Migraines vs. Headaches: Understanding Key Differences Can Bring You Much-Needed Relief

Posted June 20, 2024 by Bassey Ijoma MSN, RN, BSN, Manager, Clinical Quality Improvement

Person laying in bed and holding their head

It’s a fact of life: Everyone will get a dreaded headache at one time or another.

But, not all headaches are created equal: They can range in severity, frequency and cause. So, when you have pain and pressure in your head, how do you know whether it’s a headache or a migraine?

A migraine is much worse than a bad headache. It can cause severe, sometimes debilitating, throbbing pain, typically on one side of the head, and disrupt school or work. It also can be accompanied by nausea, vision changes, and sensitivity to light and sound. Migraines are a chronic condition and the exact cause is unknown.

On the other hand, a headache is not usually a symptom of an underlying condition. Instead, headaches may be due to over activity of blood vessels, muscles, nerves or brain chemicals. Factors that can lead to headaches include stress, anxiety or depression, a physical injury or even changes in the weather.

So, before you write off your pain as just another headache, make sure you understand the difference between a headache and migraine attack. While both have overlapping symptoms, telling them apart could mean faster relief with a more targeted treatment and even prevention of future pain, in some cases.

What is a headache?

Headaches typically cause pain that can be described as throbbing, aching or dull pressure. The pain can range from mild to severe and last up to four hours. Pain from headaches can occur in the forehead, temples and the back of the neck.
There are many kinds of headaches, but the three most common include:

Tension headaches: Typically, people feel the pain spread across both sides of their head, almost like a belt being tightened around the head. It’s the most common form of headache and can be due to eyestrain, stress, hunger and dehydration.
Sinus headaches: People often experience these headaches when they’re sick or congested. These headaches are caused by swelling in the sinuses and cause pain behind the cheeks, nose and eyes. It can be at its worst in the morning or after bending over.
Medication overuse/Rebound headaches: People often experience this type of headache from regular, long-term use of pain medication to treat headaches. Rebound headaches tend to occur daily and may improve with pain relief medication, but will return once it wears off due to withdrawal. Once a person stops taking pain medication, the rebound headache should go away.

What is a migraine?

When compared to headaches, migraines are severe and often have other symptoms that go along with the head pain. Migraines usually only affect one side of the head, and the pain and throbbing can be so severe that it can make performing everyday tasks very difficult.

Several hours or even days before the migraine begins, you might experience subtle symptoms, such as mood swings, food cravings and stiffness in the neck. During the migraine, you might have sensory issues, including blurred vision, blind spots, numbness and slurred speech. Physical activity and exposure to light, sound and smells can worsen the pain.

There are two main types of migraines:

Migraine with aura: Some people who suffer from migraines experience some or all the following symptoms up to 60 minutes before the pain starts:

Nausea
Increased sensitivity to light, sound or smells
Temporary vision loss
Seeing spots or flashing lights
Dizziness
Extreme fatigue

Migraine without aura: This is extreme headache pain without warning, usually behind one ear or eye, or in the temples. The pain can last up to 72 hours.

Migraine triggers

If you suffer from migraines, you may find that certain triggers cause their onset, such as:

Hormonal changes: Menstrual cycles and hormonal changes in women can cause migraines. In fact, women are three times more likely to suffer from migraines than men, according to the National Institutes of Health.
Allergies: Because allergies can cause irritation and inflammation and migraines are associated with inflammation of blood vessels, allergies are a trigger for migraines.
Genetics: People with a family history of migraines are more likely to develop them.
Environmental: There are a wide range of triggers in a person’s environment that can cause migraines, including stress, certain foods, skipping meals, weather and lack of sleep.

Migraine vs. headache: Treatment and relief

There is no specific cure for headaches and migraines, but usually medication and lifestyle changes can bring much-needed relief.

Over-the-counter drugs, such as acetaminophen (Tylenol), ibuprofen (Advil) and aspirin (Bayer) can bring relief for headaches and mild migraines. Also, Excedrin Migraine is another option that has been shown to work well.

However, if you experience moderate to severe migraines on a regular basis — 15 or more a month — it’s a good idea to speak to your doctor about prescription medicines. They may be able to reduce the severity of your chronic migraines and prevent future ones from occurring.

Can headaches and migraines be prevented?

Because headaches and migraines can be triggered by environmental factors, making lifestyle changes could help prevent them, such as:

Exercising regularly
Avoiding trigger foods and beverages, and limiting caffeine
Eating regularly and never skipping meals
Improving sleep habits
Developing relaxation habits, such as meditation, yoga and stretching and heat or massage therapy

Headache and migraine triggers can be highly individualized. That’s why keeping a headache journal can help you track patterns and identify possible triggers to help keep pain at bay. At the first sign of pain, jot down the day and time of onset, your symptoms, along with any activities and foods you consumed about 24 hours before the pain began.

Journaling this information can help you and your doctor create a customized plan to avoid triggers and reduce the frequency of your headaches to bring you the long-awaited relief you’ve been waiting for.