Although not part of the official diagnostic criteria, many people living with cluster headache describe a low-level persistent headache that can be a precursor to full-blown cluster headache attacks. We call these “shadows.” Read patient descriptions of this unique symptom.

“Shadow pain is what we call lower level pain that presents in the same location as your CH, but is of a different nature and comes without the other issues of a closed up nasal passage, runny nose, tearing eye … My husband describes a CH attack as feeling like a spike being driven into his skull. Shadow pain feels like a very painful bruise where the spike was. Shadow pain can be debilitating as well, reaching levels as high as seven or even a little higher for him, but it doesn’t feel the same way as the CH spike.” ~ Anonymous caregiver

“Shadows feel like migraine attacks without all the nausea, light, and sound sensitivity. The biggest difference is that shadows are located only in the same eye that is affected during a cluster headache attack. Many times, using oxygen or taking a triptan will abort it. Other times, I just have to live with it until it finally erupts into a full-blown attack.” ~ Tammy Rome


  1. marleycb

    have you ever considered medical cannabinoids-specifically the CBD rich types, say 4:1 or 8:1 ratios, certainly helpful (good supporting literature), especially if your “attacks” come in the evening or early morning. This can really knock down the prodrome and/or the more sudden attack

    1. Several members have had mixed results with cannabinoids. The research is limited and not conclusive. Hopefully over time, we will get a clearer picture of the role cannabis, and specifically CBD, may play in treating cluster headache. You can find more information in our comprehensive list of journal articles and FAQs.

  2. tmeseck77

    For me this “shadow” feels like a nerve is being twisted, it doesn’t hurt as much but is bothersome and adds to a exaughsting time for me.

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