What is the difference between a headache and a migraine?

Most of us have experienced a headache at some point. Whether it's a dull ache after a long, stressful day or a throbbing pain from staring at a screen for too long, headaches are common. If you have a headache that feels more intense than normal, lasts longer, and comes with other symptoms like nausea or light sensitivity, it might be something more than a typical headache — it could be a migraine. While both headaches and migraines involve head pain, they're not the same thing. Here, we'll explore the differences between headaches and migraines to help you understand your symptoms, find relief, and make informed decisions about your health.

What's the difference between migraines and headaches?

At a glance, a headache might just seem like a migraine's milder cousin, but the two actually come from very different mechanisms within the brain. A headache is a general term. It refers to pain in the head, neck, or scalp area. Headaches can be mild to severe, and can last anywhere from a few minutes to a few hours. Headaches can be triggered by stress, dehydration, muscle tension, sinus pressure, or lack of sleep. Often, people with headaches are able to find relief with over-the-counter pain relievers.

Migraines, on the other hand, are an often-chronic neurological condition. They don't just involve head pain — they also include symptoms like nausea, vomiting, light and sound sensitivity, and visual disturbances called auras. Migraines are usually more intense and longer-lasting than standard headaches, and can seriously interfere with daily functioning. Often, migraine pain requires more than a quick fix solution. People who experience migraines may need prescription medication, lifestyle changes, or long-term strategies to find relief.

Common headache types and their characteristics

Not all headaches feel the same, and they don't all have the same cause. These are some of the most common types of headaches:

Tension headaches: These are the most common type of headache and feel like a dull, aching pressure on both sides of the head or around the forehead. They can last from 30 minutes to several hours and are often triggered by stress, anxiety, or muscle tension. People who have tension headaches can also experience tightness in the neck and shoulders.
Cluster headaches: These are less common than tension headaches, but still incredibly painful. They occur in cyclical patterns or clusters, often striking around the same time each day for weeks or even months. The pain associated with cluster headaches is sharp and stabbing, and is often felt around one eye. The pain may be accompanied by redness, tearing, or nasal congestion on the affected side.
Sinus headaches: Caused by inflammation in the sinus cavities, these headaches often occur with a sinus infection. They bring pressure and pain in the forehead, cheeks, and around the nose. You might also notice a feeling of fullness in your face, as well as congestion and/or a fever.
Exertion headaches: These types of headaches occur after intense physical activity, like running or working out. While exertion headaches can be intense, they're typically short-lived.
Caffeine-related headaches: Consuming too much caffeine or suddenly cutting caffeine out altogether can lead to headaches. Caffeine headaches are typically dull and throbbing, and may show up behind the eyes or at the temples.

Recognizing migraine symptoms and phases

Migraines are more than just headaches. They come in phases, and affect many systems in the body.

Migraine phases typically include:

Prodrome stage: This can start a day or two before the migraine hits. You might feel unusually tired, irritable, or crave certain foods. You may also notice neck stiffness, frequent yawning, or difficulty concentrating.
Aura stage: More than 25% of migraine sufferers experience a condition called aura. This can include visual disturbances like flashing lights, zigzag lines, blind spots, or seeing shimmering shapes. Others might feel tingling in the hands or face, hear strange sounds, or have trouble speaking.
Attack: This is the headache phase, and can last from a few hours to several days. The pain is often on one side of the head and may pulse or throb. You might also experience nausea, vomiting, sensitivity to light, sound, and even smells. Movement tends to make the pain worse, and lying down in a dark, quiet room may be the only relief.
Postdrome: As the migraine pain fades, many people go through a recovery phase which may include fatigue, confusion, moodiness, dizziness, or generally feeling unwell. It can take a day or more to get back to normal.

What makes someone prone to migraines

Migraines often run in families, suggesting a strong genetic component — if your parent or sibling has migraines, your risk is higher. But it's not just about genes — environmental and lifestyle factors also play a big role.

Common migraine triggers include:

Hormonal changes: Many people experience hormones related to hormonal changes, such as those experienced during the menstrual cycle, pregnancy, or menopause.
Diet: Certain foods and drinks, like aged cheese, processed meats, red wine, or artificial sweeteners, can set off a migraine.
Sleep: Too much or too little sleep, an irregular sleep schedule, or poor sleep quality may trigger migraines for some people.
Stress: Emotional stress (or even the let-down period following high levels of stress) can be a major migraine trigger.
Sensory overload: Bright lights, loud sounds, and strong smells can all set off migraines.
Weather changes: Barometric pressure changes before a storm, heat waves, and even high humidity can all influence migraine activity.

Migraine tips

If you're dealing with migraines, there's no single fix — but small changes can make a big difference.

Try these strategies to help manage migraines:

Keep a migraine diary. Tracking when your migraines occur, what you ate, how you slept, and how stressed you felt can help identify patterns and triggers.
Stick to a routine. Aim for consistency in sleep, meals, hydration, and physical activity.
Manage stress. Try yoga, meditation, breathing exercises, or simple walks outside. Even five minutes of mindful breathing can lower stress hormones.
Be mindful of your diet. Watch out for common food triggers like MSG, nitrates, caffeine, and alcohol. If you suspect a food is setting you off, try an elimination diet (talk to your doctor first).
Work with a healthcare provider. There are prescription medications that can help. Anti-seizure drugs, Botox, triptane, and CGRP inhibitors may all help your symptoms.
Avoid over-medicating. Using over-the-counter pain relievers too often can actually cause rebound headaches. If you're taking them more than two or three times a week, it's time to talk to your provider about other options.

Using Evidation's MigraineSmart tool to understand your migraine patterns

Tracking your migraines used to mean jotting down notes in a journal or trying to remember patterns from memory — but that's not always reliable or convenient. That's where Evidation's MigraineSmart tool can help. MigraineSmart lets you log symptoms, track triggers, and record how well treatment works — all in one place. It also utilizes the other information you provide to Evidation (like information about your activity, sleep, hydration, and nutrition) to find patterns that can help lessen migraine attacks and symptoms. Click here to learn more and get started with Evidation and MigraineSmart today.