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Migraine vs. Headaches: What's the Difference?

Medically reviewed by Amit M. Shelat, D.O.
Written by Victoria Menard
Posted on March 11, 2021

Many people think migraine headaches are just severe headaches. But in reality, headaches are just one symptom of migraine. Migraine itself is a complex condition, a collection of neurological symptoms. These symptoms, including migraine headaches, can be disabling.

“Woke up early with headache, severe nausea, abdominal and generalized body pain,” wrote a member of MyMigraineTeam. “Headache pain decreased some [with medications] but nausea and abdominal pain continue tonight. … Praying for relief and sleep. Can't eat without increased nausea.”

Distinguishing a migraine headache from another type of severe headache can be difficult. However, there are some key differences for telling them apart. Understanding those differences may help you and your doctor determine which type you’re experiencing.

Different Types of Headache

Headaches can be categorized into different types based on their causes and symptoms. The three most common types are:

  • Migraine headaches
  • Tension headaches
  • Cluster headaches, which are considered primary headaches

Primary headaches refer to headaches that aren’t caused by any underlying health conditions. In other words, the headache itself is the problem.

Secondary headaches, on the other hand, are a symptom of other diseases or health conditions that also cause head pain. These include sinus headaches, caused by a sinus infection, and headaches caused by overusing pain medications.

Migraine Headaches

Migraine headaches, which are considered primary headaches, are often accompanied by symptoms other than pain. Aside from severe, throbbing head pain, a migraine attack may also cause:

  • Nausea and vomiting
  • Sensitivity to light or sound
  • Lightheadedness
  • Visual changes

In certain cases, people with migraine may experience only light or noise sensitivity or visual symptoms — without any head pain at all. This condition is known as acephalgic or amigrainous migraine.

Watch migraine specialist Dr. Amaal Starling explain how migraine is more than just a headache.

Tension Headaches

Tension headaches, also referred to as tension-type headaches, are the most common type of headache people experience. These primary headaches are typically less severe than migraine headaches and are rarely painful enough to be disabling. However, it is possible to have both migraine headaches and tension headaches. In some people, tension headaches can trigger migraines.

Cluster Headaches

Cluster headaches, among the most severe types of headache, are less common than migraine and tension headaches. These headaches come on suddenly and cause excruciating pain, usually in or around one eye.

As their name suggests, cluster headaches tend to occur in groups, each attack lasting one to three hours. These attacks may occur daily or even several times a day. Periods of frequent cluster headaches, referred to as cluster periods, may last from weeks to months. Epidemiologically, cluster headaches are much more common in men than women.

Sinus Headaches

Sinus headaches often cause throbbing pain and pressure in the sinuses (the cavities in the skull found behind the eyes and around the nose). Sinus headaches are often confused with other forms of headaches, including migraine headaches. In fact, studies have shown that about 90 percent of people who seek medical help for sinus headaches are actually experiencing migraine headaches.

Symptoms of Migraine and Headache

MyMigraineTeam members have shared the broad spectrum of symptoms that often accompany migraine pain.

  • “I am having flu-like symptoms with migraine.”
  • “[I have] migraine without the pain today — just all the other symptoms.”
  • “It sounds funny to say that I don’t mind my pain. It’s the other symptoms that shut me down and make this miserable.”

Severe, throbbing headache pain is the symptom most often associated with migraine, but a person diagnosed with migraine may experience a variety of other symptoms during a migraine attack, including:

  • Visual phenomena (hallucinations), such as seeing bright spots, flashing lights, or shapes that aren’t really there
  • Vision loss or blind spots
  • Changes in speech
  • Sensitivity to light and sound (and, in some cases, smell and touch)
  • Weakness, numbness, or pins and needles
  • Dizziness
  • Nausea or vomiting
  • Fatigue, anxiety, and depression

Untreated migraine headaches may last from four to 72 hours.

Migraine vs. Tension Headache

Tension headaches do not tend to cause additional symptoms like nausea and vomiting. And whereas migraine headaches usually affect just one side of the head, tension headaches typically cause moderate pain on or around both sides of the head or in the back of the head and neck. Tension pain is generally felt as a steady ache, unlike the throbbing or pulsing pain felt in migraine headaches.

Migraine vs. Sinus Headache

Sinus headaches are often confused with migraine headaches, as the symptoms of the two may overlap. Like tension headaches, sinus headaches caused by sinus infection aren’t usually accompanied by nausea, vomiting, or sensitivity to light or sound. However, both migraine headaches and sinus headaches tend to worsen when you bend forward.

Sinus headaches are accompanied by the symptoms of sinus infection, including:

  • Loss of smell
  • Discolored nasal mucus
  • Pain in the upper teeth or one cheek

A migraine headache may also be associated with some similar symptoms, including facial pressure, congestion, and a runny nose. Whereas migraines often last from several hours to one or two days, headaches caused by sinus infection commonly last for several days or longer.

What Causes Migraine and Other Types of Headache?

The exact cause of migraine isn’t fully understood. Individual migraine attacks may occur as the result of the body’s nervous system reflex, experts believe. The trigeminovascular theory of migraine is currently the most accepted theory behind the etiology of migraines. According to this theory, migraine originates from the trigeminal nerve surrounding the cerebral vessels, which supply blood to the brain.

In some people, stress on the nervous system can cause the brain to become overly sensitive to light, sound, and pain, resulting in a migraine attack. Genetics also appear to play a role in a person’s likelihood of experiencing migraine, as roughly 90 percent of people with migraine have a family history of the condition.

The cause of tension headaches is not fully understood, either. It was once believed that they resulted from muscle contractions brought on by tension or stress. However, it’s now thought that people who get tension headaches have a heightened sensitivity to pain, leading to the muscle tenderness commonly felt in tension headaches.

Cluster headaches occur when the body releases serotonin (a mood-stabilizing hormone) and histamines (the chemicals responsible for allergic reactions), causing the blood vessels in the brain to dilate. This dilation may occur in response to bright lights, physical exertion, or even changes in altitude.

Migraine and Other Headache Triggers

Like migraine headaches, tension and cluster headaches may be triggered by certain factors. The following are some common triggers for different types of headaches.

Migraine Headache Triggers

Anything that activates the nervous system may trigger migraine attacks, including environmental factors such as lack of sleep, stress, changes in weather, smells, and food. Alcohol, artificial sweeteners, chocolate, and cured meats are all commonly reported dietary migraine triggers. Hormonal changes are also known to contribute to migraines in women.

Allergies can also trigger migraines by causing inflammation of the blood vessels. One MyMigraineTeam member described how a migraine headache “started with allergy symptoms (which was once a trigger) and stopped at about noon.”

Tension Headache Triggers

Some migraine triggers, including fatigue and stress, can also cause tension headaches. Some people, for instance, develop tension headaches after particularly stressful days or events.

In addition to stress, hunger and eye strain frequently trigger tension headaches.

Cluster Headache Triggers

A variety of factors may trigger cluster headaches, including alcohol or tobacco use, bright lights, heat (such as the weather or a hot shower), physical exercise or exertion, change to a higher altitude (elevation), and foods that contain nitrates, including bacon and lunch meat.

Is It a Migraine or a Headache?

It can be difficult to tell whether you’re experiencing a migraine headache or a different type of headache. “I still have no idea what type of headaches I struggle with, as mine are really never the same,” one MyMigraineTeam member said.

If you’re having severe or frequent headaches, talk to your doctor. They’re the best person to determine the cause and type of your headaches and help find the right treatment for you.

In order to diagnose you with migraine, your doctor may assess your medical history and symptoms and perform a physical and neurological examination. However, taking note of the following will help you provide your doctor with as much information as possible to make the right diagnosis:

  • How frequently you experience headaches
  • Where your head pain occurs
  • How long your headaches last
  • When (in the day, month, or time of year) your headaches occur
  • Other symptoms that accompany your headaches, such as nausea or vision changes
  • Any medications you are taking or have taken, including over-the-counter medicines

Treatments for Migraine and Headache

What treatment a doctor recommends for migraine or another headache depends on the frequency and severity of your headaches. Treatment may include the following medications or lifestyle changes.

Over-the-Counter Medications

Over-the-counter (OTC) pain relievers, including Tylenol (acetaminophen), Advil (ibuprofen), and Bayer (aspirin) may help relieve headaches, including mild migraines. Certain OTC options combine multiple treatments to target certain types of headaches, including Excedrin Migraine and Excedrin Tension Headache.

According to a 2016 study, melatonin — a hormone that regulates the body’s sleep-wake cycle — may help prevent migraines and cluster headaches. Melatonin is typically available as an OTC oral supplement.

Prescription Medications

If you regularly experience severe migraine headaches, your doctor may prescribe medication to help reduce their frequency and severity. These may include:

Lifestyle Changes

People who have or are at risk of migraine, such as those with a family history of the condition, should:

  • Avoid stressors and known triggers
  • Maintain a regular sleeping schedule
  • Exercise regularly
  • Eat well, including consuming healthy foods and maintaining a normal meal schedule

Find Your Support System

MyMigraineTeam is the social network for people with migraine and their loved ones. On MyMigraineTeam, you can meet, exchange advice, and share your story with more than 65,000 people who understand life with migraine.

Do you experience other types of headaches with migraine? What made you suspect that your headaches might be something more? Let members know in the comments below, or start a conversation on MyMigraineTeam.

  1. Migraine vs. Headache: How to Tell the Difference — Penn Medicine
  2. What Is Migraine? — Migraine Research Foundation
  3. Migraine — Mayo Clinic
  4. Know Your Headaches — Cedars-Sinai
  5. Types of Headache — Stanford Health Care
  6. Acephalgic Migraine — ScienceDirect
  7. Headache Causes — Mayo Clinic
  8. Migraine Headaches — Cedars-Sinai
  9. Serotonin and CGRP in Migraine — Annals of Neurosciences
  10. Migraine — U.S. Office of Women’s Health
  11. Tension Headaches — Cedars-Sinai
  12. Headache Types and Their Treatment — National Institute of Neurological Disorders and Stroke
  13. Tension Headaches — University of Michigan Medicine
  14. Cluster Headaches — Cedars-Sinai
  15. Cluster Headache — Mayo Clinic
  16. Sinus Headaches — Mayo Clinic
  17. Headache and Facial Pain — Columbia University Department of Neurology
  18. Migraine or Headache? How to Tell the Difference — University of Michigan Medicine
  19. Melatonin — Mayo Clinic
  20. The Role of Melatonin in the Treatment of Primary Headache Disorders — Headache
  21. An Overview of Generic Triptans for Migraine — U.S. Pharmacist
  22. Beta Blockers — Mayo Clinic
  23. Headache Hygiene: What Is It? — American Migraine Foundation
  24. Migraine Facts — Migraine Research Foundation
  25. Migraine Information Page — National Institute of Neurological Disorders and Stroke
  26. Serotonin — Hormone Health Network
  27. Histamine Defined — American Academy of Allergy Asthma & Immunology
  28. Migraine and Diet — American Migraine Foundation
  29. Migraine in Women: The Role of Hormones and Their Impact on Vascular Diseases — The Journal of Headache and Pain

Are your headaches a symptom of migraine? Get a quick assessment.

Posted on March 11, 2021
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Amit M. Shelat, D.O. is a fellow of the American Academy of Neurology and the American College of Physicians. Review provided by VeriMed Healthcare Network. Learn more about him here.
Victoria Menard is a writer at MyHealthTeam. Learn more about her here.

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