Headaches versus Migraines

While a migraine is a type of headache, not all headaches are migraines. The distinction between migraines and headaches is vital because it affects your treatment options. 

Headaches are unpleasant pains in your head that typically occur on both sides of your head and can cause mild to severe pain. These can last for anywhere from a few minutes to a week and vary in frequency and intensity. Headache disorders can be either primary or secondary causes of pain.

Primary headaches are those independent conditions that cause pain where secondary headaches are caused by another medical condition or stress. Primary headaches include tension, cluster, and hemicrania headaches while secondary headaches can result from sleep disorders, brain tumors, dehydration, withdrawal or abuse of certain medications or drugs, and side effects from certain medications. 

Migraines produce more intense and debilitating symptoms than headaches, and some types of migraines don’t produce head pain. Migraines are only primary headache disorders that have more symptoms than just head pain and typically only cause pain in one side of the head. Migraines typically have four distinct phases that can last anywhere from a few hours to a few weeks. 

Treatment options 

• Biofeedback
• Natural remedies such as acupuncture, hot or cold therapy, yoga
• Prescribed medications such as antidepressants, antianxiety, anticonvulsants, prescription painkillers
• Over the counter pain medications such as acetaminophen, ibuprofen, naproxen 
• Transcranial magnetic stimulation 

Some medications are meant to treat the symptoms of migraines while others are preventative. 

Migraines can sometimes be prevented through dietary and lifestyle changes such as:

• Limiting caffeine, alcohol, or other drug intakes
• Avoiding trigger foods, such as MSG, cheeses, and tomatoes
• Avoiding triggers such as strobe or flashing lights
• Staying hydrated and getting at least 8 hours of sleep a night
• Relation and stress-management techniques
• Regular exercise
• Limiting screen time

Symptoms

Migraines have four distinct phases, but you may not experience all four. These symptoms may gradually increase in intensity or duration over time. 

Premonitory Phase

This is the pre-headache phase that occurs hours or days before your migraine arrives. It’s typically characterized by nonpainful symptoms such as:

• Neck or upper back stiffness
• Fatigue
• Sensitivity to light or sound
• Unexplainable mood changes such as increased irritability 

Aura Phase

This phase causes sensory disturbances that affect your vision, touch, or speech. These disturbances may dissipate before or continue into your migraine phase.

Headache phase

This phase is when your mild to severe head pain begins. Physical activity and exposure to light, sound, and smells can worsen your pain. Some people will not experience head pain during a migraine attack while others will.

Postdrome phase

This phase occurs after your migraine dissipates and is characterized by exhaustion, confusion, or sometimes relief. 

Diagnostic tests

While many migraines may resolve themselves without needing to visit a medical professional if you experience recurring migraines or migraines that don’t go away, schedule an appointment with your doctor. If your migraine is accompanied by a stiff neck, fever, vomiting, difficulty speaking, or numbness or weakness in the limbs, seek medical attention immediately. These may be signs of a more serious medical condition. 

When preparing for your appointment, you should create a migraine diary to track how often you experience migraines, their severity and duration, their accompanying symptoms, any triggers you’ve noticed, and what treatment options you’ve already tried. This will help your doctor better understand your migraine disorder and prescribe the appropriate treatment.

Bring a list of any medications, vitamins, or other supplements you take including the dosage and the frequency you take them to your appointment. 

Your doctor will conduct a general and neurological exam and may refer you to a neurologist who can help further diagnose you. There’s no test that can determine if you’re experiencing migraines, but your doctor may order blood work or scans such as an MRI or CT scan to rule out other conditions. 

Types

• Migraines without aura: intense, throbbing headaches that skip the aura phase
• Migraines with aura: intense, throbbing headaches that go through the aura phase but may not always cause head pain
• Hemiplegic migraine: a rare type of migraine that causes temporary paralysis before or during the attack and may cause dizziness, vision problems, difficulty speaking or swallowing, and difficulty moving one side of your body
• Ophthalmic migraine: causes short-term partial or total loss of vision in one eye accompanied by a dull ache behind your eye
• Refractory migraine: persistent migraines that don’t respond to standard or aggressive treatments
• Silent migraine: have aura symptoms but no head pain

Causes

Triggers, or causes, of migraines, can vary from person to person and can include:

• Stress
• Hormonal changes
• Sleep deprivation or lack of sleep
• Hunger or dehydration
• Alcohol or other drugs
  • Prescription or illicit drug abuse
• Consuming too much caffeine or caffeine withdrawal 
• Weather changes
• Certain foods
• Sensory stimuli, like too bright of lights or loud sounds

Risk factors:

• Being female
• Working in high-stress jobs
• Having a family history of migraines
• Psychological or sleep disorders, such as depression, insomnia, anxiety

Facts 

The World Health Organization (WHO) estimates headache disorders affect approximately 50% of adults worldwide. Migraines are more common in women than men and most often affect those 35-45 years old.