Migraines vs. Headaches: What’s the Difference?

Headaches and migraine headaches are superficially similar but happen for very different reasons. The most common causes of tension headaches are stress and anxiety. Migraines, on the other hand, develop over the course of several days and finally culminates in a powerful and overwhelming attack, often accompanied by nausea, vision problems (from vision loss to seeing lights), vomiting, and extremely intense pain (usually on one side of the head, and rarely on both sides).

While tension headaches can be very discomforting as well, they usually do not last as long as migraine attacks do, neither do they feature the same symptoms of flashing lights or ‘auras’, temporary vision loss, and excruciating pain localized entirely on one-half of the head. Other types of head pain may feature similar symptoms to migraine attacks and must be distinguished from one another in order to know when to seek appropriate medical attention. Because tension headaches and migraine have very different causes, the treatment is often different as well.

What Are Migraines?

Migraine headaches affect roughly a billion people all over the world, and about a quarter of US households have one person struggling with a migraine. About 18 percent of women struggle with migraine, versus about 6 percent of men and 10 percent of children. Migraine symptoms usually begin between ages 18 and 44, and nearly 90 percent of migraine sufferers have relatives who also struggle with migraine attacks.

As the third most prevalent disease on the planet and the sixth most disabling, it’s a serious condition that inflicts massive and debilitating pain on those who struggle with it. It’s so severe that an estimated 1.2 million ER visits every year are due to migraine attacks, which are often triggered like any other headache, by things such as bright lights, smoke, dehydration, and stress.

The Stages of a Migraine

Unlike regular tension headaches, migraine headaches are considered a neurological condition with symptoms ranging from difficulty speaking to vomiting. Migraine attacks are usually differentiated between classic migraine and migraine with aura. Unlike headaches, migraine begins several days before the onset of pain, during the prodrome stage. Symptoms during the prodrome stage include neck stiffness, irritability, and frequent yawning.

In cases where a migraine is accompanied by aura, the aura sets in after the prodrome stage ends (usually within 1-2 days). Aura symptoms include seeing flashing lights and shapes, vision loss, and loss of verbal faculties. With or without preceding auras, a migraine’s next stage is an attack, which can last a few hours or several days. Migraine attacks involve:

• Pulsating pain on one side of the head (usually);
• Extreme nausea or vomiting;
• Sensitivity to light and sound.

Once an attack ends, the person goes through the postdrome stage. This might still be accompanied by a mild headache but is usually characterized by sudden changes in mood (usually for the better). It’s not completely understood how or why migraine attacks occur. Neurotransmitters, which are specific brain chemicals, may play a role. Changes in blood flow may trigger migraine, but don’t explain the pain. Hormone fluctuations as are common in women may help explain migraine attacks are more often experienced by women. However, a migraine’s triggers are demonstrably similar to those of other headaches.

How Do Headaches Happen?

The most common headache is a tension headache, caused by tension in the neck and head, and the activation of sensitive nerve endings, most commonly due to stress, hunger, lack of sleep, certain triggering foods (depending on the individual), withdrawal (from a variety of substances), and weather changes (pressure). The duration and intensity of a headache depend entirely on the person, and their sensitivity. Furthermore, headaches aren’t completely understood. Their triggers differ from person to person. Some common headache triggers include:

• Certain medication;
• Alcohol consumption;
• Smelling strong smoke;
• Bright lights, flashing lights;
• Glutamate, nitrates, and other preservatives;
• Other smells (air fresheners, perfumes, specific odors);
• Withdrawal from caffeine, over-the-counter medication, and illicit substances;
• Certain foods, including fermented food, chocolate, bananas, nuts, avocados, pork, and dairy.

Types of Headaches

Triggers for headaches and migraines are similar. However, headaches have different symptoms. There are different types of headaches, including:

• Tension headaches
• Sinus headaches
• Cluster headaches
• Chiari headaches
• Thunderclap headaches
• Exertional headaches
• Hypnic headaches
• Withdrawal headaches
• Injury headaches
• Menstrual headaches
• Hangover headaches

Different headaches require different treatments. Because headaches occur for such a vast variety of reasons, understanding what caused the pain, to begin with, is the most important step to figuring out how to end it. Over-the-counter medication can often work, but isn’t always appropriate, especially in cases where it contributed to causing the pain to begin with. If you’re facing unbearable pain, consult a professional.

Treating Migraines

While there are different ways to tackle headaches, including OTC meds and better hydration, it can be a little trickier to address a migraine. Migraine cannot be completely cured, but it can be managed, and even reduced into insignificance in some cases. Treatments that have been found successful for some cases of migraine pain include:

• Triptans;
• Antihistamines;
• Botox injections;
• Tricyclic antidepressants;
• Anticonvulsant medication;
• Prescription medication (for pain or nausea);
• Counseling to help deal with stress and avoid triggers;
• Hormone therapy (for migraine linked to menstruation);
• Alternative medicine, including massage and herbal supplements.

Your treatment plan will depend entirely on what works for you. Some treatments are only effective on very severe and frequent forms of migraine, such as Botox, which has proven effective when injected into the forehead every three or so months at very low dosages. In some cases, relying on OTC medication may be enough to reduce the pain and get through a particularly vicious attack, especially if the attacks are very rare and infrequent.

Alternative treatments like acupuncture and massages aren’t proven to work but may work in some cases. The use of prescription medication to combat nausea or prevent muscle strain has proven partially successful yet may not always be the right answer for you. Different cases of migraine occur for different reasons and identifying the right cause can lead to the right treatment.