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Most of us have gotten a headache at some point. Maybe you didn’t hydrate properly all day, or you drank just a little too much red wine one night. NBD, right? Pop some acetaminophen, and you feel like yourself again.
Unfortunately, not all headaches are so simple. In fact, some headaches can feel really bad: throbbing pain for hours, sensitivity to light or sound, nausea, or even vomiting. If this is what you’re experiencing, you might have the supervillain of the headache world: a migraine.
Here’s what you need to know about the difference between headaches and migraines, what causes them, and how to find that sweet, sweet relief.
Headaches are common. In fact, almost half of all adults worldwide experienced a headache in the past year, according to the World Health Organization.
Headaches are a general category, and there are lots of different types with different causes and levels of pain.
Migraine is a neurological disorder that often involves headaches and other symptoms. When one occurs, it’s moderate to severe, throbbing pain, and usually worse on one side, according to the American Migraine Foundation.
The disorder affects over 37 million adults and children in the U.S. alone. Migraine is an inherited condition, but attacks can be triggered by hormonal fluctuations, stress, food, and alcohol, among other things.
Migraines can severely interfere with your quality of life. Unfortunately, there’s a lot more about migraines that we need to know.
A headache is pain in your head, scalp, neck, or face, particularly around your eyes. According to the Columbia University Department of Neurology, you feel the pain in:
- a nerve network on the scalp
- muscles in the head, shoulders, or neck
- nerves on the face, mouth, and throat
- blood vessels on the surface of and base of the brain
A note about your noggin: A headache might feel like your brain hurts, but the cranium itself is not feeling any pain. Why? Because your brain tissue actually doesn’t have pain-sensitive nerve fibers.
What causes a headache
There are two main genres of headaches: primary headaches (including migraine), and headaches from secondary causes, aka medical conditions.
Headaches that aren’t due to another medical condition are classified as primary headaches. Some common headache triggers are:
- stress (shocker, we know)
- alcohol (sorry, #ThirstyThursday)
- sugar (dammit)
- secondhand smoke
There are a few types of primary headaches and each type has its own triggers and symptoms.
Tension or stress headache
That headache you get when pulling an all-nighter at work? That’s a tension headache (aka a stress headache) and it’s the most common type. Typically referred to as a “normal, everyday headache,” these can be triggered by noise, lack of physical activity, bad posture, or missed meals.
- dull, aching, and non-pulsating pain on both sides of the head
- pain is mild to moderate, doesn’t typically cause nausea or light sensitivity, shouldn’t curtail everyday activities
- can last from 30 minutes to a couple of days
Treatment: over-the-counter (OTC) pain relievers and lifestyle tweaks
- sharp piercing or burning sensation on one side of the head
- droopy eyelids, watery eyes, small pupils
- runny nose, facial swelling, sweating
- occur in a series over weeks or months, one to eight times daily
- may appear at the same time(s) each day
- may disappear completely for months or years, but recur later
- tend to happen at the same time of year, typically spring or autumn
- can be triggered by alcohol or smoking
- men comprise 80 percent of those affected, and they are typically between the ages of 20 and 50
Treatment: breathing through an oxygen mask, nasal sprays
New daily persistent headache (NDPH)
New daily persistent headache (NDPH) is a condition where a person with no past history of headaches suddenly starts having daily headaches for 3 months or more. Causes of NDPH require a lot more study.
- constant pain on both sides of the head
- mild to moderate pain, light or noise sensitivity, nausea
- can occur after an illness or stressful event
- symptoms are similar to tension headaches or migraine, so consult a healthcare provider
Treatment: no treatment has proven effective but medications can help ease symptoms
Headaches caused by an underlying medical condition or an injury are called secondary headaches. That medical issue needs to be treated to ease the headache pain.
Here are a few types of secondary headaches:
Medication overuse headache (MOH)
Medication overuse headache (MOH) happens when a headache is treated too often with OTC or prescription painkillers.
- headaches after taking meds
- occurs more than 15 days a month after taking headache medication for 3 months or more
- no longer taking the medications can cause symptoms of withdrawal like constipation, nausea, or vomiting
Treatment: ceasing the medication
The word “cervicogenic” sounds gynecological, but we’re actually talking about the base of your skull.
A cervicogenic headache is caused by injury to the neck (like whiplash), malformations of vertebrae in the neck, or arthritis of the upper spine. Cervicogenic headaches can mimic the symptoms of migraines, so consult with a healthcare provider.
- stiff neck
- pain on one side of the head or face
- blurred vision
- sensitivity to light and noise
Treatment: medications like aspirin or ibuprofen, or physical therapy
If your headache occurs when your sinuses (your nose and eyes) are congested, congratulations: you’ve got a sinus headache.
- pain in the nasal area, severe nasal congestion, fever
- can be brought on by seasonal allergies
- may indicate a sinus infection (sinusitis)
Thunderclap headaches are a sudden and severe. Their apparent lack of trigger are part of why they’re so scary, says the American Migraine Foundation.
Possible causes include dangerous blood vessel tearing or blockage, although there can also be headaches that are benign.
- severe head pain
- reach full intensity in less than a minute
- last at least 5 minutes
Treatment: see a healthcare provider immediately
Unlike headaches, migraine is a neurological disorder.
Migraines are mysterious and can be unpredictable; symptoms vary by person and sometimes even by the migraine attack itself.
Migraines interfere with education, career, or social activities for more than 90 percent of patients. “But it’s just a headache!” you might exclaim. Unless you’ve had a migraine, it’s difficult to grasp how crippling it is.
There are some specific types of migraines you can experience:
- symptoms can mimic those of a stroke or seizures
- numbing, tingling, or paralysis on one side of the body
- fever, impaired vision, nausea, vomiting, confusion, difficulty speaking
“Silent migraine,” or migraine with an aura
A silent migraine doesn’t cause pain, but instead, you experience an “aura” — temporary visual, sensory and/or speech/language symptoms that can be debilitating.
- blurry vision, “kaleidoscope vision,” numbness, dizziness, difficulty speaking, weakness, tingling
- aura lasts 5 to 60 minutes
- usually predates traditional migraine symptoms, like light sensitivity
- can mimic symptoms of stroke or meningitis
Treatment: it’s difficult to treat the aura because it has usually passed by the time medications start to work
Common migraine, or migraine without aura
The most common migraine, affecting about 75 percent of patients, is a migraine without aura. It has three phases.
- moderate to severe throbbing pain on one side of the head, nausea, vomiting, sensitivity to light and sound
- the “premonitory” phase indicates the migraine is coming, with symptoms like muscle stiffness and fatigue
- the headache phase can last 4 to 72 hours if untreated
- the postdrome phase is the recovery after the headache and can include depression and poor concentration
Treatment: medications, cognitive behavior therapy, lifestyle changes
A vestibular migraine is a rare type of migraine that accompanies vertigo and occurs to patients with a history of migraines.
- dizziness, balance problems, feels like rocking on a boat
- sometimes the vertigo appears without a headache
- can last from a few seconds to 72 hours
Treatment: anti-nausea or dizziness medications that treat vertigo
Treatment depends on your specific type of headache, which is why it’s important to consult your healthcare provider. But generally speaking, headache treatment can include:
- OTC pain relievers like aspirin or ibuprofen
- prescription medication
- essential oils
- lifestyle changes like more sleep, and cutting caffeine, alcohol, and triggering foods
Migraine is a type of primary headache, but migraine is a neurological disorder and requires its own unique treatment options (see below).
Treatment for secondary headaches, like sinus headaches, will involve treatment for the underlying medical condition or injury causing the headache.
Migraines are mysterious and require a lot more research; finding relief can involve trial and error. Generally speaking, however, migraine treatment can include:
- oral triptans (a class of drugs), including Imitrex, Amerge, Zomig, Maxalt, Axert, Frova, or Relpax
- nasal triptans (nasal spray), including Imitrex and Zomig
- Tosymyra (nasal spray) for migraine with or without aura in adults
- yoga and stress reduction
- lifestyle changes
There are some possible preventative treatments for migraines, including:
- Aimovig, a CGRP-blocker
- other daily medications like blood pressure medications, antidepressants, anticonvulsants, or serotonin antagonists
- botox injections can numb the nerve endings and reduce pain for chronic migraines
Treatment depends on your specific type of migraine, so it’s important to consult your healthcare provider.
See a healthcare provider immediately — we’re talking the ER — if you experience a sudden, severe headache. It could be another medical issue, like an aneurysm.
If you typically experience headaches or migraine, consult a doctor if you experience new, unusual symptoms, including:
- vision loss or double vision
If you don’t typically experience headaches, mild pain is easily managed with OTC meds or lifestyle changes. But it’s time to see a doctor when headaches:
- cause moderate to severe pain
- occur daily, or multiple times daily
- last for hours or days at a time
- include vision problems, confusion, nausea, or vomiting
- interrupt your work/sleep, education, or social life