What Is a Headache?
A headache is defined as pain located in any area of the head. Headaches occur when pain-sensitive nerves in the scalp, blood vessels, and other brain tissues send signals that register as pain in the brain cells.
Other definitions describe a headache as pain being above the eyes or ears, behind the head (occipital region), or in the back of the upper neck. Some definitions use the term “continuous pain” instead of just the term “pain,” but do not specify what “continuous” means. Since there are many types of headaches, some of which localize to certain areas of the head and others that do not.
What Is a Migraine Headache?
A migraine headache is defined as a severe throbbing pain or pulsing sensation, most often on one side of the head, which is usually accompanied by nausea, vomiting, and extreme sensitivity to light and sound. People with migraines (migraineurs) often have certain symptoms termed “an aura” (visual or other sensory symptoms) that occur before the migraine, although some people experience auras during and/or after the migraine. Many migraine sufferers find the pain is debilitating and interferes with daily activities. Migraine headaches occur more frequently in women than men.
Just a note of caution, even if you have experienced migraines and/or other headaches, but suddenly develop “… the worst headache of your life…,” you need to be seen by a doctor immediately. This type of headache may indicate a medical emergency other than a recurrent migraine or other headache type.
Is the Pain from Migraine Different from Other Headache Pain?
In most instances, migraine pain is different from other headache pain since to classify as a headache as a migraine, the pain must have at least a combination of three of five features. The pain is 1) moderate to severe, 2) is pulsating, and 3) is only on one side of the head (unilateral location), and it is accompanied by either 4) nausea and/or vomiting or 5) photophobia and phonophobia.
What Are the Most Common Types of Headaches?
The most common type of headache is considered by the International Headache Society to be a tension headache (also termed a tension-type headache or TTH). There are over 22 types of headaches that have been described. Many are common (hangover headaches, eyestrain headaches). However, this article will be limited to migraine, tension, cluster, sinus, and hormonal headaches as these are common types.
- Tension headaches: A tension headache is characterized by mild to moderate chronic headache pain, often with a band-like tightness discomfort or pain on both sides of the head.
- Cluster headaches: A cluster headache produces pain on only one side of the head (unilateral). The pain is excruciating with stabbing pain in the head and eye. It has been described as feeling as if the eyes are being pushed out. Cluster headaches are not preceded by an aura, and usually do not have symptoms of nausea, vomiting or aversion to light and sound.
- Sinus headaches: A sinus headache is a type of headache usually is caused by an infection of the facial sinuses and/or sinus congestion. A sinus headache is mild to moderate head pain, and has symptoms of throbbing head pain, and/or pain (mainly pressure) produced around the facial sinuses, eyes, cheeks, and forehead, usually occurring with an infection of a facial sinus and/or sinus congestion.
- Hormonal headaches: Hormonal headaches are headaches that can resemble either migraines or tension headaches, but occur during hormonal changes in women during the menstrual cycle, pregnancy, and/or menopause.
What Signs and Symptoms of Migraine vs. Headaches Are the Same?
Migraines and other headaches cause discomfort and/or pain in the head. Some headaches, like migraines, may cause a pulsating pain. Migraines usually occur on one side of the head and/or neck, and some other kinds of headaches (for example, cluster headaches, and hormonal headaches) may cause the same symptoms.
What Signs and Symptoms Only Occur in Migraines?
Usually, but not always, migraine headaches are preceded by an aura that most commonly is a visual band with a shimmering or glittering border that precedes the head pain, and lasts about 5 to 60 minutes. However, migraine auras may consist of many different perceptions and vary from person to person. These signs and symptoms usually are present in migraine headaches:
- Moderate to intense pain that is throbbing and/or pulsating on one side of the head and/or neck, and are often accompanied by nausea and/or vomiting
- Photophobia and/or phonophobia (sensitivity to light and/or sounds)
- Physical activity may worsen headache pain
Are the Causes of Headache vs. Migraine the Same?
Researchers have suggested that the cause of migraines has a strong genetic component since approximately 70% of people with this type of headache have a relative with the history of migraines. Some researchers suggest that migraines are related to or caused, or partially caused by blood flow changes in the brain.
Although some doctors suggest that tension in muscles cause other types of headaches, most now think that the specific cause of headaches is unknown, and likely due to several factors, for example:
- Muscle tension in the scalp and/or neck
- Infection and/or sinus congestion
- Other undefined factors
- Some headaches, for example, headaches caused by hormones, are likely related to changes in hormonal levels.
Are the Triggers for Headache vs. Migraine the Same?
Many things can trigger migraines and other types of headaches (for example, tension headache). Here is a list of examples of products and medical problems that may trigger headaches, including migraine. (This is not a complete list).
Triggers for migraines and other headaches are both highly variable and unique to each individual.
How Can I Tell if It Is a Migraine or Another Type of Headache?
There is no test to diagnose a migraine headache, so the diagnosis usually is based on your history and symptoms for migraines or another type of headache, like cluster or tension headaches. The International Headache Society criteria for diagnosis of migraine headaches state that a patient must have at least five headache attacks that have lasted 4 to 72 hours, and that the headache must have had at least two of the following characteristics:
- The pain is only on one side of the head (unilateral).
- It has a pulsating quality to it
- It causes moderate to severe pain
- It is aggravated by routine physical activity
In addition, the patient must have one of two criteria, either nausea and/or vomiting, or photophobia and phonophobia.
Finally, these symptoms listed here do not occur due to any other disorder or condition the patient may have.
What Is the Treatment for Migraines and Other Types of Headaches?
People that have migraine headaches can benefit from consultation with a neurologist, neuro-ophthalmologist and/or neurosurgeon. People with other headache diagnoses also may benefit from such consultations, especially for cluster headaches.
Treatment of migraine headaches depends on the patient’s condition. Does the patient need treatment for an ongoing migraine (moderate, severe or extreme pain), or does he or she need preventive (or reduction of migraine occurrences) therapy?
- Treatment for an ongoing migraine is most effective if given within 15 minutes of the onset of pain. Treatment is based on the severity of pain.
- A migraine with moderate pain may respond to over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, and/or a class of drugs known as triptans.
- Severe migraine headaches may be treated with triptans and/or ergot alkaloid drugs. Combination drugs such as a triptan and NSAID may be effective.
- Patients with severe or extreme headaches may need intravenous, intranasal, or subcutaneous injections of an ergot or triptan. Some patients may require an additional opioid analgesic combination with a dopamine antagonist.
There are many different choices of drugs to treat migraine headaches. Your doctor, neurologist, or pain specialist will treat you based upon your medical condition, any other health problems, and the type of migraine symptoms you have.
Treatment for Tension, Cluster, Sinus, and Hormonal Headaches
- Tension headaches usually can be treated with OTC anti-inflammatories like ibuprofen.
- Cluster headache treatment is similar to the treatment of migraine headaches.
- Sinus headaches. For congestion, antihistamines or decongestants can be used for short time periods. If you have a sinus headache and a sinus infection you may need treatment with antibiotics.
- Hormonal headaches usually can be treated with an NSAID alone, or in combination with a triptan.
Reviewed on 5/21/2022
Blanda, M. "Cluster Headache." Medscape. May 13, 2021. <http://emedicine.medscape.com/article/1142459-overview>.
Brook, I. "Acute Sinuitis." Medscape. Feb. 23, 2021. <http://emedicine.medscape.com/article/232670-overview>.
Chawla, J. "Migraine Headache." Medscape. Oct. 1, 2021. <http://emedicine.medscape.com/article/1142556-overview#a>.