Headache or migraine: Why it’s important to know the difference

by Kaiser Permanente |
Woman with migraine closes her eyes

Traffic. Bills. Juggling work and family. It can all lead to stress — and headaches.

For many people, headaches are a minor discomfort. They may even feel like a normal part of modern life. But if your headaches are severe and frequent, they might be migraines — which are much more than just a bad headache.

“A migraine is a fairly severe, serious neurologic condition that causes all types of symptoms other than just a headache,” says Dr. Kenneth Nudelman, MD, who is board-certified in headache medicine and runs the headache management clinic at West Los Angeles Medical Center.

Because migraines are often caused by hormonal changes, women are 3 times more likely to get one than men. Migraines are also the fourth leading cause of disability among women.1

The good news is that migraines are treatable. That’s why it’s important to know the difference between headaches and migraines, so you can get the right treatment and relief.

Common headache symptoms and causes

There are many kinds of headaches, but the most common is the tension headache.

Common tension headache symptoms include:

  • Mild to moderate pain that feels like an ache or pressure in your head
  • Pain that lasts 30 minutes to several hours
  • Pain that feels like a tight band around your head
  • Pain that may travel to your upper back and neck

Common causes, also known as triggers, include:

  • Stress
  • Eye strain or too much screen time
  • Neck strain or neck injuries
  • Illnesses like cold or flu

Common migraine symptoms

Migraines are painful headaches that can last 4 to 72 hours. To confirm that your headaches are migraines, a doctor will examine you and ask about your symptoms. A headache must meet several criteria to be considered a migraine.

Common migraine symptoms include:

  • Moderate to severe pain that throbs
  • Pain that’s on one side of your head
  • Pain that gets worse with physical activity or when you move your head
  • Nausea
  • Sensitivity to light, noise, or both
  • Auras — visual distortions like flashing or neon lights — that last 5 to 60 minutes
  • Numbness on one side of your body

“People can feel bad before the migraine even starts — and that can be for hours or even days before,” says Dr. Nudelman.

Before the start of a migraine, you might feel fatigued, emotional, or have food cravings. You might also feel neck pain or stiffness.

After a migraine, you may have trouble concentrating or feel irritable. Also, your head or scalp may feel sensitive.

Common causes of migraines

Migraine triggers are different for every person, but common ones include:

  • Stress
  • Hormonal changes, such as the start of a menstrual cycle
  • Sudden weather changes
  • Certain smells or odors
  • Certain foods, such as red wine, chocolate, and artificial sweeteners
  • Changes in routine like too much or too little sleep
  • Skipping meals

Sometimes, a migraine is only triggered when causes are “stacked.” For example, a day of travel may cause stress, poor sleep, and skipped meals.

The link between caffeine and migraines

Caffeine is where the subject of migraines gets tricky.

“On one hand, caffeine can actually be helpful because it can reduce the pain of the migraine. But daily excessive caffeine can make headaches worse,” says Dr. Nudelman. “So, from a lifestyle point of view, if you’re drinking caffeinated products daily, you may benefit from cutting back.”

Try to reduce the amount of caffeine you drink gradually. People react to caffeine differently, so try cutting back by a single 8-ounce cup a day until you find an amount that works for you. If you cut back too quickly, or stop completely right away, you could get withdrawal headaches.

How to prevent and treat headaches and migraines

To prevent a headache or migraine, avoid or reduce the triggers. For headaches, you can try stress-reduction techniques like meditation, or limiting screen time to avoid eye strain.

Migraine triggers are different for everyone. If you’re not sure what yours are, keep a log of your migraines and include what you did or ate before they started and look for patterns.

To treat a tension headache, take over-the-counter pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol).2 You can also apply a cold or warm compress to your head, depending on your preference.

Unlike headaches, migraines have very specific treatments.

“It’s important to consult with your doctor if you think you’re having migraines because there are treatments that are available,” says Dr. Nudelman. “Don’t assume that if the over the counter doesn’t work, ‘I’m just stuck and I just have to suffer,’ which some people believe.”

  • Pain-relieving treatments are used at the start of a migraine. They include over-the-counter medications like ibuprofen (Advil) or acetaminophen (Tylenol),2 or stronger prescription versions. They also include medications that are specific to migraines.
  • Preventive treatments are prescription medications that are taken daily to reduce the number of migraines you have.

When to get help

You don’t have to figure out how to treat your headaches on your own. Talk to your doctor if you’re concerned — especially if your headaches interfere with work, school, or your overall daily life.

It’s also important to talk to your doctor if you’re taking more over-the-counter medications than usual, or more often, to get pain relief.

“Unfortunately, we don’t have a way to cure migraines,” says Dr. Nudelman. “But with good lifestyle modification and good therapy, it can be very well controlled and not take a hold of your life.”

Pavlovic, “ The Impact of Midlife and Migraine on Women: Summary of Current Views,” Women’s Midlife Health, October 6, 2020.

Kaiser Permanente does not endorse the medications mentioned. Any trade names listed are for easy identification only.