Overview

Headaches aren’t uncommon. In fact, almost everyone will experience at least one headache in their lifetime, and many will deal with them off and on throughout their lives. However, some headaches are worse than others. These may be a sign of migraine.

There are several theories on the mechanism of migraine. It is a complex disorder that is caused by the interaction of nerve impulses and the release of chemicals that irritate some parts of the brain. These parts include the cerebral cortex and the trigeminal nerve, which is the largest cranial nerve.

Here’s how to tell the difference between a common headache and migraine headache.

The majority of all headaches are not due to migraine. Simply put, they are pain signals within your head. These headaches are most often associated with and made worse by fatigue, sleep deprivation, certain allergens, or stress. They’re usually successfully treated with medications or rest.

Did you know?

According to the Migraine Research Foundation, migraine affects 38 million Americans. They’re less common than tension headaches, although still rather prevalent.

People with migraine may experience:

  • sensitivity to light or noise
  • dizziness
  • eye pain
  • nausea or vomiting
  • vision blurring
  • visual aura, such as seeing “floaters” or bright spots
  • irritability

Someone with migraine may experience one or several of these symptoms concurrently, in addition to the headache itself. Each person’s experience is different, and symptoms may change with each migraine headache.

Both migraine and tension headaches affect women more than men. In fact, 3 out of 4 people with migraine are women, according to the Office on Women’s Health. This may be because of hormonal fluctuations brought on by menstruation or menopause. The journal Current Pain and Headache Reports estimates that migraine affects 18 percent of all women. Migraine also tends to run in families, which points to a genetic component.

Though obesity isn’t a direct trigger of migraine, weight can increase the risk for a regular headache progressing into a migraine headache.

One way to determine whether you have migraine or a tension headache is to assess your symptoms. Understand the key differences between the two. Keep a log of your headaches to share with your doctor.

Pain and sensitivity

People with migraine report deeply throbbing, pounding, and pulsating pain. Tension headache pain can range from dull pressure to a tight squeeze on the head or around the neck.

Migraine may cause sensitivity to bright light, loud noise, or smells. Tension headaches rarely cause such sensitivities.

Location of pain

Pain behind or near the eye on one side of the head is another mark of migraine. This divided pain in the head commonly occurs with migraine. Pain throughout the head, across the forehead, or at the base of the neck is generally associated with a tension headache.

Severity of pain

Migraine headaches can be quite painful. People who get them report moderate to severe pain that often prevents them from being able to work or focus. Tension headaches are typically only mildly or moderately painful.

Length of headache

A migraine headache may develop and worsen over a period of several hours or days. A tension headache often develops and resolves much more quickly, typically within a day.

Other symptoms

Nausea, vomiting, and upset stomach are all common with migraine headaches but rarely occur during a tension headache.

A visual aura (bright, flashing lights or dots that appear in the field of vision) can occur before a migraine attack begins, though it’s not common even among people with a history of migraine. Other types of auras may occur, too. These include:

  • loss of language
  • pins-and-needles sensation in arms or legs
  • speech problems
  • vision loss

Warning signs

Your body may give you warning signs a day or two before a migraine headache occurs. These subtle changes include:

  • constipation
  • depression
  • diarrhea
  • hyperactivity
  • irritability
  • neck stiffness

Such symptoms typically don’t occur before a tension headache.

When it comes to tension headaches, stress, fatigue, and sleep deprivation are the most common triggers. For migraine, there are different triggers. The most common include:

  • alcohol use
  • bright lights (photophobia)
  • consumption of sweets or processed foods
  • changes in sleep patterns, including lack of sleep
  • exposure to odors, such as strong perfume or cigarette smoke
  • loud noises (phonophobia)
  • skipping meals
  • in females, hormone changes

There are other types of headaches that aren’t classified as migraine or a tension headache. A cluster headache is an intense headache with one to three painful episodes, or clusters, each day, which tend to recur at exactly the same time.

People who have cluster headaches report the pain to be severe and searing, with the center of the pain typically located behind one eye. These may also be accompanied by red, teary eyes, something that isn’t common in migraines or tension headaches. This type of headache is more common in men than women.

A sinus headache isn’t actually a headache. Instead, it’s a painful response to nasal congestion or runny nose. You may experience pain across your forehead and cheeks when the sinuses are inflamed or irritated. This pressure may feel like a headache and cause symptoms of a headache.

Migraine management is essential. Current Pain and Headache Reports estimates that people who have chronic migraines miss an average of five work days in a three-month period. Combined with painful symptoms, this makes regular management essential.

Some treatment options include:

  • antidepressants
  • other prescription drugs, for both prevention and acute treatment
  • birth control pills (for women)
  • daily exercise
  • dietary changes
  • getting adequate sleep
  • meditation
  • yoga

Talk with your doctor. They can help you explore ways to treat and manage migraine.