A woman is dealing with a migraine or headache and holds hand to her head
Learn how to tell the differences between a migraine or headache by spotting the common patterns, phases, and specific symptoms.
Photo Credit: InnerVisionPRO / iStockphoto.com

Migraine or Headache? Which One Is It?

Headaches are never fun but sometimes they can be particularly distressing, even frightening. When pain comes on fast and won’t go away, it’s natural to assume there’s something more serious at play. In some cases, there is a deeper problem that will explain the pain; in other cases, you might be dealing with a migraine.

Migraines aren’t uncommon — it’s estimated that around 18% of women and 6% of men in America suffer from them — but they can go untreated and misdiagnosed for far too long. Left untreated, frequent migraines can overturn your daily life and crush your vitality, so don’t let things get out of hand. Learn how to tell the differences between a migraine or headache by spotting the common patterns, phases, and specific symptoms.

The Two Categories of Headache

In many cases, headaches are determined and defined by their cause – how and when the headache pain comes on can tell you a lot about which sort of headache you’re dealing with.

Primary Headaches

The vast majority of headaches fall into this category. Primary headaches are patterns of pain that occur without other medical conditions, and they can be further divided into two specific groups:

  • Tension headaches: Very common and generally benign (though still exceptionally uncomfortable), tension headaches bring the dull, mild, throbbing pressure that most people experience from time to time. Too little sleep, not enough water, muscle ache, or any other number of problems could be to blame for tension headaches.
  • Cluster headaches: Far less common than tension headaches, cluster headaches involve more severe and localized pain. Stabbing pain behind the eye is a common complaint, and you may feel a good deal of sinus pressure along with the headache pain. Cluster headaches hit suddenly and may only last for an hour or two, they often recur for days, if not weeks. Men are more susceptible to these types of headaches than women.
  • Migraine headaches: More common than cluster headaches but not as prevalent as tension headaches, migraines are incredibly painful episodes that usually occur on one side of the head only, and can last for days. More women than men suffer from migraines. There is more than one type of migraine.

Secondary Headaches

A secondary headache is one that comes from another sort of trauma or underlying condition. In turn, secondary headaches are often much more dangerous: they can indicate a more serious condition, like a tumour or inflammatory disease. In many cases, some neurological symptoms come along with the pain, like problems with eye movement, numbness or paralysis. Your doctor will conduct tests to unveil the source of the headache.

Spotting Migraine Symptoms

Once you’ve determined yours is a primary headache, you’ll need to take a closer look at your set of symptoms to rule out migraine.

Type of Pain

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Many people would describe migraine pain as incredibly severe tension headache pain: throbbing, pounding, radiating pain that’s difficult to ignore. The difference is while tension headaches are merely distracting, migraine pain is debilitating and will quite literally weaken you to the point of inactivity.

Migraines are also asymmetrical — they appear on one side of the head, and remain there for the duration. However, the pain could show up anywhere on that side, from behind the eye (which may resemble a cluster headache), to the ear or temple.

Phases of Pain

Migraines follow a distinct course, and each phase is fairly predictable:

  • Prodromal phase: Well before the migraine begins, you may notice unusual symptoms like irritability, increased thirst, frequent yawning or food cravings.
  • Aura phase: Before any pain comes, you may notice a flickering in your peripheral vision, or an area of vision loss. You may find it hard to focus, and you might also feel confused. A feeling of pins and needles in the hands and face can come along with the vision and cognitive change.
  • Attack phase: The pain hits, and it hits hard. You’ll probably be out of commission from this point until the headaches wanes.
  • Postdromal phase: You rarely bounce back to your regular self immediately after a migraine. Instead there is often a 'migraine hangover' where it’s common to feel weak and sluggish, maybe even confused, for several hours afterwards.

You may not experience all four stages ¬— sometimes the progression will stop with the aura, or some stages may go more quickly than the others.

Food Triggers

Not every migraine sufferer will be vulnerable to certain ingredients, but many people complain that food and drinks containing tyramine lead straight to a migraine. Aged and fermented foods are the common culprits of triggering migraines: strong cheese, smoked or cured meat and fish, aged meat and some brands of beer.

Tyramine may cause your brain to produce more norepinephrine, and experts suspect that higher levels of this chemical can lead to a migraine headache. In contrast, other headaches tend not to be triggered by food or drink (unless there is a specific allergy at the root of your reaction).

Extra-Sensory Symptoms

Tension and cluster headaches are defined by their pain, but migraines bring a broader set of symptoms. Along with the sudden and severe pain, many suffer with nausea, vomiting, sensitivity to light and sound, and the visual anomalies that fall under the “aura” phase. A cool dark room may be the only way to calm these sensations enough to weather the storm.

Response to Treatment

Migraines are very stubborn; they generally don’t respond well to regular pain relievers that would treat a tension headache. “Migraine strength” medication indicates that migraines need an extra powerful dose, but the type of drug can also make a difference. You’ll find that ibuprofen works better than acetaminophen for migraine pain.

Chronic tension headaches can be tough to treat, but a migraine management plan can take a good deal of time, patience, and creativity to put together. The sooner you can get an accurate diagnosis, the sooner you can work with your doctor to find the right blend of medication and lifestyle changes to reduce the effect and frequency of your migraines for a much better quality of life.