How To Tell If You Have A Headache Or A Migraine

Plenty of factors can trigger a migraine. (Sadly, in-laws don’t make the list. But stress does. So … maybe?)

If you’ve experienced migraines in the past, you’re probably aware of these triggers and how they make you feel. But if you haven’t ― or if you’re unsure whether you have ― understanding just how migraines can affect your life might be challenging. What is the pain really like? Is it basically just a headache?

“Headache is a general term that refers to head pain,” explained Susan Hutchinson, medical adviser for Cirrus Healthcare and director of the Orange County Migraine & Headache Center in Irvine, California. “There are primary headaches like migraines, tension and cluster headaches and then there are ‘secondary’ headaches, such as those caused by meningitis, a brain tumor or a head injury.”

Tension headaches occur within the muscular areas of the head, the back of the scalp or the forehead, while a migraine happens within the brain itself. With all this overlap, figuring out what kind of pain you’re experiencing is not easy. But there are certain signs you can look for.

Here’s how to know the difference between a run-of-the-mill head pain and a migraine, and how to treat each:

Pay Attention To The Pain

When people think “headache,” they might typically be referring to a tension headache, which is a common type of head pain. People with tension headaches tend to feel as if their head is being squeezed in a vise-grip (hence the terminology), according to Jonathan Cabin, director of The Migraine Institute in Beverly Hills, California. Migraine pain is often located elsewhere.

“For migraines classically ― but this doesn’t happen for everyone ― pain occurs on one side of the head and it’s a throbbing pain,” he explained.

For someone who is experiencing migraines, the side they occur on is typically where that person’s sensory nerve is acting as a trigger, which then sets off a migraine inside the brain. Hutchinson added that tension headaches typically won’t stop someone from completing tasks or halting their daily activity, while migraines often get worse with activity and have a throbbing, pulsating feeling.

Note Any Nausea Or Other Symptoms

In addition to their range on the pain spectrum, migraines can be differentiated by their very specific symptoms. Both Cabin and Hutchinson said telltale signs of migraines are nausea and sensitivity to lights and sounds.

“Migraines will generally last anywhere from four to 72 hours, and tension headaches are much shorter,” Cabin said. Depending on what kind of migraine you have, you may also experience an aura, which is a physical sensation such as a change in vision or sudden dizziness. “About one-third of migraine patients have these auras,” Cabin added.

Migraines will generally last anywhere from four to 72 hours, and tension headaches are much shorter. Jonathan Cabin, director of The Migraine Institute

Even with all of this information, it can be confusing to figure out what’s going on when you experience a headache ― or what you think might be a migraine.

“There are people who experience migraine-like tension headaches and there’s no blood test or scan that can be done to prove one or the other, so it’s really a matter of monitoring the symptoms,” Cabin said.

And while you might assume that most headaches are just that ― headaches ― Hutchinson believes differently. “As a headache specialist, bad recurring tension headaches are actually migraines,” she explained.

Take Stock Of Your Triggers

Whether you suffer from headaches or migraines, certain triggers can exacerbate both conditions.

Stress, dehydration, sleep (both too much and too little), diet, intense exercise in some cases and environmental changes like an increase in pollen or barometric changes are the major sources of head pain, according to both Cabin and Hutchinson. These triggers can catapult both tension headaches and migraines, but those who experience migraines will consistently experience head pain from one or a few of these triggers while a tension headache may only spur from one of these issues every so often.

Treat Your Head Pain Accordingly

One of the biggest differences between headaches and migraines is that headaches will respond to over-the-counter medicines, while migraines typically will not, Cabin said.

“Treatment for tension headaches and migraines can include both a holistic approach as well as prescription medicine,” Hutchinson added. Things like cleaning up your diet from MSG and processed foods, taking a weekly yoga class, keeping alcohol and caffeine in check, and establishing healthy sleep habits may help, Hutchinson said.

For migraine sufferers who still can’t find relief, Cabin suggested seeking care from a primary doctor or a neurologist. Depending on your condition, you may be diagnosed with chronic migraines if you suffer from 14 or more migraines a month. Treatment for that particular diagnosis can include more severe medical interventions like Botox injections in the head and surgery to help attack the trigger nerves in the brain and lessen those signals entirely.

“The way I phrase it to patients is that treatment is usually a mix-and-match of options based on that patient’s needs. There’s no universal treatment or magic bullet,” Cabin said.

Seek Additional Help From A Specialist If Necessary

“It’s critical that a headache be properly diagnosed and treated,” Hutchinson said. “Some health care providers have gone for extra training and are certified in headache medicine.” To find a specialist, Hutchinson recommended checking out the American Headache Society and the National Headache Foundation.

It’s critical that a headache be properly diagnosed and treated. Susan Hutchinson, director of the Orange County Migraine & Headache Center

At the very least, speak up at your next visit to the doctor. You may think you’re just experiencing an average headache, but there’s a chance you’re not: Research shows that 1 out of 6 Americans will suffer from migraines, with 12 percent of Americans experiencing a migraine at some point in their life. If you’re a woman, your risk is even higher. Chatting with your physician about treatment options could make a huge difference.

“There is an undertreatment of these headaches where people are either getting the wrong kind of treatment for a different type of headache or no treatment at all because they don’t know what’s available,” Cabin said.

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