Differences Between Headaches and Migraines

Headache can be of various types and the etiology determines how disabling and intense the condition is. Learn to differentiate with us between typical headache and migraine.

Written and verified by el biólogo Samuel Antonio Sánchez Amador.

Last update: 06 July, 2023

Headaches are extremely common in general society, as it’s estimated that up to 96% of adults suffer at least once throughout their lives. More than 90% are primary in nature and don’t represent a hidden disease, but a minority do have more serious causes. Do you want to know the differences between headaches and migraines?

Although they may seem the same, headaches and migraines differ in causes, diagnosis, treatment, and prognosis. Read on if you want to know how the two clinical pictures differ (and resemble each other).

Headaches and their epidemiology

As indicated by the National Library of Medicine of the United States, a headache is a pain or discomfort in the cephalic area, also including the scalp or neck. Serious causes of this condition are rare, as 90% of headaches are limited to imbalances in the nervous or musculoskeletal environment of the head.

The World Health Organization (WHO) gives us some interesting data about headaches and their global impact. We’ll highlight some in the following list:

• It’s estimated that up to 96% of the world’s population will suffer from at least one headache at some point in their life.
• Approximately 50% of the world’s population has a headache every year (at least).
• 90% of headaches are mild and don’t indicate an underlying condition. Only 1-5% of patients who come to the emergency room for this condition have a serious illness that requires immediate treatment.
• Headache-related disorders are one of the most common neurological problems in general society.
• 50% to 75% of adults report having had a headache in the past year. Up to 30% of them identified the discomfort as a migraine.

So, what are the main differences between headaches and migraines? We’ll go into more detail now.

What are the differences between headaches and migraines?

First of all, it’s necessary to emphasize that headaches can be of the migraine type, but migraines are not the only types of headaches that exist. We’ll now define each of the terms so that the distinction is clear:

1. Headache: The term headache refers to any pain and discomfort that occurs in any part of the head. This includes the tissues of the cranial cavity, the structures that attach the base of the skull to the trunk, and the muscles and blood vessels that surround the neck, scalp, and face.
2. Migraine: This is a strong and lasting headache that usually affects one side or part of the head, and is often accompanied by nausea and vomiting.

Thus, it’s more than clear to us that the terms migraine and headache are not mutually exclusive. By definition, all types of migraines are, in turn, a headache, since they occur in the cranial area and share basic symptoms with other headaches.

In any case, it should be noted that there are clear differences between classic migraine and the other variants in which the headache is divided. We’ll focus on describing them in the following paragraphs.

1. There are several types of headaches and migraines

As we have said, migraine is one type of headache, but not the only one. As indicated by the Cancer.net portal, there are 2 main types of headaches:

1. Primary headaches: These account for up to 90% of headaches and tend not to be serious, although the pain they cause can be very intense. This includes migraines, cluster headaches, and tension headaches. They don’t imply an underlying disease.
2. Secondary headaches: These represent 10% of headaches and do occur due to an underlying pathology. A brain tumor, a head injury, the application of certain medications, and certain infectious conditions can cause secondary headaches.

In the following lines we’ll see in a little more detail which are the most common primary headaches. Don’t stop reading!

Tension headache

Tension headaches represent the most common type of headache in the world. As their name suggests, they’re usually associated with muscle tension in the neck and scalp, so it’s common for them to appear during chronic stress and anxiety.

This type of headache can occur at any age, but it’s more common in adults and older adolescents. In addition, women are somewhat more prone to suffer from them and could have a certain hereditary component (either due to the emotional conditions that cause them or due to anatomical features).

Cluster headache

As the Mayo Clinic indicates, cluster headaches occur in cyclical patterns and are one of the most painful types. They usually manifest as severe pain around or behind one eye and can wake the patient up in the middle of the night.

The outbreak period can last from several weeks to months and the start and end dates are consistent with each other. The periods of chronic flare-ups can last for more than a year, while the temporary painless extensions give no respite for more than a month at this time.

Headache associated with sexual activity

Headaches associated with sexual activity is a very specific type of headache that occurs during sexual intercourse and masturbation. It’s grouped among the types of primary headaches with specific triggers, such as exercise headaches, benign coughs, and hypnic headaches. It can be of 2 types: pre-orgasmic and post-orgasmic.

Migraine

As we have said in previous lines, a migraine is a type of headache. It is characterized by an intense throbbing pain or throbbing sensation usually on only one side of the head area. It’s usually accompanied by nausea, photophobia, vomiting, and aversion to sound, something that isn’t present in typical tension headaches.

There are several types of migraine, among which the following stand out:

1. Migraine with aura: This differs from other variants in that it has a series of premonitory clinical signs before the headache. Auras can be visual (vision of flashing lights and other hallucinations), sensitive (tingling), retinal, language, and more.
2. Migraine without aura: It is more common than the previous one. This type of headache occurs without prior focal neurological symptoms.
3. Vestibular: This variant is diagnosed when the vestibular system is repeatedly affected, in episodes ranging from minutes to hours, in someone who has a history of migraines. In this case, it is characterized by the presence of vertigo.
4. Abdominal: This is characterized by episodes of acute and disabling abdominal pain. The patient can spend periods of weeks to months without any symptoms.

As you can see, there are many types of headaches and migraines. Anyway, the difference at this point is key: migraine is a type of headache, but not every headache is a migraine type.

2. Tension headaches are much less severe than migraines

At this point it makes sense to explore the differences between tension headaches and migraines, since, as we have said, migraines itself are included in the general pathological group. The symptoms are quite different between the two conditions and we’ll look at how they are they are distinguished below. Don’t miss it!

2.1 A tension headache is less severe than a migraine

The typical tension headache manifests itself as a mild, annoying, and continuous discomfort in the head. As its name suggests, it is also accompanied by a feeling of pressure on the forehead or on the sides of the head. In addition, the pain is often exacerbated when the muscles of the skull and scalp are palpated (its origin is musculoskeletal).

On the other hand, the discomfort caused by a migraine is much more palpable. It produces a pulsating, localized and very noticeable sensation. In addition, it is accompanied by vomiting, photophobia and dizziness in almost all cases. Because of this, it generates much more disabling and noticeable pain than the pain caused during an episode of tension headaches.

2.2 A migraine is usually experienced only on one side of the head

As the Mayo Clinic indicates, tension-type headaches are diffuse and can be described as “a sensation of having a tight band around the head.” On the other hand, migraines usually affect a specific side of the cephalic region, although on certain occasions it is more generalized.

2.3 Migraines may be accompanied by a prodrome

Tension headaches come on without warning. Although there are certain factors that promote its appearance (stress, anxiety, depression, muscle spasms in the neck, and more), it isn’t usually linked to premonitory signs.

However, some patients notice a series of symptoms 1-2 days before the migraine occurs. This phase is known as prodrome and is characterized by the following clinical signs:

• Constipation
• Fluctuation in moods
• Fluid retention
• Increased urge to go to the bathroom
• Neck stiffness
• Food cravings

This premonitory phase is prior to intense headaches and characterizes patients with migraines. The aforementioned stage marks one of the essential differences between headaches and migraines.

2.4 Migraines may be accompanied by an aura

We have seen that migraine can be accompanied by a prodrome phase, but it’s also capable of manifesting itself with a series of symptoms encompassed by the term aura just before or just after the headache itself. Some of the clinical signs of this picture are the following:

• Visual aura: a vision of light flashes in the center of the visual field, sensitivity to strong light (photophobia), eye pain, flashing lights and other visual disturbances.
• Sensitive: tingling in various parts of the body, including the tips of the fingers or the corners of the lips. These symptoms are known as paresthesias.
• Language: difficulty understanding a message or articulating words.
• Motor: partial or total paralysis of one side of the body and alteration of consciousness.

Not all migraines occur with an aura, but those that do are different from a tension-type headache. In this latter condition, there are no clear and shared symptoms beyond the diffuse sensation of discomfort at the head level.

2.5 Tension headaches tend to last longer

Sources already cited clarify that episodic tension headaches can last from 30 minutes to a week. There are also chronic variants of the pathology, which extend for periods of 15 days in a row, for periods of 3 months. The pain is diffuse, but the discomfort generated can be disabling.

On the other hand, migraine outbreaks (the intense pain phase) don’t usually last longer than 72 hours. These can be infrequent or appear several times a month, but the discomfort is not constant during long intervals (as it is in other types of headaches).

3. Headaches are much more common than migraines

Tension headaches are very common. In the past it was believed that its appearance was due to a spasm in the cephalic muscles, but it seems that the specific cause is found in a greater sensitivity to pain in people who suffer from them. In any case, the prevalence of this condition throughout life is 80% in its episodic variant and 3% in the chronic one.

In other words, 8 out of 10 people experience a diffuse tension headache in their lifetime. The peak of appearance is between 35 and 40 years, but the numbers of people affected decrease from this limit. With these figures, it is easy to recognize that headaches are very common.

On the other hand, the prevalence of migraine is 18%. This means that a little less than 2 in 10 people will experience an outbreak of this type at some point in their life. Changes in the brainstem and its interactions with the trigeminal nerve could explain part of its etiology, but they represent a much more specific cause.

These figures exemplify that tension headaches are much more common than migraine headaches. In any case, it shouldn’t be forgotten that more than 90% of the world’s population suffers from some type of headache in their life (be it migraine, tension, clusters, or other).

Differences between headaches and migraines: two spectra of the same picture

Although we have mentioned many differences between the classic headache and migraines, it is necessary to bear in mind that both are included within the group of headaches. For this reason, and due to the variability that exists in both tables, they can overlap and even be confused.

If your head hurts in an intense or sustained way, don’t hesitate to go to the doctor for a specialized diagnosis. Most likely, a specific cause for your discomfort won’t be found and you’ll be offered only symptomatic treatment, but it’s always better to be safe than sorry.