Doctor's Notes on Headache vs. Migraine
A headache is a general term that is defined as pain located in any area of the head. A migraine is a type of headache that 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. Migraine pain signs and symptoms are different from other headache pains. To classify 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 whereas a headache is simply pain located in any area of the head. If a patient is having "the worst headache of my life," the person should have 911 called and be transported to an emergency department.
There are many causes (triggers) for headaches and/or migraine headaches; some are known and some are not known. For example, trauma to the head and/or bleeding into the brain can cause severe headaches, but the cause of occasional headaches that come and go is not clear. Although many different triggers for migraine headaches are known (stress, hormonal, strobe lights, and many others), others are not. The underlying causes are not well understood and seem unique to each individual.
What Are the Different Treatments of Migraines vs. Headaches?
The treatment of headaches and migraines is simple. If your diagnosis is a non-emergency, non-traumatic headache and does not fit the definition above as a migraine headache, then it can be treated with over-the-counter pain medications like Tylenol. Medications for migraines have two main categories: pain relief and preventive medications.
Medications for pain and discomfort relief:
- Over-the-counter pain relief (only against mild migraines)
- Opioids (note addictiveness of drug)
- Anti-nausea drugs
- Blood-pressure-lowering drugs like metoprolol
- Antidepressants like amitriptyline
- Anti-seizure drugs like valproate
- Botox injections
- Monoclonal antibodies like erenumab-aooe
Your doctor can help you to get relief from moderate to severe migraines with prescription drugs.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.