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What Classifies a Migraine vs. Headache? (Different Types of Headaches & How to Treat Them)

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According to the Migraine Research Foundation, migraines are the third most prevalent illness in the world. While most sufferers experience attacks once or twice a month, more than 4 million people have chronic migraine headaches, with at least 15 migraines per month[1]. The pain one might experience from headaches and migraines can often be mistaken for one anotherhere’s how you can tell the difference between the two. 

What is a Headache?

Everyone experiences some sort of headache once in a while, and others suffer this pain more often. The main symptom of a headache is a pain in your head or face, which can be anywhere from moderate to severe throbbing, constant, sharp, or dull pain. Headache pain is caused by signals interacting among the brain, blood vessels, and surrounding nerves. During a headache, an unknown mechanism activates specific nerves that affect muscles and blood vessels, these nerves send pain signals to the brain[2].

Different Types of Headaches 

There are over 150 different types of headaches. These are categorized by primary (aren’t due to another health condition), and secondary (are caused by another health condition).  

Common Primary Headaches: 

Cluster Headache

One of the most painful types of headaches, cluster headaches occur in cynical patterns. Bouts of frequent attacks, known as cluster periods, can last from weeks to months, usually followed by remission periods when the headaches stop. During remission, no headaches occur for months and sometimes even years[2]

Tension Type Headache

Often triggered by stress, if you’re experiencing a tension headache you may feel a dull, aching sensation all over your head. You may also feel tender or sensitive around your neck, forehead, scalp, or shoulder muscles.

New Daily Persistent Headaches (NDPH)

The headache associated with NDPH often resembles a migraine. You can experience light or sound sensitivity, nausea, and throbbing pain. The pain usually occurs daily and is diagnosed when it has been persistent for over three months.

Common Secondary Headaches:

Head Injury/Trauma

Post-traumatic headaches can develop after any type of head injury. These headaches feel like migraine or tension-type headaches, and usually, last up to 6 to 12 months after your injury occurs. Medications such as Triptans, sumatriptan (Imitrex®), beta-blockers, and amitriptyline are often prescribed to help control the pain from trauma headaches[2].

High Blood Pressure (Hypertension)

A hypertension headache occurs when your blood pressure becomes dangerously high. It will usually occur on both sides of your head and is typically worsened by any activity. You may also experience changes in vision, numbness or tingling, nosebleeds, chest pain, or shortness of breath[2].

If you think you’re experiencing a hypertension headache, you should seek immediate medical attention. These types of headaches typically go away once blood pressure is under better control[3].

Allergy or Sinus Headache

Sinus headaches may feel like an infection in the sinuses (sinusitis). Symptoms include pressure around your eyes, cheeks, and forehead. Allergies may also cause congestion in the nose and sinuses resulting in a sinus headache.

Caffeine

Caffeine affects blood flow to your brain, consuming too much can give you a headache, as can quitting caffeine “cold turkey.” People who have frequent migraines are at risk of triggering a headache due to their caffeine use.

Rebound Headache

Rebound headaches, also known as medication overuse headaches, can feel like a dull, tension-type headache, or they may feel more intensely painful, like a migraine. These types of headaches are typically caused by frequent use of OTC pain relievers such as acetaminophen, ibuprofen, aspirin, and naproxen[2]. The best treatment for rebound headaches is to slowly wean yourself off of the medication that you’ve been taking to control pain.

Exertion Headaches

Exertion headaches can happen after periods of intense physical activity such as weight lifting, running, and sexual intercourse. It’s thought that these activities cause increased blood flow to your skull, which can lead to a throbbing headache on both sides of your head. This type of headache usually resolves within a few minutes or several hours. Analgesics, such as aspirin and ibuprofen (Advil®), should ease your symptoms. If you develop exertion headaches, make sure to see your doctor. In some cases, they may be a sign of a serious underlying medication condition.

What is a Migraine?

Migraine headaches are intense or severe and often have other symptoms in addition to head pain. They usually produce symptoms that are more intense and debilitating than headaches, these may include:

  • Nausea
  • Pain behind one eye or ear
  • Pain in the temples
  • Seeing spots or flashing lights
  • Sensitivity to light and/or sound
  • Temporary vision loss
  • Vomiting

A migraine episode can occur in four distinct phases (not everyone experiences every phase). These include: 

Premonitory Phase

Also called the premonitory phase, the pre-headache or prodrome phase. It includes non-painful symptoms that occur hours or days before the headache arrives. Premonitory phase symptoms can include:[5]

  • Unexplainable mood changes
  • Food cravings
  • Stiffness of the neck
  • Frequent yawning
  • Constipation or diarrhea
  • Sensitivity to light, sound, or smells

Aura Phase

Auras refer to sensory disturbances that occur before or during a migraine attack. Auras can affect a person’s vision, touch, or speech. Visual auras can cause the following symptoms in one or both eyes:[5]

  • Flashing lights
  • Zig-zagging lines
  • Blurred vision
  • Blind spots that expand over time

Sensory auras cause numbness or tingling that starts in the arm and radiates to the face. Motor auras affect a person’s ability to communicate and think clearly and include:

  • Slurred or jumbled speech
  • Difficulty understanding what others say
  • Difficulty writing words or sentences
  • Having trouble thinking clearly

Headache Phase

Migraine headaches can range from mild to severe. People who have a severe migraine headache may need to seek emergency medical treatment. Physical activity and exposure to light, sound, and smells worsen the pain. People can have migraine episodes without developing a headache, however.

Postdrome Phase

The postdrome phase occurs after the headache subsides. People may feel exhausted, confused, or generally unwell during the postdrome phase. This phase can last anywhere from a few hours or several days.

Researchers believe that migraine headaches result when unstable nerve cells overreact to various factors. The nerve cells send out impulses to blood vessels and cause chemical changes in the brain, resulting in disabling pain[2]. Common triggers of migraine headaches include:

  • Excessive alcohol use
  • Changes in eating or sleeping patterns
  • Depression
  • Emotional stress
  • Excessive medication use
  • Eye, neck, or back strain caused by poor posture.
  • Lighting
  • Noise
  • Weather changes

What Causes Migraines?

Although the cause of migraines is unknown, there are common triggers, including:

  • Hormonal changes in women: Fluctuations in estrogen, such as before or during menstrual periods, pregnancy, and menopause, seem to trigger headaches in many women.
  • Alcohol and Coffee
  • Stress
  • Sensory stimuli: Bright lights, sun glare, and loud sounds, strong smells such as perfume, paint thinner, and secondhand smoke can cause migraines.
  • Changes in sleep patterns
  • Weather changes
  • Medications: Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
  • Foods and food additives: Aged cheeses and salty and processed foods, especially with preservative sweeteners, might trigger migraines—so might skipping meals or fasting.

Medications for Migraine Treatment

People who have migraine headaches less frequently may benefit from taking medications known to reduce migraines quickly. Examples of these medicines include[4]:

Distinguishing migraine headaches from other types of headaches can be complicated. Once you can tell the difference between a migraine headache and other headaches, it’s easier to get proper treatment. Headaches can range from being a mild inconvenience to being severe and debilitating. Pay particular attention to all of the signs and symptoms and be sure to consult with your doctor about the best course of action for you.


References

[1] https://migraineresearchfoundation.org/about-migraine/migraine-facts/#:~:text=While%20most%20sufferers%20experience%20attacks,15%20migraine%20days%20per%20month.

[2] https://my.clevelandclinic.org/health/diseases/9639-headaches

[3] https://www.healthline.com/health/migraine/migraine-vs-headache#migraine

[4] https://www.mayoclinic.org/diseases-conditions/sinus-headaches/symptoms-causes/syc-20377580

[5] https://www.medicalnewstoday.com/articles/324890#migraine