What is the Difference Between a Headache and a Migraine?
As a long-term headache sufferer, I cannot begin to tell you how many times I have cringed when I hear someone refer to a “headache” as a “migraine” interchangeably, as if the two are the exact same thing.
But a migraine is not synonymous with a headache—it is simply a type of headache.
Quite often the person talking about the headache is actually suffering from a tension headache or something else entirely—so it is misleading to call it a migraine.
This might sound nitpicky of me, but it really isn’t. Headaches are confusing. Classifying them properly is important because it helps people to identify the causes of their pain. And that is usually the first step in making any sort of recovery.
If you suffer from a migraine, you are not necessarily going to get the pain relief you need by treating it like a tension headache. And if you have a tension headache, taking medicine for a migraine may do very little to ease your suffering.
So let’s break it down and explore the differences between different types of headaches. I will give you tips for identifying and treating each!
What Is a Headache?
A headache is just what the name implies: any type of painful ache in your head. A migraine is only one type of headache, and not even the most common.
One important thing to know about headaches is that different types can feed into each other.
For example, take my situation. I suffer from two types of headaches. The two sensations were distinct sometimes, but often blended, so it was hard for me to distinguish between them or understand the differences in my pain experiences for a long time.
Eventually though I figured out that I have both tension headaches and migraines—and quite often the two feed into one another in a vicious loop.
I might for example start with a migraine, and then develop tension as a result of the pain. This leads to a tension headache. The stress then feeds into a new migraine, which then causes more tension, and so on.
It’s no fun at all. But I have things under some semblance of control, because I learned to understand my headaches and tell one type from another and treat them accordingly.
Types of Headaches
Following is a brief overview of the most common types of headaches and what you can do about them.
A migraine is a specific type of headache which tends to be moderate to severe. Migraines may strike only a few times a year, or they can strike every day. They are typically painful enough to disrupt your activities, and if they are frequent, they can greatly reduce quality of life.
Signs and Symptoms:
- Pain may be anywhere on the head or face, but is often on one side.
- Typically pain has an intense, throbbing quality.
- Pain may localize near an ear or eye or in the temples.
- Migraine pain may be accompanied by additional symptoms like nausea, vomiting, and sensitivity to light and sound. Some people also report vision loss, halos or flashing lights.
- Some people actually experience vision or nausea symptoms without head pain. That is still a form of migraine.
Researchers are still not sure why some people are more susceptible to migraines than other people. It may have something to do with genetics or with an imbalance of brain chemicals.
Your migraines may be triggered by numerous different factors, but a few to watch out for are:
- Skipping food or water
- Over-sleeping or under-sleeping
- Hormonal imbalances (this is what causes my migraines)
- Use of birth control pills
- Alcohol or caffeine (or withdrawal)
- Certain foods containing MSG, tyramine or nitrates
- Changes in the weather
- Bright sunlight or hot weather (another major trigger for me)
- Other headaches
Keep a log of your attacks. Over time, you should be able to isolate and identify likely triggers. You can then pursue appropriate treatment.
- Take medicine—I find that Midol works quite well. Even though this OTC medication is usually taken for PMS, men can take it too. It contains nothing more than a pain reliever, caffeine and an antihistamine.
- If your case is particularly out of control, you may be able to get prescription pain medication. Note however that it is hard to get a doctor to take migraine pain seriously. You may have a hard time getting a prescription.
- Start or quit hormone therapy/birth control pills (depending on your imbalance). Better yet, avoid hormone replacement therapy, and start taking herbs to balance out your hormones instead (this has worked wonders for me—Vitex specifically).
- Avoid your triggers.
- Take an herbal supplement for pain relief from migraines. Common choices include feverfew, butterbur and magnesium.
- Ice and heat can help—ice in particular is great.
- Lie down and get some sleep.
- Consider sexual activity. It may sound like the worst idea possible, but it actually can effectively reduce migraine pain in many people.
Many people believe that migraines are the most common headaches, but that is incorrect. Tension headaches are actually more common. If I had a dollar for every time I have heard someone incorrectly identify their tension headache as a migraine, I could buy myself something nice.
A tension headache is the result of pain being referred from tight muscles in your face, neck, shoulders, or back. Why does this happen? Most doctors aren’t too sure. This can leave you feeling pretty helpless—but there is a lot you can do to treat your tension headaches.
Signs and Symptoms:
- The classic tension headache feels like tightness or pressure across your forehead, the sides of your head, or the back of your scalp.
- Nonetheless, tension headaches can be located anywhere. I often feel them over my mouth, jaw, cheeks and nose.
- Tension headaches are often mild to moderate, but can be intense and debilitating, especially when continuous.
- A tension headache will often migrate to a new spot if you change the position you are sitting or lying in.
- Pain is typically “dull” in character, not throbbing like a migraine.
- Low-level tension headaches may feel more like a general physical malaise.
- If you press on the tense muscles in your neck, shoulders or back, you may feel an intense or subtle ache in your trigger points. Sometimes you will also feel the referral pattern radiating to your head.
A tension headache is the result of pain being referred from tight muscles in your face, neck, shoulders, or back.
- Holding tension in your shoulders
- Mistakes while exercising
- Other headaches (i.e. migraines)
- TMJ or other misaligned joints, especially in the spine
- Take medicine (OTC or prescription).
- Treat any contributing migraines.
- Practice relaxation techniques. Learn to stop holding tension in your shoulders.
- Stretch, warm up, and cool down appropriately when exercising.
- Treat any underlying injuries or misaligned joints. A chiropractor or massage therapist can work wonders.
- Try a heating pad to relax your muscles. If you can find a position to sit or lie down in which releases the tension, you may feel better.
- Try the traditional Chinese practice of Gua sha. I can tell you from personal experience that it is ridiculously easy, it can provide some immediate relief, and despite appearances, it is not painful.
Whatever you do—I cannot emphasize this enough—DO NOT GIVE UP. Techniques to control tension and migraine headaches only work if you use them diligently every single day for an extended time period. Your recovery will be gradual.
Cluster headaches can be even more intense than migraines, though they typically do not last nearly as long. They are excruciatingly painful, but thankfully they are the least common type of headaches.
Signs and Symptoms:
- Pain develops rapidly into an explosive attack within 5-10 minutes.
- Pain is usually on one side only and tends to center on your eye.
- Pain may be constant or throbbing and may feel like it burns or pierces your skull.
- Most cluster headaches last 30-90 minutes, but they may be longer or shorter. One to three a day are typical during periods of attacks.
- Cluster headaches can go into remission for months or years.
- Attacks may happen at the exact same time each day or night.
Cluster headaches can be even more intense than migraines, though they typically do not last nearly as long.
The condition appears to involve the triggering of pain in the trigeminal nerve.
- Preventative prescription medications are usually used to treat cluster headaches.
- Sumatriptan and breathing oxygen through a mask for a period of 20 minutes may be used for an attack.
- Sometimes surgery is recommended.
Sinus Headaches (and Other Secondary Headaches)
Sinus headaches are also regularly confused with migraines. Sinus infections are quite common, and headaches are a defining feature of many.
If you have migraine symptoms like nausea or light sensitivity, you probably don’t have a sinus infection—unless you also have sinus symptoms like thick or discolored nasal secretions or a fever.
Another classic symptom of a sinus headache is for the headache to get worse if you bend over with your face toward the floor.
Note that some other illnesses, injuries and health conditions can also cause headaches as a secondary symptom.
- Take a painkiller to treat your symptoms.
- You may be prescribed a round of antibiotics to kill your sinus infection.
- Get plenty of rest and give yourself time to recover.
One more type of headache to be aware of is a “rebound headache.” This headache occurs when you are suffering from withdrawal from a painkiller. It may be an OTC medicine or a prescription medicine—or even coffee or caffeine.
You are at elevated risk for rebound headaches if you take painkillers two to three times a week or more or 10 or more days out of the month.
Rebound Headaches occur when you are suffering from withdrawal from a painkiller.
Even a daily cup of coffee can lead to rebound headaches in some people. I remember in high school a lot of kids who had terrible headaches if they didn’t drink their morning coffee.
Rebound headaches may feel identical to either tension headaches or migraines.
Unfortunately if you suspect you are suffering from rebound headaches, you have to reduce your dosage gradually or quit your medication altogether long enough to detoxify your body and stop the rebound cycle. If the painkiller triggering the headaches is a narcotic, sedative, or hypnotic, you may need to be admitted to a hospital.
Identifying Your Headache Type is the First Step to Finding Relief
One headache is not the same as another. A migraine is not a tension headache or a cluster headache or a sinus headache.
It will likely take a lot of careful observation, journaling, and trial and error to properly identify the type(s) of headaches you experience.
But once you have figured it out and started finding treatments which work for you, you can vastly reduce your symptoms. You may even be able to eliminate the majority of your headaches over time.
I know what this is like in the beginning—I have been there. It is intensely frustrating, and at times, it can be deeply discouraging, especially if doctors do not take your complaints of agony seriously.
But just remember, your life can change for the better, even if it takes months or years to make it happen. So don’t give up. There was a time I felt completely helpless against my pain, but most days I now feel pretty good. I overcame my headaches, and you can too.