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.

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.

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.

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.

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.

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


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

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.