Nearly 40% of the world’s population suffers from headaches, in fact, they are among the top 3 neurological conditions. And anyone who has had a really terrible headache has probably asked themselves “is this a migraine”? But migraines aren’t just bad headaches, they’re a specific kind of headache and it’s important to know the difference. How can you differentiate between a headache and a migraine that needs special care? We sat down with Tufts Medicine Neurologist Dr. Hassaan Bashir to learn more.
Q. What is the difference between a headache and a migraine?
A. A migraine is a type of primary headache disorder typically characterized by an intense, throbbing pain on one or both sides of the head, usually lasting 4 to 72 hours, accompanied by nausea or vomiting and light or sound sensitivity. A unique feature of migraine is that they may be associated with an aura.
Alternatively, tension-type headaches (TTH) include pressure or tightness, often like a band around the head, sometimes spreading into or from the neck. They may be stress-related or associated with musculoskeletal problems in the neck.
Much less common is cluster headache (CH), a primary headache disorder characterized by frequently recurring (up to several times a day), brief but extremely severe headache, usually focused in or around one eye, with tearing and redness of the eye. The nose often runs or is blocked on the affected side and the eyelid may droop. This affects about 1 in 1,000 adults.
Q. What are the symptoms of a migraine?
A. The experience of a migraine is very different for each person, but some features are common.
- A moderate to severe throbbing headache
- One-sided pain that may alternate or involve the whole head
- Pulsating or throbbing pain
- Aggravated by routine physical activity
- Lasts for 4-72 hours (although this can vary significantly)
- Hypersensitivity to bright lights and/or loud sounds
- Nausea or vomiting or both
Migraines are further divided into migraine with aura and migraine without aura.
Q. What is an aura?
A. An aura is a fully reversible experience of sensory or motor symptoms, typically lasting minutes, that may occur before or with a migraine headache. These are often visual, such as flashes of light, an enlarging dark spot or zigzags. Others may experience difficulty speaking or weakness on one side.
Q. How long does a migraine last?
A. Migraines can last anywhere from hours to days.
Q. How is a headache or migraine treated?
A. Migraine treatment begins with identifying and avoiding personal migraine triggers. Medication can be used to reduce headache pain when you have a migraine but also to prevent migraine and reduce headache burden.
The main classes of drugs to treat headache disorders include analgesics, anti-emetics, and specific anti-migraine medications. A neurologist can help you review and understand all the options that are available. Physical therapy, acupuncture and massage are also great options for many people.
Q. What should I do if I’m experiencing frequent headaches or migraines?
A. Learning about and avoiding migraine triggers and making other lifestyle modifications are highly effective in preventing headaches and migraines. Restricting or eliminating alcohol, getting enough sleep, exercising, eating a healthy diet and staying hydrated can help provide relief.
Keeping a log of headaches and when they occur can help you identify triggers. Other common triggers are hormonal changes, food and food additives, stress, bright lights, strong smells, and loud noises, sleep pattern changes, changes in the weather and certain medications.
If you are experiencing a headache disorder, including migraine, you should speak to your doctor. Your primary care physician may refer you to a neurologist who specializes in treating migraines.
