A headache is a general term for pain in the head, while a migraine is a complex neurological disease defined by head pain and a cascade of neurological events. Understanding the difference is important for accurate self-care and effective treatment. Identifying the specific type of head pain is the first step toward finding relief and managing the condition successfully.
Distinguishing Pain Characteristics
The quality and intensity of the pain itself offer the most immediate distinction between a headache and a migraine. A common tension-type headache typically involves mild to moderate pain that feels like a constant, dull ache or pressure, often described as a tight band squeezing the head. This pain is usually bilateral, affecting both sides of the head equally, and rarely worsens with physical activity, allowing a person to continue with daily tasks.
Migraine pain, in contrast, is frequently described as a moderate to severe throbbing or pulsating sensation. The intensity is often debilitating, making even simple movements difficult or impossible. While migraines can affect the entire head, they are classically unilateral, beginning or remaining on only one side. The pain typically ranges from four to 72 hours without treatment.
Non-Pain Related Associated Symptoms
Migraines are defined by accompanying neurological symptoms that are generally absent or mild in a typical headache. A defining feature is heightened sensory sensitivity, including photophobia (sensitivity to light) and phonophobia (sensitivity to sound). Sufferers frequently seek a dark, quiet environment to reduce discomfort. Some people also report osmophobia, an increased sensitivity to smells.
Gastrointestinal symptoms like nausea and vomiting are extremely common with migraines, but they are not typically associated with tension-type headaches. These symptoms contribute significantly to the overall distress and disability during an attack. Approximately 25% of people with migraines experience an aura, a temporary neurological event that often precedes the pain. This aura most frequently involves visual disturbances, such as flashing lights or temporary blind spots, but it can also include tingling, numbness, or difficulty speaking.
Major Types of Primary Headaches
Headaches are broadly classified as primary, meaning the headache is the main condition, or secondary, meaning the pain is a symptom of another underlying issue. Migraines are one of the most common types of primary headaches, which are recurring pain disorders. The other two most prevalent primary headache disorders are tension-type headaches and cluster headaches.
Tension-type headaches are the most common of all headache types, characterized by the mild, bilateral pressure described earlier. Although they can be chronic, they are generally less severe and less disruptive to daily function than a migraine. Cluster headaches, which belong to a group called trigeminal autonomic cephalgias, are far less common but represent the most severe form of primary head pain.
Cluster headache attacks are short, lasting from 15 minutes to three hours. The pain is excruciatingly sharp and burning, almost always localized around or behind one eye. These attacks occur in series, or “clusters,” often multiple times a day for weeks or months, followed by periods of remission. The pain is accompanied by distinct signs on the affected side, such as eye tearing, nasal congestion, or a drooping eyelid, which are unique to this type of headache.
Knowing When to Seek Professional Help
While most headaches are temporary and not medically dangerous, certain symptoms are considered “red flags” that require immediate medical evaluation. A sudden, extremely severe headache that reaches its maximum intensity within seconds, known as a “thunderclap headache,” warrants emergency care. This symptom can signal a potentially life-threatening condition, such as a brain hemorrhage.
Other urgent warning signs include a headache accompanied by neurological symptoms like confusion, slurred speech, or weakness or numbness on one side of the body. A headache paired with a stiff neck and fever may indicate meningitis, an infection of the membranes surrounding the brain and spinal cord. Any progressive headache that changes in pattern, frequency, or severity should also prompt a consultation with a healthcare provider. Finally, a physician should evaluate any headache that prevents working, sleeping, or participating in normal activities, or one that worsens despite over-the-counter medication use.