Is it a migraine or a headache?

Having a headache is — well, a headache. But knowing what kind it is can help you find the right treatment and send discomfort packing.

What is a headache?

A headache is a common condition that causes pain in your face or head. “A headache is a symptom, not a diagnosis,” says Abigail Chua, DO, director of headache medicine at Geisinger.

Lots of things can trigger them, including:

• Lack of sleep
• Dehydration
• Stress
• Caffeine withdrawal
• Injury
• Colds and other viruses
• Conditions that affect your jaw or teeth
• Hormonal changes
• Seasonal allergies
• Sinus congestion
• Changes in blood pressure 

When a headache is caused by another medical issue, like illness or changes in blood pressure, it’s called a “secondary headache.”

But a headache that happens on its own is called a primary headache disorder. Illness, injury or other issues don’t cause this kind of headache — but can certainly make it worse. 

The 2 most common primary headache disorders are: 

Tension headaches

Tension headaches are the most common type. They’re typically short-lived, disappearing after 30 minutes. However, for some people they can last for up to a week.

With a tension headache, you may feel like you have a band squeezing your head, especially your forehead and temples. You may also have sore shoulder or neck muscles. 

While tension headaches can be uncomfortable, they’re typically not debilitating.

“Most people can work through a tension headache,” Dr. Chua says. “You may feel better when you’re distracted or exercising.”

Migraine

“Migraine is a neurologic condition that causes throbbing or pulsing pain on the side of your head,” Dr. Chua says. Besides pain, you may also have:

• Nausea/vomiting
• Sensitivity to light or sound
• Mood changes
• Fatigue

The pain you feel with a migraine can be severe and gets worse with your regular activities.

How to tell the difference between migraines and headaches

All migraines are headaches, but not all headaches are migraines. So how do they differ?

Headaches and migraines have similar causes — and they can both be painful.

But unlike other headaches, migraines come in stages. During the first stage, your body may warn you that a migraine is on the way. This stage is known as the prodrome phase.

The warning

In the pre-headache phase before a migraine, some people notice mood swings, skin sensitivity and neck stiffness. You may also crave certain foods.

The aura

Next comes the aura. During this phase, some people have a visual disturbance (also called an aura). This can include other symptoms like:

• Blurry vision
• Slurred speech
• Numbness in the arms, hands or fingers

The pain

During the active headache phase, you’ll feel head pain ranging from mild to severe. This pain may worsen with physical activity, or from light, smells or sounds. However, some lucky people have migraine symptoms without head pain.

Symptoms may last anywhere from a few hours to a few days.

The aftermath

A migraine looks different once it’s over, too. The final phase, when a migraine ends, is called the postdrome phase. During this time, you may not feel well. It’s not uncommon to feel exhausted or confused, too.

“Some people will still feel ‘off’ for another few hours or days after their migraine ends,” Dr. Chua says.

Treating migraines and headaches

The treatment needed will depend on the type of headache you have. For most headaches, start with at-home remedies, like:

• Drinking water
• Eating a small meal or snack
• Taking a short nap
• Massaging your head, face or hands
• Using warm or cold compresses

If those treatments don’t work, try over-the-counter pain medicines like acetaminophen or ibuprofen. However, be mindful of how often you take them. Taking pain relievers more than a few times a week can actually lead to more frequent headaches — a condition known as medication overuse headaches.

Unlike other headaches, migraines may need more aggressive treatment.

“If you have severe symptoms with your headaches or you’re having at least 4 headaches per month, it may be time for preventive treatments,” says Dr. Chua.

Using preventive treatments regularly for several weeks (or months) reduces the number of headaches you have. They come in a few different forms, including:

• Over-the-counter supplements
• Prescription medications
• Medical devices
• Procedures like Botox^® 

Your provider might recommend another type of medication that stops a migraine when taken in the early stages.

The goal: to get rid of your headache in a few hours or less, so you can get back to feeling your best.

Headaches that continue even after treatment mean it may be time to try a different treatment method, Dr. Chua says.

When to see a healthcare provider

Most headaches can be managed at home. But if you notice any of these, contact your healthcare provider right away to discuss next steps:

• Headaches that are new or different than previous ones
• Headaches with vision changes, numbness or weakness
• Headaches lasting longer than a few days

“If your headache is the worst you’ve ever had, call 911 or head to the nearest emergency room right away for evaluation,” Dr. Chua says.

Next steps:  

Learn about headache care at Geisinger
When a headache is more than a pain 
These foods can trigger a migraine