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Tension Headache vs Cluster Headache

By the AllHealth UK editorial teamLast reviewed Next review due Compiled from published NHS and NICE guidance. Not reviewed by a clinician.

Is it a tension headache or a cluster headache?

A tension headache is a dull, pressing band across both sides of the head, mild to moderate, and you can usually carry on with your day. A cluster headache is a sharp, burning pain on one side around the eye, severe enough that you cannot sit still, with a red watering eye and a blocked nose on the same side. Attacks last 15 minutes to 3 hours.

Immediate action required: call 999 or go to A&E if

  • One of your eyelids is drooping for the first time
  • The pupil in one eye is suddenly smaller than the other
  • A headache that started suddenly and is extremely painful
  • Headache with a seizure, numbness or weakness, confusion, loss of vision, or a stiff neck
  • A severe headache with jaw pain when eating, a sore scalp, or blurred or double vision — call 111 or get an urgent GP appointment, these can be signs of temporal arteritis

If you are weighing up whether it is bad enough to call, that is itself a reason to call. Nobody is annoyed by a 999 call that turns out to be the less serious of the two.

Tension Headache compared with Cluster Headache
FeatureTension HeadacheCluster Headache
Typical signs
  • Dull, pressing pain on both sides
  • Tight band around the head
  • Mild to moderate — you can keep going
  • No watering eye or blocked nose
  • Paracetamol and ibuprofen usually help
  • Sharp, burning or piercing pain on one side around the eye
  • Red, watering eye on the painful side
  • Drooping or swollen eyelid, blocked or runny nose on the same side
  • Restless and agitated — you want to pace, not lie down
  • Attacks at the same time of day, in bouts lasting weeks or months
How long it lastsAt least 30 minutes, sometimes several days15 minutes to 3 hours per attack, sometimes several times a day
What helpsParacetamol or ibuprofen, rest, drinking enough water, managing stressParacetamol and ibuprofen do not work. A GP or specialist can prescribe triptan injections or nasal spray, or oxygen through a mask
What to doSelf-care at homeSee a GP

Sources and further reading

This page was written from the following published guidance. All links checked 26 August 2026.

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