Some people who don’t have direct experience with migraines may confuse them with a headache. What are the key differences between a migraine vs. headache, and how can you tell the two apart? If you’re experiencing head pain, of any kind, it’s important to understand the type of headache you have. That way, you can seek the best and most appropriate treatment plan.
Migraine vs. headache — the basics
The most common types of headaches are:
- Cluster headaches
- Tension headaches
- Secondary headaches
Let’s take a look at each of those in more detail to better understand the differences between migraine vs. headache.
Migraines are an extreme form of headache that affect 36 million people in the U.S., 14 million of whom suffer from daily migraine pain. In addition to severe pain in various parts of the head (e.g., behind the eyes and ears), migraine sufferers may experience some or all of the following symptoms:
- Increased sensitivity to sounds and smells
- Extreme fatigue
Individuals suffering from migraine headaches often can’t sit upright and need to be in a dark, cool space until the pain subsides. Migraine headaches can be caused by environmental or food triggers or stress.
The following video gives a brief overview of migraines.
Cluster headaches are a type of head pain that occurs in the exact same spot around the same time of day during a specific time of year. Tearing from the eye when the pain is occurring is also possible. Food and emotions do not trigger cluster headaches. Instead they are caused by dilations in the blood vessels of the brain due to a release of serotonin and histamines. They can be caused by physical exertion, bright lights, or even altitude.
Tension headaches are felt just behind the eyes, in the face and neck, and at the base of the skull. It may be the most common form of headache pain. Eyestrain, stress, and hunger are the most common causes of tension headaches. They can be chronic or reoccurring in nature. Most often they are treated with over-the-counter NSAID medications.
Secondary headaches are symptoms related to primary conditions. For example, headaches that appear in patients diagnosed with brain tumors are likely to have headache pain related to the cancer, though the headache itself is not the primary source of pain. The causes of secondary headaches are numerous and need to be addressed by your pain specialist.
The following video gives a brief overview of the science behind headaches.
6 differences between migraine vs. headache
When it comes to migraine vs. headache, there are six major areas that can help you identify which one you’re suffering from. As always, understanding the actual cause of your pain is the first step to treating it.
While both headache and migraine feature pain, the intensity level of a migraine headache is much higher than that of a regular headache. Pain feels as if it is coming from inside the skull and is often accompanied by throbbing in the temples or pain behind the eyes.
Tension and cluster headaches typically resolve within a few hours. Migraine pain can last for days at a time.
Headaches usually have one symptom: pain. Migraine headaches come with a variety of symptoms that can include some or all of the following:
- Photosensitivity: Light is unbearable and increases the pain.
- Environmental sensitivity: Just as with light, sounds and smells in the environment can intensify pain.
- Dizziness: A migraine can feel very disorienting, both mentally and physically.
- Nausea: Whether due to dizziness or prompted by photosensitivity, nausea and vomiting often accompany migraine pain.
- Extreme fatigue: Migraine pain can make it impossible to sleep, and lack of sleep can intensify migraine symptoms.
4. Migraine phases
Those who suffer from migraine vs. headache will also notice that their migraine symptoms follow certain phases. These migraine phases typically include:
- Phase 1: The prodromal phase serves as a warning that pain is imminent. Migraine sufferers may experience mood swings, lethargy, and an increased need to use the bathroom.
- Phase 2: Aura is not present for everyone who suffers from migraine but can include a glow around figures and shapes or wavy lines. This is a neurological event that can occur 20 to 60 minutes before pain.
- Phase 3: The attack phase is when pain hits.
- Phase 4: The final phase is the postdromal phase when the pain has subsided. Sufferers may be exhausted but may also feel mildly elated.
The following video gives a greater overview of these migraine phases.
Tension and cluster headaches in general can have easily traceable causes. Tension headaches may be caused by additional stress or lack of sleep, while cluster headaches may be a result of dehydration. Migraine headaches have common triggers but are a neurological condition with no one cause. A person who has migraine headaches may find that their pain is triggered by a combination of factors.
While tension and cluster headaches may be caused at times by these factors, an important distinguishing factor is that those who suffer from migraine vs. headache will nearly always be triggered by their particular combination of factors. These migraine causes include the following:
- Gender and hormonal shifts
- Family history and genetics
- Nerve damage
- Environmental causes
Women are three times more likely to suffer from migraines than men. They are also more likely to see migraine pain diminish, if not disappear, after menopause, which leads some researchers to conclude that changes in hormones are a factor in migraine in women. Michael A. Moskowitz, MD, professor of neurology at Harvard Medical School at the Massachusetts General Hospital in Boston had this to say about the connection:
“Hormonal changes are a big contributor to the higher female incidence. There are lines of evidence that support this from lab to clinical evidence and a decrease (although not abolished) incidence in post-menopausal females.”
A study published in the November 25, 2013 edition of the online journal Cephalalgia connected allergies and migraine headaches for the first time. Allergies, also called allergic rhinitis, are a condition that causes irritation and inflammation in the body. Because migraines are also associated with inflammation of the blood vessels, it makes sense that one might exacerbate (or trigger) the other.
Vincent Martin, MD is a professor of medicine and a co-director of the University of Cincinnati’s headache and facial pain program. He writes:
“We are not sure whether the rhinitis causes the increased frequency of headaches or whether the migraine attacks themselves produce symptoms of rhinitis in these patients. What we can say is if you have these symptoms, you are more likely to have more frequent and disabling headaches.”
People with family members suffering from migraine are more likely to develop migraine themselves, and scientists at the University of California, San Francisco have found a genetic mutation that is common in those with the most typical type of migraine. The research team, led by a Howard Hughes Medical Institute investigator, found a mutation in the gene casein kinase I delta (CKIdelta). Researchers studied two families in which migraine was common and discovered the genetic mutation, then recreated that mutation in laboratory mice.
Another larger study of 11,000 migraine sufferers found other genetic links to migraine without aura. While the science continues to develop, it is clear that family history is a powerful cause of migraine vs. headache, with 80% of migraine sufferers having at least one family member who also has migraines.
Nerve fibers are surrounded by a protective coating called the myelin sheath. This prevents nerves from being overly stimulated at any given time, but when this sheath is damaged, migraines could result.
American Society of Plastic Surgeons (ASPS) member surgeon Bahman Guyuron, MD, of Case Western Reserve University, Cleveland found that migraine sufferers showed abnormalities in the myelin sheath surrounding their trigeminal nerve. The trigeminal nerve is a cranial nerve that originates from the brain stem to enervate the face and actions such as chewing and speaking. Dr. Guyuron examined the nerves of 15 patients with migraine and then compared them to 15 patients who were undergoing a cosmetic forehead lift. Of the results, Dr. Guyuron noted that:
“Essentially, the protective layer surrounding and insulating the normal nerves, called myelin, is missing or is defective on the nerves of the patients with migraine headaches…damage to the myelin sheath may make the nerves more prone to irritation by the dynamic structure surrounding them, such as muscle and blood vessels, potentially triggering migraine attacks.”
This is a broad category of causes that could be considered more along the lines of triggers than root causes of migraine. These include any of the following:
- Changes in weather: A falling or rising barometer can affect the pressure in the head, thus triggering a migraine.
- Stress: Stress over a long period of time can trigger a migraine, particularly immediately after a stressful time when the level of cortisol in the body drops.
- Food: Certain food preservatives or additives can trigger migraines, as can alcohol, sugar, and caffeine. Low blood sugar can also act as a trigger.
- Lack of sleep: Not enough sleep or sleep that is not restful is a common cause of migraine, a cycle that is perpetuated as migraines tend to make quality sleep elusive.
Not all of these will trigger a migraine 100% of the time, but when a migraine starts, there are a few treatment options.
Along with intensity and duration, this is where migraines vs. headaches truly part ways. A cluster or tension headache is typically easily resolved with over-the-counter remedies and a big glass of water. They are not pleasant, but they are not debilitating.
Migraine pain, on the other hand, can interfere with a person’s life for several days at a time. Over-the-counter headache medicines don’t begin to even dull the edges of the pain. Treatment for migraine is a multi-pronged approach, aimed first at an ounce of prevention before bringing in a pound of cure.
Prevention can include developing stress management techniques through meditation and meditative exercise such as yoga and tai chi. Getting plenty of rest, staying hydrated, and avoiding chemicals in foods and household cleaners are also suggested. Those suffering from migraines should neither drink nor smoke.
Treatments include getting plenty of rest in a dark room while in each migraine phase. Over-the-counter medicine, if administered at the very first sign of a migraine, coupled with rest, hydration, and relaxation, may head off a full-blown migraine. If these options do not work, doctors may prescribe medications that address pain as well as nausea and vomiting. Preventative prescription medicines can include beta blockers and antidepressants. However, these are only indicated if a person suffers from four or more debilitating events per month.
For migraine patients who do not respond to the above treatments, doctors may consider using temporary nerve blocks to see if that can identify the cause, making the block permanent if pain relief occurs. In some cases, the same techniques used in cosmetic eyelid surgery helped to permanently relieve migraine pain and may be an option.
Complementary medicine can be very effective as well. Pain doctors may also recommend participating in biofeedback training to complement any traditional treatments offered. Biofeedback training can help migraine sufferers to regulate their body’s response, and acupuncture can work to calm the mind. Staying hydrated and resting in a dark room with a weighted eye pillow can sometimes offer relief.
As with other medical research and treatment studies, there is some evidence that research and treatment for migraine is lagging because this is a condition that primarily affects women. This condition is the seventh most disabling condition in the world. It needs further study and treatment options if only for that.
Regardless of whether or not the studying of migraine is influenced by gender bias, there is one basic truth. Migraines are not just headaches.
Once you’ve figured out if it’s a migraine vs. headache
Once you know whether you’re suffering from a migraine vs. headache, it’s time to get help. You can try simple relaxation and stress-reduction techniques to get started. Find even more advice for treating mild to moderate cases of head pain on our blog.
If these techniques don’t work, it may be time to call in a pain doctor. For more severe or chronic cases, a pain doctor can help you identify your symptoms, diagnose the cause of your pain, and provide options for treatments that could work. Get started today by clicking the button below.