Migraine vs Headache: What’s the Difference?
Learn how to spot migraine symptoms and get the right care
Learn how to spot migraine symptoms and get the right care
Many people get headaches from time to time, but frequent headaches that disrupt work or personal life can be a sign of something that should be treated. Recurring headaches, regardless of severity, often indicate migraines.
Migraines aren’t always debilitating, days-long ordeals, explains Emily Rubenstein Engel, MD, a neurologist at Scripps Clinic Torrey Pines, and the director of the Donald J. Dalessio Headache Center at Scripps Clinic.
Migraine is often misdiagnosed as a tension, stress or sinus headache. This confusion occurs because migraines cause the trigeminal nerves, which run behind the eyes, through the sinus area and jaw, and into the upper cervical spine, to become hypersensitive, leading to pain in these areas.
Common migraine symptoms you might overlook
“A lot of people are surprised to learn that their recurring headaches are actually migraines. If you have headaches that are moderate to severe at times, and if you occasionally get nauseated or have sensitivity to light, most likely you have a migraine,” says Dr. Engel. “Migraine is the most common cause of recurring severe headaches in somebody who’s otherwise healthy.”
Unfortunately, frequent headache sufferers often rely on over-the-counter pain relievers instead of seeking medical help.
Treatment options for migraine relief
“There are many options for acute treatment and preventive treatment,” says Dr. Engel. “If you're struggling, it might be helpful to explore whether a different diagnosis could provide clarity and more effective treatment."
Treatment options vary depending on headache frequency.
“Rescue” medications, such as triptans and a newer class of medications called CGRP blockers, can stop a migraine in its tracks. Physicians can also prescribe preventive medications that decrease the frequency of migraines, including Botox and certain medications.
Prevention strategies
Dr. Engel also recommends avoiding one of the biggest migraine triggers: changes in routine. Try to go to sleep around the same time, get up at the same time, and don’t skip meals. Since hormonal changes due to perimenopause can also trigger migraines in women, hormone replacement therapy may be an option alongside preventive medication for some women.
Dr. Engel notes that it’s important to remember that migraines aren’t the only type of headache, though it’s among the most common.
Cluster headaches are rare in comparison to migraine. They are more common in men and can cause agitation and pacing, whereas with migraine, patients want to lie down in a dark room. There is sometimes confusion about this diagnosis too, because migraines often happen in “clusters” but that doesn’t mean it’s a cluster headache!
Medication-overuse headache — also known as rebound headache — occurs when pain relievers,like over-the-counters and prescription pain medications, are taken too frequently.
How do I know if something dangerous is causing my headache?
Certain headaches require immediate medical attention. Dr. Engel uses the mnemonic “first, worst or cursed” to indicate that you should be concerned about the cause of your headaches. If it’s truly the first headache of your life and you’re over 30, seek medical attention. Same goes for the worst headache of your life. It may be a sign of a serious condition, such as brain hemorrhage. “Cursed” refers to headaches with other red flags, such as an abnormal physical examination.
“Even if it’s not first, worst or cursed, but you are having frequent headaches — more than one or two days a week — or debilitating headaches, then you should go see your doctor,” Dr. Engel says. “This is a very common problem. It’s very treatable and you should not be suffering.”
This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.