Headaches are the most common form of pain, according to the National Institutes of Health (NIH). Pretty much every person has experienced a headache at some point in their life, and at least half of all adults have had a headache in the past year, per stats from the World Health Organization. Migraines, on the other hand, are a little less common. Roughly 12 percent of adults experience migraine headaches, according to the American Migraine Foundation (AMF).
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While many of us rightly think of a migraine as a specific kind of headache—one that tends to be severe—there’s a lot more to it than that. Both migraine and non-migraine headaches can be broken down into more than 150 “primary” and “secondary” headache subtypes—each of which has its own symptoms and underlying causes. (Pretty crazy, right?)
At a high level, the word “headache” is a catchall term for any kind of head-related pain. “Headache is a non-specific diagnosis and usually refers to tension headaches, which almost everyone has experienced at some point in his or her life,” says Susan Hutchinson, M.D., a board-certified family practice physician and founder of Orange County Migraine & Headache Center.
A migraine, on the other hand, is “much more than just a headache,” Hutchinson says. “Migraine is a chronic neurological disease.”
It may be helpful to think of the difference between headaches and migraine as akin to the difference between joint pain and rheumatoid arthritis. One is a health complaint stemming from a wide range of issues, while the other is a specific medical condition with distinct underlying causes.
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How to tell migraine pain from regular headache pain
These rules don’t apply to everyone, but there are a few easy ways to differentiate typical migraine pain from the pain of non-migraine headaches.
Migraine headaches
Among people who experience migraine headaches, the pain tends to be “moderate to severe,” and it’s usually just on one side of the head, according to the AMF. The pain also tends to have a “pulsing” or throbbing quality, and it often gets worse if you walk around, climb stairs, or workout. (Um, ouch!) Also, bright lights or loud noises tend to make the pain worse, Hutchinson says.
Non-migraine headaches
Tension headaches—the non-migraine type that Hutchinson says a lot of people experience from time to time—usually cause pain on both sides of the head. They also tend to be mild or moderate. A sensation of pressing or tightening is also typical. “It’s most commonly described as a tight band-like feeling around the head,” she says.
These headaches don’t tend to get worse with movement or after exposure to bright lights or loud sounds, and they usually don’t pulse or throb the way migraine headaches do, according to International Headache Society (IHS) resources.
However, in some cases, a non-migraine headache can be much more painful than a migraine.
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Other symptoms that differentiate migraines from regular headaches
Short-term vision trouble
Many migraine patients experience the presence of short-term vision trouble, which usually takes the form of zigzagging or blinking splotches, dark spots, or patches. (If you look at a bright light and then look away, the resulting dark spot you see is similar to what we’re talking about here.)
These vision symptoms are the most common feature of something called “aura,” which is the name for a handful of neurological symptoms experienced by roughly 30 percent of migraine patients, according to the IHS. This is not something that occurs during your typical headache.
Dizziness
Some other aura symptoms include numbness or prickling in one or more parts of the body, problems speaking, and dizziness, but these are less common than a visual aura. These issues tend to show up shortly before migraine pain sets in. To be clear, the majority of migraine patients do NOT experience an aura, according to the AMF. But if you do, it’s a near certainty that you’re dealing with a migraine—not a regular headache.
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Nausea
Nausea is another common symptom of migraine headaches, Hutchinson says. If you’ve thrown up or felt like you could throw up as a result of your headaches, that’s a strong sign you’re dealing migraine, not a headache.
Symptoms leading up to and following your head pain
Sometimes migraine patients will experience prodromal or postdromal symptoms. These include fatigue, neck stiffness or pain, feeling like your mind is either racing or sluggish, feeling depressed, craving specific foods, or repeated yawning.
The causes of migraine and non-migraine headaches
Non-migraine headaches
Experts aren’t sure about the underlying causes of run-of-the-mill headaches, however, there’s evidence that stress or emotional conflict can bring them on. Jaw-clenching, insomnia, skipping meals, and depression are all associated with these headaches, although it’s not clear why these experiences cause head pain in some people but not others
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Migraine headaches
Many of these same factors—stuff like stress and poor sleep—can cause a migraine. Weather-related changes in barometric pressure can also bring on a migraine. (Hutchinson is a medical advisor to a company called WeatherX, which makes specially designed earplugs that can help shield patients prone to head pain from these pressure changes.)
Experts also recognize some underlying neurological issues that may contribute to migraine headaches. Specifically, there’s evidence that overactivity of some groups of brain cells may play a big part in the development of migraine headaches. The rise and fall in the levels of hormones such as serotonin and estrogen seem to contribute to this activity. In some cases, a non-migraine headache can be much more painful than a migraine. Changes in blood flow in certain parts of the brain also play a role. But the nitty gritty of a migraine’s underlying causes is still being sorted out.
How do doctors diagnose migraines vs. regular headaches?
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Doctors usually diagnose both migraine and non-migraine headaches based on a patient’s experiences and symptoms. For this reason, the NIH recommends keeping some kind of journal or record related to your headaches—something you can bring with you when you see your doctor.
You’ll want to write down any symptoms you experience before, during, and after your headache. Also, write down any foods or drinks you consumed before your headache started, whether you were stressed or sleep deprived, and anything else that seems like it could have triggered your pain. Additionally, you should note how often your headaches occur and how long they last. All of this information can help your doctor diagnose your headache type and provide more effective treatment.
Okay, so how do migraine and headache treatments differ?
Migraine headaches
There are four different classes of drug that are formulated specifically to relieve migraine pain and symptoms, according to the U.S. National Library of Medicine. Stress management techniques (stuff like meditation and yoga) as well as lifestyle changes (like avoiding certain foods or alcohol) can also help prevent migraine headaches in some patients. Getting at least seven to eight hours of sleep each evening is also helpful, the AMF notes.
Non-migraine headaches
Different types of drugs (like non-steroidal anti-inflammatory drugs, including aspirin) are used to treat non-migraine headaches, according to the National Institute of Neurological Disorders and Stroke. But managing your stress, getting plenty of sleep, and, in some cases, avoiding certain foods or substances can help relieve non-migraine headaches.