I've had CH for 20 years, pretty much standard episodic. I'll point out a few things that I've noticed with myself and maybe this is normal and maybe it will help someone else. I got a lot of back and neck pain during my episodes, well I've had injuries but it seemed just worse during a cluster. My wife is very supportive and helpful and would rub my neck and shoulders to help my get through. Over the years we figured there were some spots that would alleviate a little and 1 inch over would make it worse, very weird. We found an area right around my floating ribs that was really tender, there's not much there but a nerve, couple floating ribs very little muscle. Using pressure treatment there was like a knifing. This is not a spot that would normally hurt outside of my cluster episodes. The first time we did pressure therapy on the right side it was excruciating (I should mention that my CH are always the right hemisphere). Well it helped a lot, the left ribs didn't hurt much to the touch normally but when we used pressure there it was unbearable but my headache melted instantly, symptom free in about 30 seconds, 2 days later I felt one coming on and we hit it again, CH aborted and episode ended with no episodes for 4 years.
   Now I should say I've had a few minor episodes but treating the spot ends it - strait up. I would say that the episode I'm in now, my 1st real episode in 5 years is nothing like it used to be ive had 3 minor headaches in a week, all aborted when we hit the spot, I can do it myself with one of those hooked thera-canes. The lower back pain is there for sure and the rib areas are strangely tender to the touch but we hit them real hard and poof - done!
Some observations I've had
- CH seemingly affect men more something like 80% (??)
- Seem to start between 15 and 25 years old
- ER admissions for spinal injury are 90% male between the ages of 15 and 30
- Mine started a few months after a car accident around 18y/o
- I always get them about 1-2 weeks after straining my lower back (I install/repair hot tubs for a living),. A skiing crash or wipeout on my mountain bike... its hard to tell because it's always a week later or so.
- I always thought it was a muscular/skeletal issue but thought it was in my neck or at least upper back.

Well I hope this can maybe this helps one person out there, jab your thumb in your floating ribs opposite side of your CH next episode and see if it helps. Ask me for more clarification if you want, the pressure treatment hurts worse than the CH believe me but it works, even if one person out reads this and it helps them!!

LeoL,

Thanks for sharing!  Have you seen a chiropractor for your rib pain?  I'm guessing you may have a subluxation that they could fix once and for all.

I once had a CH cluster where, near the end of my 4 week stint, a had a chiropractic adjustment for my Axis bone.  The next CH I had started on the right brow as normal, but I felt it move towards the center and then to the left for the first time ever.  It didn't end my headaches, but proved to me that there could indeed be a link between subluxation and these headaches - at least a contributing factor.

Alan