What Is the Difference Between a Headache and a Migraine?

April 14, 2023 · By Aneesh Vaze

Almost everyone has experienced a headache at some point in their life. But for the approximately 39 million Americans who suffer from migraines, the experience goes far beyond ordinary head pain. Understanding the difference between a headache and a migraine is important because the two conditions have different causes, different symptoms, and often require different treatment approaches.

What Is a Headache?

A headache is a broad term for pain or discomfort in the head, scalp, or neck. Headaches are extremely common and can be caused by a wide range of factors, including stress, dehydration, eye strain, sinus congestion, lack of sleep, and muscle tension. The most common type of headache is a tension-type headache, which typically produces:

A dull, aching pain on both sides of the head
A sensation of pressure or tightness, sometimes described as a band around the forehead
Mild to moderate intensity
Pain that does not typically worsen with routine physical activity
No nausea, vomiting, or sensitivity to light and sound

Other types of headaches include sinus headaches (related to sinus infection or inflammation), cluster headaches (severe pain around one eye occurring in cyclical patterns), and rebound headaches (caused by overuse of pain medication).

What Is a Migraine?

A migraine is a neurological condition that causes episodes of moderate to severe head pain along with a variety of other symptoms. Migraines are not simply bad headaches -- they involve complex changes in brain activity, blood flow, and nerve signaling. A migraine attack typically includes some or all of the following:

Intense, throbbing, or pulsating pain, usually on one side of the head (though it can affect both sides)
Nausea and/or vomiting
Sensitivity to light (photophobia)
Sensitivity to sound (phonophobia)
Sensitivity to smell
Visual disturbances known as aura (flashing lights, zigzag lines, temporary blind spots)
Pain that worsens with physical activity or movement
Duration lasting 4 to 72 hours if untreated

Key Differences at a Glance

While both headaches and migraines involve head pain, there are several important differences:

Location: Tension headaches affect both sides of the head; migraines often affect one side.
Intensity: Headaches tend to be mild to moderate; migraines are moderate to severe and can be debilitating.
Quality of pain: Headaches produce a dull, steady ache; migraines produce a throbbing or pulsating sensation.
Associated symptoms: Headaches typically do not cause nausea, vomiting, or sensory sensitivity; migraines frequently do.
Duration: Tension headaches may last 30 minutes to several hours; migraines can last days.
Aura: Only migraines can be preceded by aura -- visual or sensory disturbances that occur 20-60 minutes before the headache phase.
Impact on function: Headaches are usually manageable; migraines often require you to stop your activities and rest in a dark, quiet room.

What Causes Migraines?

The exact cause of migraines is not fully understood, but research points to a combination of genetic and environmental factors. Known triggers include:

Hormonal changes, particularly in women (related to menstruation, pregnancy, or menopause)
Certain foods and beverages (aged cheese, alcohol, processed foods, caffeine)
Stress and anxiety
Changes in sleep patterns
Sensory stimuli (bright lights, strong smells, loud sounds)
Weather changes
Physical exertion

When to See a Doctor

You should consult a healthcare provider if you experience any of the following:

Headaches that occur more than 15 days per month
Headaches that are progressively getting worse
A sudden, severe headache unlike any you have had before
Headaches accompanied by fever, stiff neck, confusion, seizures, or vision changes
Headaches that interfere with your daily activities, work, or quality of life