Headaches and migraines both cause head pain, but are distinct. A headache is general head pain; a migraine is a complex neurological disorder with specific symptoms. Understanding their differences is crucial for proper management.
What Are Headaches?
Headaches are common, characterized by pain in the head or face. Pain varies by type. Most are primary headaches, not caused by underlying medical conditions.
Common types include tension headaches, causing dull, aching pain or tightness across the forehead, sides, or back of the head. Sinus headaches feel like a constant, dull ache or pressure behind the eyes, in the cheekbones, forehead, or bridge of the nose, often worsening with head movement. Cluster headaches, though rarer, involve sudden, sharp pain usually around one eye or on one side of the face, often accompanied by tearing eyes and nasal congestion.
What Are Migraines?
Migraines are a complex neurological condition, extending beyond a typical headache. They cause severe, throbbing or pulsing head pain, often on one side but can occur on both. Attacks progress through several phases.
The prodrome phase, up to 24 hours before the headache, may include mood shifts, neck stiffness, or increased thirst. Some experience an aura, temporary neurological symptoms preceding or accompanying pain. Auras often involve visual disturbances like flashing lights, zigzag lines, or blind spots, or tingling, numbness, or speech difficulties. The main attack phase follows, with intense head pain lasting four hours to several days, accompanied by other symptoms. Finally, a postdrome phase, often called a “migraine hangover,” can leave individuals drained or confused for up to 48 hours.
Distinguishing Features
Migraines and headaches differ in pain, intensity, associated symptoms, duration, and impact. Headaches, like tension headaches, present as dull ache or pressure; migraine pain is throbbing or pulsating. Headache intensity ranges from mild to moderate, causing minor disruption. Migraines are moderate to severe, debilitating pain.
Headache pain can be generalized or localized to specific areas like the forehead or sinuses. Migraines frequently manifest with pain on one side, though they can affect both. Associated symptoms are a key differentiator. Migraines are often accompanied by nausea, vomiting, and extreme sensitivity to light (photophobia), sound (phonophobia), and sometimes smell (osmophobia). Physical activity tends to worsen migraine pain. Headaches typically resolve within a few hours, but migraine attacks can last hours to several days, significantly impairing daily activities.
Common Triggers and Risk Factors
Headaches and migraines are influenced by various factors, but their specific triggers differ. General headaches stem from common lifestyle elements such as stress, dehydration, eye strain, poor posture, lack of sleep, or skipping meals.
Migraines are often triggered by more specific factors. Hormonal changes, especially estrogen fluctuations during menstrual periods, pregnancy, or menopause, are common triggers for women. Certain foods and drinks, including aged cheeses, processed meats, artificial sweeteners, caffeine, and alcohol, can also trigger migraines. Sensory stimuli like bright or flickering lights, loud noises, and strong smells are common triggers, as are changes in weather or barometric pressure. Genetic predisposition is a significant risk factor, as migraines often run in families.
Treatment and When to Seek Medical Attention
Managing headaches involves over-the-counter (OTC) pain relievers like ibuprofen or acetaminophen, and lifestyle adjustments like hydration, adequate sleep, and stress management. For migraines, treatment is more targeted. Acute treatments, at attack onset, include triptans, ditans, and gepants. Anti-nausea medications may also be prescribed if vomiting is a symptom.
For frequent migraines, preventive measures include daily medications such as beta-blockers, anti-seizure drugs, certain antidepressants, or calcitonin gene-related peptide (CGRP) monoclonal antibodies. Non-pharmacological options like acupuncture or biofeedback can also be considered. Seek medical attention if headaches become more frequent or severe, do not improve with OTC medications, or interfere with daily life. Immediate medical consultation is necessary for “red flag” symptoms, such as:
- A sudden, severe “thunderclap” headache
- A headache following a head injury
- Headaches accompanied by a high fever
- Stiff neck
- Confusion
- Vision changes
- Numbness
- Weakness
- Difficulty speaking
These symptoms could indicate a serious underlying condition requiring urgent evaluation.