I had constant daily headaches, 3 times a day, 4 hours each until mom said here try one of these and she was right that med combo still works but I cannot take it everyday I understand and it's not a great solution but hopefully I will either find something non narcodic non steroid that will work or these headaches will end.