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Headache vs. Migraine: What Are the Differences?

Not sure if your pain is a migraine, or just a bad headache? Here’s how to tell the difference.


Ever get such a splitting headache that you wonder: Is this a bad tension headache? Or could this be a migraine? 

It can be hard to tell the difference between the two if you’re not familiar, but there are some key migraine-specific symptoms to look out for (and if you think you have them, a neurologist can formally diagnose you and recommend the best treatment options for you). Read this guide for some helpful clues.

Tension Headaches

The most common type of headache is a tension headache, and symptoms may include a dull ache, tightness, or pressure in the forehead area, the temples, or around the sides or back of your head. The pressure tends to be constant, rather than throbbing, and it's usually mild to moderate in intensity. Sometimes you might also feel tenderness in the scalp, neck, or shoulders. 

Tension headaches can be "episodic," meaning they come and go and might last for as little as 30 minutes or as long as a week. Or they can be "chronic," meaning they generally last for hours and/or occur more than 15 days a month for at least three months. 

An over-the counter pain reliever may make a tension headache go away. If you’re experiencing them frequently, your doctor may recommend you try some non-medication prevention techniques, including acupuncture, massage therapy, relaxation, and physical therapy.

Migraine Headaches

A day or two before a migraine headache, you might notice something called a "prodrome" or a subtle warning sign. This could include neck stiffness, frequent yawning, changes in your mood, constipation, food cravings, or increased thirst and urination. 

Moments before the migraine, you may experience an "aura." For instance, you might see spots of flashing lights or feel a tingling on one side of your face, arm, or leg. (Not everyone experiences these; for example, only about a quarter of migraine sufferers experience aura.)

During the migraine itself, you may feel an intense headache come on. The pain is usually severe. Look out for a pulsing sensation that often occurs on just one side of the head. The pain may last for hours or even days, and it may hurt so much that you have to stop whatever you're doing and lie down. 

A migraine is typically more than just a headache. It may feature visual disturbances, lightheadedness, blurry vision, vomiting, or nausea, too. You might experience increased sensitivity to light, sound, smell, or touch, and working out might make the pain even worse.  

Scientists don't completely understand what causes migraines; everyone has different triggers, which may include stress or a change in hormone levels. To treat a migraine, you may require a migraine-specific, over-the-counter pain reliever, and if that doesn't help enough, your doctor may prescribe something stronger and work with you on lifestyle changes. 

When to Call 911

If you experience a sudden, severe headache that's unlike anything you've ever felt, go to the emergency room—especially if you've just had a head injury. Other serious symptoms include: fever, confusion, numbness, trouble speaking, seizures, weakness, or a stiff neck.

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