Up until about a year ago, I had never heard of cluster headaches. I think that's one of the great challenges for those who are dealing with them. They are not well known, thus treatments aren’t well funded and as it stands currently, there is no known cure.

I enter the conversation on pain at a different angle. When a new client walked into my office hoping to find a solution for his cluster headaches, I was optimistic and willing to test my process on a new category of pain.

Within 90 to 120 days, we had made serious and definitive improvements to his cluster headache patterns. Within 6 months, we both felt that we had them under control.

Due to the severity of these pain symptoms and my history of dealing with migraines, I was particularly motivated to try to find others that I may be able to help with this new philosophy. That's when I came across this video:

After watching the entire video, I reached out to Jackie in hopes of connecting and potentially helping her find relief as well. For the past few months, Jackie and I have been working together to help solve her cluster headaches once and for all. In light of that effort, Jackie flew out to New York City to record a very special podcast with me, where she can lay out her experience and I can lay out my theory in hopes of getting it into as many hands as possible.

This article was written for those suffering from cluster headaches. I wrote it with the intent of being as thorough and in-depth as possible. I didn't want to hold back any information.

I remember standing in my family room. We had a big window seat that consisted of a large ledge where we would drop our backpacks off after school and a big window looking out into our front yard. That’s where I was standing. 

It was February of 1995. I remember that because I was holding the February edition of the Ranger Rick Magazine, a nature magazine for kids.

As I was standing there, I remember feeling a small tug behind my eyes. I had never felt this before and I didn’t think much of it, so I continued flipping through the magazine.

But soon, that tug turned into a pull. And before long that pull turned into an unrelenting pain. It genuinely felt as if someone was stabbing the back of my eyeballs.

As a seven-year-old, I was completely unprepared for this. I began to cry and ran to my Mom for help. She gave me some basic over-the-counter medication and sent me to my room to lie down in the dark, but by this point, the increasing pain was a runaway train. There was no stopping it.

About two hours after that first tug, I ran to the bathroom and threw up. 

Finally the pain subsided.

This was my first ever migraine headache.

Over the next few years, my parents and I searched for solutions. Most over-the-counter medication had no effect whatsoever and our family doctors suggested that I simply drink more water or stay out of the sun. 

As the migraines became more regular, I became attuned to the warning signs. I knew that prolonged sun exposure and dehydration were in fact triggers, so I was constantly aware of how much water I was drinking and how much time I spent outside in the sun. 

At some point, I stumbled upon a migraine specific, over-the-counter pill that worked if I caught it in time. So my Mom bought me a tiny yellow pill container and put a few capsules in it and packed it into the back pouch of my backpack, so I always had access.

“Did you pack the migraine medicine?” she would ask me each time we were about to leave home. 

If I happened to not catch the migraine in time, however, there was nothing on earth capable of stopping it. There were only two possible outcomes. The first possibility was that the pain would get so bad that I would throw up.

I remember vomiting in my friend’s front yard during my middle school days and I remember throwing up in the bushes outside of our local pizzeria where my Little League team was having their end-of-the-year pizza party. 

The other possibility was that I would somehow fall asleep. As soon as I realized that the pain had crossed the threshold and no medication would work now, I would lie down in a dark room, crank the air conditioning and pray that I would fall asleep. Sometimes I did. 

Migraines were simply part of my life. Every few weeks, I would feel that familiar tug behind my eyes and my whole world would come crashing to a stop. Whatever I was doing took a backseat to the immediate need to deal with this looming crisis. 

In 2013, however, everything changed.

I was in my first year as a Strength and Conditioning Coach for the Arizona Diamondbacks. It was my very first job out of college. I was beyond excited to have such a cool job but also very self-conscious about how unprepared I was for a job like that.

All of my colleagues had dozens of certifications, college degrees and experience, whereas I had a journalism degree. In that first season, I decided that, I may not know much about exercise science, but I can bring great energy every day and do all the little things. Each morning I would rush out to set up the cones for stretch. I didn’t need a college degree for that!

Well, as fate would have it, a few weeks into that job, that all too familiar tug behind my eyes knocked on the door. 

I was in a panic!

I knew what this meant!

I knew it would only be a matter of time before I was paralyzed with pain. If I didn’t figure something out in a hurry, I was going to have to go home, crank the air conditioning and pray that it would pass.

Next door to my office was the Diamondbacks medical office. It was a big open room where players would come to get their various injuries treated. It was not uncommon for players to have flu-like symptoms or a headache of their own, so they often had a variety of over-the-counter meds available.

I walked in.

When I opened the door, I remember seeing a bunch of players laid out on training tables getting work done. Right in front of me was one of our veteran Athletic Trainers working on one of the pitchers.

“Hey,” I said as he and I made eye contact, “Do we have anything for a migraine?”

He laughed.

“Yea,” he began, “We have Andrew.”

This annoyed me. I wasn’t in the mood to play games. I was desperate and genuinely concerned that I would leave a bad impression on my bosses because I had to leave early because my head hurt. 

Andrew, however, was our medical director and our resident genius. He was known for his “voo-doo” style treatments. It had become routine for a player to come into the training room with some serious pain and walk out feeling like a million bucks a few short minutes later. 

Andrew looked up at me, “Give me five minutes and I’ll come see what I can do.”

I was willing to do anything.

Five minutes later, Andrew came strolling into the weight room and asked me to lay down on one of our massage tables. I complied.

He began a battery of tests, exercises and stretches. I had no idea what he was doing. I was just hoping it would work.

At one point, he asked me to close my eyes and he placed his finger on my forehead. He asked me to keep my eyes shut, but follow his finger with my eyes. 

This felt ridiculous but I followed instructions.

“Ahhh!” he blurted out, “I got it!”

He said it with confidence.

“Lay on your left side in the fetal position,” he instructed.

I assumed the position and then he asked me to lift my right knee in the air (like a clamshell exercise). 

“At some point in the next few moments,” he started, “I’m going to push your right knee down, don’t let me.”

I waited…and waited…and BOOM, he jammed my knee down and I reflexively shot it back up.

“There,” he said, “Stand up and tell me how you feel.”

I was curious. 

That might be an understatement. 

I had just spent 5-10 minutes going through a bunch of bizarre exercises and he performs a glute activation technique to me and this is supposed to cure my HEADache?

I spun to my feet and slowly began walking.

My skepticism didn’t last long.

Over the next few minutes, like someone turning down the volume, that familiar tug behind my eyes began to fade away. 

I want to pause right now to emphasize to you just how profound this moment was. Up to this point, I had suffered for roughly fifteen years with debilitating headaches. 

Migraines had been woven into the fabric of who I was. It was just something that was a part of my life and something I would always have to deal with.

And in the snap of a finger. Or in this case, a jam of the knee, suddenly there was light at the end of the tunnel.

I was emotional.

“Dude!” I said to him, “What did you just do to me?”

He laughed.

“I’m serious man,” I continued, “You have no idea how big of a deal this is to me. You gotta explain to me what you just did.”

He thought for a moment and replied, “Ahhh, it’s too complicated to explain.”

I could not accept that.

“You HAVE TO tell me what that was,” I pleaded, “Dumb it down, give me SOMETHING!”

He paused, clearly trying to put the pieces together in his head to try and explain it in a way I could understand.

“It’s just too complicated,” he punctuated.

This is where my story begins. 

Until this moment, I had been stuck, like everyone else, in the world of conventional medicine. The doctors were the experts and if they didn’t have the answers, no one did.

But on this sunny afternoon in Phoenix, Arizona, I was opened up to the possibility that there may be answers out there that the “experts” don’t know about. 

I decided then and there, that I would stop at nothing to find those answers.

As a lifelong migraine sufferer, headaches have always been the thing I am most motivated to solve.

If your knee hurts or your shoulder hurts, you can carry on. But if your headache reaches a certain threshold, you simply cannot.

There is no pain like head pain. It’s all consuming.

Back in 2013, when my colleague performed this magic on me and cured my headache, it was the first time I realized that their may be some science out there that could help me. Over the next decade, I set out on a personal crusade to dig up that science and learn it for myself.

After 13 years, I am overjoyed to share that migraines are no longer a part of my life and haven’t been for many years.

What I’m going to share with you in this article is everything I have learned in hopes that it can help you solve your own.

Cluster headaches are widely considered one of the most painful conditions a person can experience. Some patients rate the pain higher than childbirth or kidney stones, and in medical circles they're sometimes nicknamed "suicide headaches" because of how severe the pain can get. Here's what sets them apart.

The Pain Itself
It's a sudden, severe, one-sided pain centered around or behind one eye, or in the temple. It builds fast, often reaching peak intensity within 10-15 minutes and is usually described as boring, stabbing, or burning, unlike the throbbing pain of a migraine. Attacks typically last 15 minutes to 3 hours if untreated.

Why "Cluster?"
The name comes from their pattern: attacks occur in cyclical periods called "cluster periods," which can last weeks to months, during which a person might have one to eight attacks a day. These cluster periods are often followed by remission periods that can last months or years. Many patients also notice a striking circadian rhythm where attacks often strike at the same time each day, frequently waking people from sleep 1-2 hours after they fall asleep.

How They Differ from Migraines
A few key contrasts:

Why the Pain is so Extreme
The leading theory involves the hypothalamus, the brain's internal clock — its activation is thought to trigger the trigeminal-autonomic reflex, a pathway that both generates the intense pain signal and produces those autonomic symptoms simultaneously. There's also a strong vascular component: dilation of blood vessels around the trigeminal nerve is believed to contribute to the pain. The combination of a highly pain-sensitive nerve pathway, rapid onset, and the autonomic "storm" happening at once is thought to be why the pain registers as so overwhelming compared to other headache types.

Treatment Differences
Because standard oral painkillers act too slowly for how fast these attacks peak, first-line abortive treatments are things that work within minutes: high-flow oxygen via mask, or injectable/nasal triptans. Preventive treatment during a cluster period often involves verapamil, and short courses of steroids or nerve blocks are sometimes used to break a cycle.

There is a classic testing protocol that Strength and Conditioning Coaches have been following for decades. It’s called the Functional Movement Screen.

Way back when I was playing college basketball, our team’s performance coach would take us through the FMS at the beginning of each school year to see where we stood.

The very first assessment is the Deep Squat Test. You can see the test here along with usual modification that everyone uses by elevating the heels.

The FMS instructors taught us all that when someone couldn’t achieved a perfect deep squat that it was probably an ankle flexibility issue. When you elevate the heels, you give the ankle a little more breathing room. If, after you elevate the heels, the body can now squat fully, it is confirmed that the ankles were the limiting factor.

Next, the instructors provided a list of corrective exercises to increase the range-of-motion in your ankle joint.

Back in 2013, during my first season as a Strength and Conditioning Coach in professional sports, I noticed a big problem with this.

No one’s ankles ever got more flexible.

In fact, I saw this theme play out across many of the accepted practices taught by most strength and conditioning coaches.

This is where I deviated from the traditional pathway.

Where all of my colleagues were typically regurgitating a pre-scripted template that was given to them in a text book, I had no such training. I had a degree in journalism. I was a blank slate.

I was just trying to see what actually worked. What delivered results. To my surprise, the results-oriented approach was dramatically different than what was being taught in schools.

Over the next decade, I slowly migrated from sport performance to alternative medicine. And as I became more and more focused on chronic pain, the same themes started surfacing again.

What traditional medicine was prescribing for chronic pain didn’t make any sense to me. Most of the accepted practices centered around the symptom. Drugs were prescribed and procedures were recommended that revolved entirely around making the pain go away.

But what about the source? Why are they in pain in the first place?

Sure, I could give someone a nerve ablation procedure where we literally fry the end of a nerve so that it stops producing a pain signal, but what have we accomplished? The body is still in disarray, it’s just not barking at us anymore.

I began building my own philosophy behind chronic pain that looked at the body as a collection of systems rather than isolated parts. I began training all four systems at once and treating each client as if they were an NBA player striving for elite performance.

What we discovered was that a body at peak performance is not a body in pain.

We weren’t dealing with simple cases either. We were getting the worst of the worst. Several of our clients had suicidal level pain but our success rate was astonishing. Over 92% of our clients were reporting dramatic reduction in symptoms if not complete recovery over the course of our program.

We’re talking decades of pain wiped out in a few months. Sometimes faster.

It was the consistent delivery of these results that continued to give me the confidence to take on more and more complex cases.

A client of mine came in complaining of some discomfort in his eyes. He was a sport performance client training for an Ironman when this random symptom popped up.

For all of our athlete-centered clients, little things like this tend to pop up. It’s just the nature of training your body to extreme levels of performance. One of my best skillsets is being able to get rid of those random little aches and pains in just a few minutes.

In this case, I knew exactly what to do. I coached him through a single corrective exercises and erased the pain.

He was in shock.

He had no clue how these exercises can have such a global impact on something like vision.

“You know,” he said, “Someone I know has these things called cluster headaches. Do you think you have something for that?”

I had never heard of cluster headaches, but being that I started in this field because of my own severe headaches, I was excited to learn more.

Later that evening, I opened ChatGPT and start learning everything I could about cluster headaches.

I learned that they are commonly called “suicide headaches” because it is thought to be the highest level of pain a human can experience.

I learned that, while some treatments seem to help, this condition remained largely mysterious.

What struck me most was the symptoms are always just on one side of the head. I had studied asymmetric pain very deeply and considered myself the absolute best in the world at dealing with it and my increasing confidence with cases of greater and greater difficulty led me to agreeing to meet my client’s friend.

He came in a week or two later and laid out everything he had experienced. The symptoms, what triggers it, where the pain starts and where it travels as it grows.

Despite the mystery surrounding clusters, this sounded obvious to me. All of the symptoms and locations of the pain made perfect sense to me. For someone in the typical dysfunctional patterns (I will explain all of this shortly), this was normal. The only thing abnormal was the severity of the symptoms.

This document is intended to be exhaustive. If there is anything I’ve learned about cluster headache clients is that they are desperate for a solution, they’ve tried everything and I want to be respectfully thorough with my breakdown.

The following is a link to a PDF document called Predictable Pain. It is not a short read but, if you or someone you love is dealing with this, you must read it. As far as I’m concerned, these pages contain a legitimate cure for a large percentage of cluster headache patients…if not all of them.

Before you download and read it, let me give you a little overview.

The body holds a few secrets that, for whatever reason, most people don’t know about it. I learned about it from a small physical therapy clinic in Lincoln, Nebraska. Every time I bring this up in a presentation or lecture, doctors, coaches and specialists alike grab me afterwards to tell me that they have never knew this.

Anatomically, your body is not the same on the left as it is on the right. It’s asymmetrical.

You have two lobes of lungs on the left and three lobes on the right.

The right diaphragm is bigger, more muscular and has larger attachments than the left side.

Your left brain specializes in language, logic and sequential tasks. While the right brain excels in spatial awareness, holistic thinking and emotional nuance.

Because of these asymmetries, one side of the body naturally has more leverage than the other. That side is ALWAYS the right side.

This is where dysfunction quietly begins and because we are all anatomically the same, the pathway of dysfunction becomes very predictable.

In this eBook, you will learn:

Click Here to Download Predictable Pain

The remainder of this document will operate under the assumption that you already know these patterns. It would be a great idea to download a copy of this manual to your computer so you can have it as a reference document.

Now that you have read Predictable Pain, you should have a baseline understanding of the four major patterns of dysfunction that we all tend to find ourselves in. These patterns are…

When you step with your right foot, the muscles of right single leg stance turn on. At this point, your entire body should shift into…

When you step with your left foot, the muscles of LEFT single leg stance should turn on which would produce…

These fancy names are really just a scientific way of describing how your body moves while you walk.

The problem that Predictable Pain is attempting to outline is this: because of the anatomical bias towards the right side, the Left AIC, Right BC and Right TMCC patterns never shut off.

Here is a discussion I had with Neal Hallinan on this unique perspective on anatomy and how these natural asymmetries make their way up into the head and neck.

When my client described the sequence of symptoms that he experienced whenever he would experience a cluster, he was perfectly describing the Right BC and Right TMCC pattern. The only difference was the severity of the pain.

This gave me great confidence that we knew what the issue was.

On page 14 of Predictable Pain, I outline the most classic symptoms that come as a result of the Left AIC Pattern:

But as you can imagine, people often show up with other symptoms. People often show up with left lower back pain, left neck tension, or clusters on the left side.

The above list is really just Level 1 dysfunction and people can and do go well beyond that. As you continue to learn more, you’ll see just how far you can travel from this list.

Here is a clip from an interview I did with Dr. Frank Mallon. Frank is in our network of experts that we send some of our clients to whenever we feel like their teeth are preventing them from getting better.

Yes, you read that correctly. Teeth.

Here is another clip from my conversation with Neal Hallinan where we discuss these neurosensory levers.

The body operates entirely through gait mechanics. Gait mechanics is the scientific term for walking.

Walking is the alternation of your right foot to your left foot and back again.

Every muscle in your body must adjust itself with every move you make.

When you are walking up stairs, muscles inside of your skull are contracting and relaxing to accommodate this movement.

At Saint Bartholomew, we are experts in gait mechanics. We understand everything that goes into proper gait mechanics and are assessments are designed to figure out where yours are falling apart.

To treat cluster headaches, it would appear that this information may be the missing link. If our contention is correct, treating clusters is about restoring balance between the right and left side of the body.

I’m not going to pretend that any of this is simple and that I’m going to cure your cluster headaches through this document.

What I am suggesting is that there is a science out there that might explain where cluster headaches come from.

I also think it’s important to say that I am not an expert in cluster headaches. I do, however, believe I am an expert in human movement, biomechanics and function of the body.

I believe that my unique perspective on the body has been the lead domino that has triggered cures for various chronic pain conditions that were previously thought to be incurable.

Traditional western medicine is a practice of zooming in. What I am suggesting is a practice of zooming out.

High-flow oxygen is given to cluster headache patients to directly attack the pain itself. I am suggesting that we go beyond that.

Why do you have the pain in the first place?

Is it just random?

My contention is the cluster headaches likely stem from dysfunctional movement patterns throughout the body and the headache is just a downstream alarm bell for a greater issue.

My contention is that if you were to fix those dysfunctional movement patterns, the headaches will stop because the source has been removed.

That’s what we do and here’s how we do it.

There are four systems of the body that contribute significantly to physical pain and performance.

If you are in pain, of any kind, one or more of these systems has broken down somewhere.

While working in the NBA, my job was to maximize the physical performance of the athletes on our roster. This meant not isolating my focus to just weight room workouts, rather focusing on every area that contributed to the output of the individual. This is where the four systems come from.

At the NBA level, these guys were attempting to max out each category and the intensity and commitment to training that came with that attempt is significant.

When I left the NBA and began working with the general population, I was struck by how wide the gap was between what NBA players were doing to take care of their body versus what the average person was doing.

If you ran any NBA player through our assessment, they would score a 95% or better. But the average civilian was scoring a 35% on the same test.

I was discovering that the health habits of the average citizen had fallen into mediocrity at best. At worst, they were non-existent. Their workout routines make no scientific sense and are often pulled from unqualified influencers. Their nutrition was insufficient and their attention to their mind was nowhere to be found. The amount of people that I came across that could not meditate for more than three minutes was alarming.

It quickly became clear to me that closing this gap between the average score (35%) and the professional athlete score (95%) was where we would solve these mysterious chronic pain cases.

It’s important to note that you do not have to train with the intensity of an NBA player to become pain free.

Many people will complain that they don’t have the time or resources to commit to this level of health which may be true and understandable. However it does not change the fact that there are minimum requirements to having a healthy body and if you fall below them, eventually, the wheels will come off.

Thus, we have set our passing threshold at 85%.

Clinically speaking, if you come to our clinic and train yourself enough to hit that 85% threshold, it is highly unlikely that you will continue having the pain symptoms that you came in hoping to solve.

This is the very foundation of the body.

It is a bit more complicated than this, but in short, we are looking to see if you can get your ribs to be perfectly stacked on top of your pelvis.

Can you even acquire the right posture?

Additionally, we need to see if you are able to breathe in that posture. Breathing is the most fundamental muscular movement that the body performs (aside from the beating of your heart) and if you cannot do this correctly, nothing else can be done correctly.

Everything comes back to “the stack.”

Simply being able to acquire “the stack” and effectively breathe in that posture is not enough unless you plan to live in a bubble and never move. You need to have some resilience to that stack to be able to tolerate the demands of living.

In the NBA, what if you’re driving to the basket and get hit by LeBron James while trying to score? Without strength, your body will crumble.

Now, you may not be in danger of getting hip checked by LeBron James on your way to work, but there are real physical demands to your day-to-day life and you must have the resilience to meet them.

You must develop adequate strength.

Now you have good posture and breathing mechanics AND you have some strength to ensure you don’t fall apart when life throws you a curveball.

But can you do it for long enough?

It is not uncommon for us to hear from a client that they feel fine when they wake up but somewhere around 2pm, things start to fall apart.

This tells me that they can hold “the stack” for a little bit but they run out of gas. This is just a different type of training.

Those same muscles that we have been training in the first two systems need to be trained to produce long sustaining energy.

One of our clients is a New York City Firefighter. His shifts are 24 hours long. He needs to be able to hold the position from beginning to end. From the first fire to the last. All day. All night. All week. All month. All year. All life.

This is not rocket science, it’s just completely neglected in traditional medicine and

Your brain is constantly evaluating the world around you to decide whether your environment is safe or dangerous. To make that decision, it uses six senses to acquire information about your surroundings.

The first five senses are your normal ones: vision, hearing, smell, taste, and touch. The sixth sense is unique to human beings.

If you are a zebra grazing on the prairie and you see a lion approaching, your body is going to go into fight or flight. If the lion hides behind a rock, you're able to relax again because you are no longer getting that visual input.

Human beings have a more evolved neocortex in their brain, which allows us to understand that the lion is still behind the rock. Because of our higher cortical processing ability, we can up-regulate our nervous system into fight or flight through thought alone.

Everyone reading this article right now has the ability to think about something related to their life that could cause them stress. this is uniquely human.

If any one of these six senses is collecting information that is being perceived by the brain as dangerous, it will activate your fight-or-flight response. This is called sympathetic activation. When your body goes into sympathetic drive, there is a physical response in the body. The ribs flare upwards, the pelvis tilts downwards, the spine extends, the body stiffens, and unnecessary functions shut down. You are quite literally preparing to fight. With this reaction, you are compromising good fluid biomechanical movement in favor of dealing with this perceived emergency.

A major part of our assessment is evaluating your nervous system to see if any one of these six senses is standing in the way of you getting out of pain.

Our evaluation consists of 60 data points designed to test each one of these systems.

We are looking to get a clear picture of the current status of each one of these categories. Once we have that, we can follow our process called “The Work” that systematically goes through this scorecard and improves each system until the individual hits 85%.

Click Here to Read About our Process “The Work.”

What really draws my attention about cluster headaches is that they only occur on one side of the body. Anytime I see this, I believe that it stems from the asymmetrical nature of our body.

In my opinion, this indicates that cluster headaches are rooted in posture and gait mechanics. Remember, gait mechanics is just the scientific way of saying walking. Walking is the alternating between right single-leg stance and left single-leg stance

Because the body is so biased towards the right side, whenever an individual tries to get into left stance, the right side of the body won't let go. This causes a variety of pain symptoms on the right side of the body. This is why we see more right-sided pain than we do on the left.

In my opinion, cluster headaches will be solved by fully restoring balanced gate mechanics on both the left and right side of the body.

In our assessment process, this is what we are measuring in the posture and breathing section.

Over the last few months, there are a few things that I have learned about clusters…

In an effort to help, we at Saint Bartholomew would like to announce the Saint Bartholomew Cluster Headache Trial Program.

Anyone with documented cluster headaches can apply for our program and if accepted, receive admission to the program at no cost.

If you are interested in applying to this program, click the link below, fill out the information and someone from our team will reach out to your shortly.

Click Here to Apply to the Cluster Headache Trial Program

*** Spots are Limited Due to Capacity ***