How to Tell the Difference Between Migraine and Other Types of Headaches
Migraine is a neurological disorder distinguished from typical headaches by its intensity, often affecting one side of the head and accompanied by symptoms like nausea and sensitivity to light and sound.
While tension headaches typically last minutes to a few hours and can be relieved with over-the-counter treatments, migraine episodes can persist for days and may require specific medications like triptans.
Lifestyle adjustments, such as maintaining consistent sleep patterns and identifying dietary triggers, play a crucial role in preventing migraine episodes and reducing their frequency.
When there's pressure or pain in your head, it can be difficult to tell whether you're experiencing a typical headache or a migraine attack.
Differentiating migraine from other headache disorders and vice versa is important. It can mean faster relief through more targeted treatments based on the type of headache. It can also help prevent future headaches from occurring in the first place.
So, how can you tell the difference between a common headache and a migraine attack?
What is a headache?
Headaches are unpleasant pains in your head that can cause pressure and aching. They usually occur on both sides of your head. The pain can range from mild to severe. Some specific areas where headaches can occur include the:
forehead
temples
back of the neck
A typical headache usually lasts between 5 minutes and 4 hours. Some migraine episodes can last for days or even longer.
According to the World Health Organization (WHO), the most common headache type is a tension headache. Triggers for this headache type include:
stress
anxiety
muscle strain
eyestrain
Tension headaches aren't the only type of headache.
Other headache types include:
Cluster headaches
Cluster headaches are severely painful headaches that occur on one side of the head and come in clusters. This means you experience cycles of headache attacks, followed by headache-free periods. They're most commonly experienced behind or above the eye or at the temple.
Cluster headaches affect up to 0.1% of the population. They typically occur between ages 20 and 49 years. Males are more likely than females to experience them.
By race and ethnicity, most of the large-scale epidemiological studies have been performed in white people, and less is therefore known across other races or ethnicities.
Sinus headaches
Often confused with migraine, sinus headaches co-occur with sinus infection symptoms like fever, stuffy nose, cough, congestion, and facial pressure. A 2018 survey found that sinus infections affect about 11.6% of adults.
By race and ethnicity, here's a breakdown of adults who have received a diagnosis of sinus infection according to this survey:
white people: 12.2%
Black people: 11%
American Indian or Alaska Native people: 10.4%
Hispanic or Latino people: 8%
Asian people: 6.5%
Secondary causes of headaches
Injuries and medical conditions can also lead to headaches. Before diagnosing a primary headache disorder, doctors work to rule out dangerous causes that could lead to serious complications.
A Chiari headache is caused by a congenital Chiari malformation. This extremely rare condition causes the skull to push against parts of the brain, often causing pain in the back of the head.
Increased intracranial pressure is a life threatening medical problem that can also lead to headaches. It can occur from conditions such as:
aneurysm
arteriovenous malformation
brain tumor
meningitis
encephalitis
idiopathic intracranial hypertension
Thunderclap headaches
A thunderclap headache is a very severe headache that develops in 60 seconds or less. It could be a symptom of a subarachnoid hemorrhage, a serious medical condition that requires immediate medical attention. An aneurysm, stroke, or other injury may also cause it.
Thunderclap headaches are rare, but the true incidence is not clear due to poor quality data. The only population-based estimate so far is from a 2002 study from Sweden, where researchers report the incidence as 43 cases per 100,000 adults per year.
Call 911 or local emergency services immediately if you experience a headache of this kind.
What is migraine?
Migraine attacks are intense or severe and often have other symptoms in addition to head pain. Symptoms associated with migraine without aura include:
neck and shoulder pain
nausea
pain behind one eye or ear
pain in the temples
visual disturbances
sensitivity to light, sound, or both
vomiting
muscle aches
When compared with tension or other headache types, migraine pain can be moderate to severe. Some people may experience migraine attacks so severe that they seek care at an emergency room.
Migraine episodes typically affect only one side of the head. However, it's possible to have a migraine episode that affects both sides of the head.
Other differences include the pain's quality. A migraine attack causes intense pain that may be throbbing and will make performing daily tasks very difficult.
A 2018 study found that more than 15% of U.S. adults had experienced a migraine episode or a severe headache within the last 3 months.
In a 2015 analysis of nine studies, researchers looked at the average rate of severe headache or migraine by race and ethnicity from 2005 to 2012 in the United States. They found that the prevalence rates of episodes across all groups were similar:
Native American people: 17.7%
white people: 15.5%
Hispanic people: 14.5%
Black people: 14.45%
Asian people: 9.2%
Migraine episodes are typically divided into two categories: migraine with aura and migraine without aura.
An aura refers to sensations a person experiences before a migraine episode. The sensations typically occur anywhere from 10 to 30 minutes before a migraine attack. These can include:
feeling less mentally alert or having trouble thinking
seeing flashing lights or unusual lines
feeling tingling or numbness in the face or hands
having an unusual sense of smell, taste, or touch
Some people who have migraine may experience symptoms a day or two before the actual migraine episode occurs. Known as the prodrome phase, these subtler symptoms can include:
constipation
depression
frequent yawning
irritability
food cravings
Migraine triggers
People who experience migraine episodes report various factors that are associated with them. These are called migraine triggers and may include:
emotional anxiety
lack of sleep
skipping meals
contraceptives
alcohol
hormonal changes
changes in altitude
changes in barometric pressure
caffeine overuse
Hormonal changes can trigger a menstrual migraine headache, which can occur a few days before a period and during the first 1 to 2 days.
Where is migraine pain located?
Migraine pain is usually, but not always, on one side of the head. Depending on the type of migraine attack, the pain may be felt:
in the temples
in the forehead
behind one or both eyes
in the neck
How does sleep affect headaches or migraine?
Migraine
According to a 2018 study, participants with sleep disorders were more likely to have a migraine disorder. It's believed that a lack of sleep can trigger migraine attacks or make them worse.
While the research is still ongoing, it appears that sleep may play a role in migraine prevention. A 2018 review of studies found that people who experience migraine attacks often report sleep as an effective therapy for migraine.
One hypothesis is that the glymphatic system, a newly discovered waste clearance system in the brain that's similar to the lymphatic system in the rest of the body, may be more active during sleep.
The glymphatic system helps remove toxins from the brain that build up during wakefulness. While there's minimal evidence to support this claim, it's possible that getting enough sleep helps cleanse the brain and prevent migraine attacks.
Headache
Poor sleep may contribute to headaches or make them worse. In one 2019 review, those who underwent behavioral sleep treatments for tension headaches reported a significant reduction in headache frequency and intensity. Sleep quality and time spent asleep also improved during treatment.
Since headaches and lack of sleep may be linked, it's important to practice good sleep habits if you have a headache.
To help improve sleep quality:
limit screen time before bed
establish a relaxing bedtime routine
create a quiet sleep environment
get regular physical activity
avoid napping throughout the day
avoid caffeine and alcohol close to bedtime
Treatment of headaches and migraine
Headache treatments
Most tension headaches go away with over-the-counter treatments. These include:
acetaminophen
aspirin
ibuprofen
Because some headaches are stress-induced, taking steps to reduce stress can help relieve headache pain and reduce the risk of future headaches. These include:
heat therapy, such as applying warm compresses or taking a warm shower
massage
meditation
neck stretching
relaxation exercises
Migraine treatments
People who have migraine less frequently may benefit from taking medications known to reduce migraine quickly. Examples of these medications include:
anti-nausea medications, such as:
promethazine (Phenergan)
chlorpromazine (Thorazine)
prochlorperazine (Compazine)
mild to moderate pain relievers, such as acetaminophen
nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
aspirin
naproxen sodium
ibuprofen
triptans, such as:
almotriptan (Axert)
rizatriptan (Maxalt)
sumatriptan (Alsuma, Imitrex, and Zecuity)
If a person takes as-needed migraine medications more than 10 days a month, this could cause medication overuse headache, also known as medication adaptation headache. This practice will worsen their headaches instead of helping them feel better.
Frequently asked questions
Below are some frequently asked questions about migraine attacks and other headaches.
Can dehydration cause a headache?
Dehydration from insufficient water intake or losing too much fluid from the body can cause headaches for some people.
To avoid dehydration-related headaches, make sure to drink plenty of fluids throughout the day, especially when it's hot or you're sweating a lot.
Can a headache turn into a migraine attack?
Migraine episodes and headaches share some risk factors and causes, so it's possible for a headache to turn into a migraine episode.
Migraine episodes aren't always severe and could start off mild. If left untreated, they can progress and become more severe.
For example, stress may bring on both migraine episodes and tension headaches. If a person with a tension headache experiences severe stress or trauma, this may cause them to develop migraine features, such as a visual aura.
What type of doctor treats migraine?
Migraine attacks are usually treated by a neurologist, a doctor specializing in brain and nervous system disorders. A headache specialist may also treat migraine. If you experience frequent or severe migraine attacks, talk with a healthcare professional about available treatment options.
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