Migraine is an often lifelong neurological disorder characterized by recurrent moderate to severe headaches, usually on one side of the head. Headache is a term used to describe a variety of different pain symptoms that originate from different parts of the head.

When there’s pressure or pain in your head, it can be difficult to tell whether you’re experiencing a typical headache or a migraine attack.

Differentiating migraine from other headache disorders, and vice versa, is important. It can mean faster relief through more targeted treatments based on the type of headache. It can also help prevent future headaches from occurring in the first place.

So how can you tell the difference between a common headache and a migraine attack?

Headaches are unpleasant pains in your head that can cause pressure and aching. They usually occur on both sides of your head, and the pain can range from mild to severe. Some specific areas where headaches can occur include the:

  • forehead
  • temples
  • back of the neck

A typical headache usually lasts between 5 minutes and 4 hours. Some migraine episodes can last for days or even longer.

According to the World Health Organization (WHO), the most common headache type is a tension headache. Triggers for this headache type include:

Tension headaches aren’t the only type of headache.

Other headache types include:

Cluster headaches

Cluster headaches are severely painful headaches that occur on one side of the head and come in clusters. This means you experience cycles of headache attacks, followed by headache-free periods. They’re most commonly experienced behind or above the eye or at the temple.

Cluster headaches affect up to 0.1% of the population. They typically occur between ages 20 and 49 years, and people assigned male at birth are more likely than those assigned female at birth to experience them.

By race and ethnicity, most of the large-scale epidemiological studies have been performed in white people, and less is therefore known across other races or ethnicities.

Sinus headaches

Often confused with migraine, sinus headaches co-occur with sinus infection symptoms like fever, stuffy nose, cough, congestion, and facial pressure. A 2018 survey found that sinus infections affect about 11.6% of adults.

By race and ethnicity, here’s a breakdown of adults who have received a diagnosis of sinus infection:

  • white people: 12.2%
  • Black people: 11%
  • American Indian or Alaska Native people: 10.4%
  • Hispanic or Latino people: 8%
  • Asian people: 6.5%

Secondary causes of headaches

Injuries and medical conditions can also lead to headaches. Before diagnosing a primary headache disorder, doctors work to rule out dangerous causes that could lead to serious complications.

A Chiari headache is caused by a congenital Chiari malformation. This extremely rare condition causes the skull to push against parts of the brain, often causing pain in the back of the head.

Increased intracranial pressure is a life threatening medical problem that can also lead to headaches. It can be caused by conditions such as:

Thunderclap headaches

A “thunderclap” headache is a very severe headache that develops in 60 seconds or less. It could be a symptom of a subarachnoid hemorrhage, a serious medical condition that requires immediate medical attention. It may also be caused by an aneurysm, stroke, or other injury.

Thunderclap headaches are a rare type of headache. The incidence in the age group of 18 years and above is 38 to 43 cases per 100,000 people per year.

Call 911 or local emergency services immediately if you experience a headache of this kind.

Learn more about headache symptoms that may be signs of serious medical conditions.

Migraine attacks are intense or severe and often have other symptoms in addition to head pain. Symptoms associated with migraine without aura include:

  • neck and shoulder pain
  • nausea
  • pain behind one eye or ear
  • pain in the temples
  • sensitivity to light and/or sound
  • vomiting
  • muscle aches

When compared with tension or other headache types, migraine pain can be moderate to severe. Some people may experience migraine attacks so severe that they seek care at an emergency room.

Migraine episodes will typically affect only one side of the head. However, it’s possible to have a migraine episode that affects both sides of the head. Other differences include the pain’s quality. A migraine attack will cause intense pain that may be throbbing and will make performing daily tasks very difficult.

A 2018 study found that more than 15% of adults in the United States had experienced a migraine episode or a severe headache within the last 3 months.

An analysis of nine studies that looked at the average prevalence of severe headache or migraine by race and ethnicity from 2005 to 2012 in the United States found that the prevalence rates of episodes across all groups were similar:

  • Native American people: 17.7%
  • white people: 15.5%
  • Hispanic people: 14.5%
  • Black people: 14.45%
  • Asian people: 9.2%

Migraine episodes are typically divided into two categories: migraine with aura and migraine without aura. An “aura” refers to sensations a person experiences before a migraine episode. The sensations typically occur anywhere from 10 to 30 minutes before a migraine attack. These can include:

  • feeling less mentally alert or having trouble thinking
  • seeing flashing lights or unusual lines
  • feeling tingling or numbness in the face or hands
  • having an unusual sense of smell, taste, or touch

Some people who have migraine may experience symptoms a day or two before the actual migraine episode occurs. Known as the “prodrome” phase, these subtler symptoms can include:

Migraine attack vs headache infographicShare on Pinterest
Infographic by Brittany England

Migraine triggers

People who experience migraine episodes report various factors that are associated with them. These are called migraine triggers and may include:

  • emotional anxiety
  • lack of sleep
  • skipping meals
  • contraceptives
  • alcohol
  • hormonal changes
  • changes in altitude
  • changes in barometric pressure
  • caffeine overuse

Hormonal changes can trigger a menstrual migraine headache, which can occur a few days before a period, and during the first 1 to 2 days.

Migraine pain is usually, but not always, on one side of the head. Depending on the type of migraine attack, the pain may be felt:

  • in the temples
  • in the forehead
  • behind one or both eyes
  • in the neck

In studies, those with sleep disorders were more likely to have a migraine disorder. It’s believed that a lack of sleep can trigger migraine attacks or make them worse.

While the research is still ongoing, it appears that sleep may play a role in migraine prevention. A 2018 review of studies found that people who experience migraine attacks often report sleep as an effective therapy for migraine.

One hypothesis is that the glymphatic system, a newly discovered waste clearance system in the brain that’s similar to the lymphatic system in the rest of the body, may be more active during sleep.

The glymphatic system helps remove toxins from the brain that build up during wakefulness. While there’s minimal evidence to support this claim, it’s possible that getting enough sleep helps cleanse the brain and prevent migraine attacks.

Poor sleep may contribute to headaches or make them worse. In one review, those who underwent behavioral sleep treatments for tension headaches reported a significant reduction in headache frequency and intensity. Sleep quality and time spent asleep also improved during treatment.

Since headaches and lack of sleep may be linked, it’s important to practice good sleep habits if you have a headache.

To help improve sleep quality:

  • limit screen time before bed
  • establish a relaxing bedtime routine
  • create a quiet sleep environment
  • exercise regularly
  • avoid napping throughout the day
  • avoid caffeine and alcohol before bed

Over-the-counter (OTC) treatments

Most tension headaches will go away with OTC treatments. These include:

  • acetaminophen
  • aspirin
  • ibuprofen

Relaxation techniques

Because some headaches are stress induced, taking steps to reduce stress can help relieve headache pain and reduce the risk of future headaches. These include:

  • heat therapy, such as applying warm compresses or taking a warm shower
  • massage
  • meditation
  • neck stretching
  • relaxation exercises

Prevention tips

Prevention is often the best treatment for migraine episodes. Examples of preventive methods a doctor may prescribe include:

Medications

People who have migraine less frequently may benefit from taking medications known to reduce migraine quickly. Examples of these medications include:

  • anti-nausea medications, such as promethazine (Phenergan), chlorpromazine (Thorazine), or prochlorperazine (Compazine)
  • mild to moderate pain relievers, such as acetaminophen
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen sodium, or ibuprofen
  • triptans, such as almotriptan (Axert), rizatriptan (Maxalt), or sumatriptan (Alsuma, Imitrex, and Zecuity)

If a person takes as-needed migraine medications more than 10 days a month, this could cause medication overuse headache, also known as medication adaptation headache. This practice will worsen their headaches instead of helping them feel better.

Below are some frequently asked questions about migraine attacks and headaches.

Can dehydration cause a headache?

Dehydration due to insufficient water intake or losing too much fluid from the body can cause headaches for some people.

To avoid dehydration-related headaches, make sure to drink plenty of fluids throughout the day, especially when it’s hot or you’re sweating a lot.

Can a headache turn into a migraine attack?

Migraine episodes and headaches share some risk factors and causes, so it’s possible for a headache to turn into a migraine episode. Most tension headaches and general headaches are truly migraine episodes.

Migraine episodes aren’t always severe and could start off mild. If left untreated, they can progress and become more severe.

For example, stress may bring both migraine episodes and tension headaches on. If a person with a tension headache experiences severe stress or trauma, this may cause them to develop migraine features, such as a visual aura.

What type of doctor treats migraine?

Migraine attacks are usually treated by a neurologist, a doctor specializing in brain and nervous system disorders. A headache specialist may also treat migraine. If you experience frequent or severe migraine attacks, talk with a doctor about available treatment options .

Headaches can range from being a mild inconvenience to being severe and debilitating. Identifying and treating headaches as early as possible can help a person engage in preventive treatments to minimize the chance of another headache.

Distinguishing migraine episodes from other types of headaches can be tricky. Pay particular attention to the time before the headache starts for signs of an aura and tell a doctor about any other symptoms.