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The difference between a migraine and a headache and how to treat each one

Dec 22, 2020, 01:19 IST
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Migraines may come with visual disruptions called auras.Westend61/Getty Images
  • Headaches are moderately painful bouts of head pain, whereas migraines are a neurological disease that may cause symptoms like nausea, vision changes, and fatigue in addition to severe head pain.
  • Unlike a headache which typically lasts less than an hour or two, the symptoms of migraines come in phases can start as early as 24 hours before any head pain.
  • You can tread a headache with hydration, deep breathing, and nonsteroidal anti-inflammatory (NSAID) medicines, but you may need prescription drugs like sumatriptan (Imitrex) or rizatriptan (Maxalt) to treat migraines.
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Headaches are a common problem, but for most people, they aren't bad enough to disrupt your everyday life. Migraines are a more severe condition - they cause intense headaches and many other symptoms like weakness, confusion, and severe nausea.

Headaches can come and go based on your lifestyle, but migraines can be a lifelong problem and may need medical treatment. Here are some of the differences between headaches and migraines and how you can tell them apart.

What is a headache?

Nearly everyone has had a headache at some point, and most often, they are only moderately painful and pass within an hour or two.

But headaches aren't all the same. "Headaches include many different subtypes and they present in different ways," says Noah Rosen, MD, the director of the Northwell Headache Center.

The most common types of headaches are:

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  • Tension headaches: Tension headaches are the most common type of headache, affecting 75% of adults. They can be caused by many factors including stress, eye strain, tiredness, or hunger. Tension headaches usually cause pain on both sides of your head and may move from the back to the front of your head. Most people get tension headaches occasionally, but for some people, they can strike three or four times per week. These headaches generally last between 20 minutes and two hours.
  • Cluster headaches: Cluster headaches are extremely painful and follow a pattern, usually coming on around the same time each day. Cluster headaches happen when your body releases too much of certain hormones that dilate the blood vessels in your brain. These headaches can be triggered by bright lights, exercise, or high altitude.

Headaches can also be secondary, Rosen says, meaning that they're caused by a separate medical issue like a brain tumor or head injury. You may have secondary headaches if:

  • You are over 50 and start getting new headaches.
  • Your headache wakes you up at night.
  • The headache starts when you cough, chew food, or change positions.

What is a migraine?

A migraine is a type of headache that is often more severe. It's a chronic neurological disease that affects your nervous system and brain chemicals. Experts don't fully understand what causes migraines, but they may be due to abnormal brain activity that triggers a release of hormones like estrogen and serotonin in your body.

A headache is only one symptom of a migraine, and you may have other effects, including:

  • Greater sensitivity to light and/or sound
  • Weakness or fatigue
  • Nausea and vomiting
  • Confusion
  • Changes in your vision
  • Mood changes

Because estrogen changes are linked to migraines, women are three times more likely to get migraines than men. You are also more likely to get migraines if you have a family member who has them.

Migraines have four phases, but you might not experience all the phases every time you have a migraine. The phases tend to happen in this order:

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1. Prodrome: The prodrome phase can start as early as 24 hours before you actually get a headache. There are a variety of symptoms you may have in the prodrome phase including mood changes, yawning, food cravings, and peeing more often.

2. Aura: Not everyone gets migraine auras, but if you have this phase, it can interfere with your vision. You may start to see lights that aren't actually there or see zig-zag lines in your vision. The aura phase can also come with muscle weakness or phantom feelings of being touched. "Auras typically last under 20 minutes, but can last hours or even days in some cases," Rosen says.

3. Headache: The headache phase of a migraine can come on gradually and become more intense over time. Migraines are often only on one side of your head, and can feel like a throbbing or stabbing pain, Rosen says. "I've had people describe them as 'an elephant stepping on my head' or 'my brains trying to break out.'" The headache phase can last for hours or in some cases, for multiple days, Rosen says. This phase can also trigger other symptoms including:

  • Sensitivity to light and sound
  • Sensitivity to smell and touch
  • Worse pain when you move
  • Nausea or vomiting

4. Postdrome: This phase comes once the headache has stopped and can last for up to a day. During the postdrome phase, you may feel weak and exhausted. You can also have disruptions in your thinking and feel confused.

How to treat a migraine vs. How to treat a headache

You can treat a headache by:

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  • Drinking water, particularly if you think your headache may be caused by dehydration.
  • Eating regularly - skipping meals or snacking too much can cause changes in your blood sugar that may trigger headaches.
  • Relaxing using deep breathing techniques - this can help ease headaches caused by tension or stress.
  • Taking nonsteroidal anti-inflammatory (NSAID) medications like ibuprofen or acetaminophen.

You can help treat a migraine by:

  • Turning off the lights and lying down in a quiet area. Migraines can make you more sensitive to light and sounds.
  • Taking an NSAID medication along with a small caffeinated drink. Caffeine can help the medication work more effectively against migraines.
  • Taking a triptan drug like sumatriptan (Imitrex) or rizatriptan (Maxalt). These are prescribed by your doctor.
  • Using a cold compress on your head or neck to numb any pain. You can also use a hot compress to relax any tense muscles that can worsen a migraine.

Insider's takeaway

Headaches and migraines have some similarities, but they have different causes and symptoms. Headaches tend to be less severe and can be prevented by avoiding common triggers. Migraines are a chronic, partly genetic condition that may require more intensive medical treatment.

If your headaches are disrupting your normal daily activities, then you should see your doctor. "Make sure that you understand your condition and learn what you can do to make it better," Rosen says.

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