A migraine feels like intense, throbbing pain that pulses with your heartbeat, typically on one side of your head. But the headache itself is only part of the experience. Most people with migraines also deal with nausea, extreme sensitivity to light and sound, and a level of exhaustion that can linger for days after the pain stops. An untreated migraine lasts anywhere from 4 to 72 hours.
How the Pain Feels
The hallmark of migraine pain is a pulsating or pounding sensation, often centered around one eye, one temple, or one side of the head. It can start dull and build in intensity over minutes to hours. Unlike a tension headache, which feels like steady pressure or a tight band wrapped around your skull, migraine pain throbs. It gets noticeably worse when you move your head, bend over, walk up stairs, or do anything physically active.
The pain doesn’t always stay put. It can start on one side and shift to the other, or spread to your face, sinuses, jaw, or neck. Some people feel it behind both eyes. At its peak, the pain is moderate to severe, and for many people it’s completely disabling, making it impossible to work, drive, or carry on a conversation.
Nausea and Stomach Symptoms
Nausea is almost universal during a migraine, affecting more than 90% of people who get them. Nearly 70% experience vomiting. This isn’t mild queasiness. Many people describe it as a deep, rolling nausea that makes eating impossible and sometimes makes the smell of food unbearable. Some also develop abdominal pain during an attack. The nausea often intensifies alongside the headache and can make it difficult to keep oral medications down, which is one reason migraines are so hard to treat once they’re fully underway.
Sensitivity to Light, Sound, and Smell
During a migraine, your brain becomes hypersensitive to sensory input. Normal room lighting can feel blinding. Ordinary conversation-level sounds can feel painful. This is why people in the middle of an attack instinctively retreat to a dark, quiet room.
Smell sensitivity is less well known but remarkably common. About 86% of migraine sufferers experience it during an attack. Perfume, cooking odors, or cleaning products that wouldn’t normally bother you can trigger waves of nausea or intensify the headache. More than half of people with smell sensitivity also have light sensitivity, sound sensitivity, and nausea all at once.
Skin Sensitivity and Allodynia
Over half of migraine sufferers (about 53%) develop something called allodynia during an attack, where normally painless touch becomes painful. Your scalp may feel so tender that brushing your hair hurts. Resting your head on a pillow on the side of the headache can be excruciating. Some people find that wearing a ponytail, putting on glasses, or even having their shirt collar touch their neck becomes unbearable.
This skin sensitivity usually shows up on the same side as the headache and peaks when the pain is at its worst. In some people, it extends beyond the head to the arms, torso, or even toes. The longer someone has lived with migraines and the more frequent their attacks, the more likely they are to develop this symptom.
What Happens Before the Pain Starts
Many migraines announce themselves one or two days in advance through subtle warning signs. You might notice unusual food cravings, excessive yawning, neck stiffness, mood swings (from feeling unusually happy to irritable or depressed), increased thirst, more frequent urination, or constipation. These prodrome symptoms are easy to miss if you don’t know to look for them, but over time, many people learn to recognize their personal warning pattern.
About a quarter of migraine sufferers also experience an aura, which typically starts 5 to 60 minutes before the headache. The most common type is visual: you might see a small spot of shimmering light that expands into a C-shaped or crescent pattern with zigzag edges, sometimes described as looking like the walls of a medieval fortress. Bright flashes, sparkles, or a patch of lost vision (a blind spot that drifts across your visual field) are also common.
Some auras aren’t visual at all. A sensory aura starts as tingling in one hand or arm that slowly creeps upward over 10 to 20 minutes and can spread to one side of the face and tongue. Rarer types cause temporary difficulty finding words or speaking clearly. In the rarest form, one side of the body becomes temporarily weak.
The “Migraine Hangover”
When the headache finally breaks, the experience isn’t over. Most people enter a postdrome phase that feels remarkably similar to an alcohol hangover. You’re exhausted, your body aches, your neck is stiff, and concentrating on even simple tasks feels like pushing through fog. The room might still feel like it’s spinning. Light and sound sensitivity can linger. Your mood may swing between brief euphoria and a low, flat sadness.
This phase lasts anywhere from a few hours to two full days. Many people say the postdrome is almost as disabling as the headache itself, because the fatigue and mental cloudiness make it hard to resume normal life even though the worst pain has passed. Resting in a dark, quiet space continues to help during this stage.
How Migraines Differ From Tension Headaches
The distinction matters because the two feel fundamentally different and respond to different treatments. A tension headache produces a dull, steady ache or pressure across both sides of your head, often radiating into the neck and upper back. It’s uncomfortable but usually doesn’t stop you from functioning. You can generally still watch TV, go for a walk, or get through your workday.
A migraine, by contrast, throbs. It typically favors one side of the head. It gets worse with physical movement. And it comes with the constellation of symptoms described above: nausea, light and sound sensitivity, and sometimes aura. Tension headaches don’t cause nausea, don’t produce auras, and don’t worsen when you move around. If your headache forces you to lie down in a dark room, it’s far more likely to be a migraine.
How Disabling Migraines Can Be
Doctors use a disability scale that measures how many days over the past three months migraines have caused you to miss work, school, or household activities, or left you functioning at less than half capacity. A score above 21 indicates severe disability. Many chronic migraine sufferers score well above that threshold. Beyond the individual attacks, the unpredictability of migraines creates a constant background of anxiety: you never know when the next one will derail your day, cancel your plans, or leave you unable to care for your kids.
In children and teenagers, migraines can be shorter (lasting as little as two hours) but are no less intense. Kids may have more trouble describing what they feel and may show the pain through irritability, pallor, or wanting to lie down rather than articulating a throbbing headache.