Ahna A. Patterson, PA-C
What is a migraine headache and how does it differ from a tension-type headache?
Migraine headaches are characterized by chronic throbbing headaches often associated with visual or sensory sensitivities. Some people may also have auras. Symptoms of migraines include the following:
- Throbbing or pulsating pain typically on one side of the head
- Pain that can occur around the eye or anywhere along head or neck
- Gradual pain that develops over one to two hours
- Nausea, vomiting, lightheadedness
- Sensitivity to light and sound
An aura is a sensory disturbance that precedes the onset of a migraine or that can accompany migraines. Auras are often visual, sensory, or motor disturbances such as:
- Tingling along one limb or one side of the face.
- A bright spot in one’s visual field temporary loss of vision in one area, zigzag lines in one’s visual field, or geometric shapes seen within one’s visual field.
Emotional stress, menstruation, sleep disturbances, not eating, weather changes, odors, lights, and alcohol intake have all been identified as possible triggers of migraine headaches.
Tension-type headaches, by comparison, can be chronic, but are most commonly episodic. Symptoms generally include:
- Mild-to-moderate headache pain described as: dull, pressure, head fullness, band-like, or a tight cap around the head.
- Pain that is usually present on both sides of the head, and is not pulsating or throbbing
Triggers for tension-type headaches include stress, computer/device eye strain, caffeine, alcohol, dehydration, fatigue, and poor posture.
Tension-type headaches most often resolve with the help of over-the-counter pain relievers such as anti-inflammatory medicines (NSAIDs) or acetaminophen. Stress management, healthy lifestyles, and improved posture can all help decrease the occurrence of tension-type headaches.
Migraines can be relieved with over-the-counter medications but may also require a range of prescription medications for relief and prevention of symptoms. Relaxation techniques, maintaining eating and sleeping routines, and staying hydrated may also be helpful.
Sometimes headaches are warning signs of other underlying health conditions, like brain tumors, aneurysms, and strokes. Concerning symptoms include: a sudden onset of headache pain (“thunderclap”), fever, loss of consciousness or confusion, slurred speech, changes in the frequency or severity of headache symptoms, and any sudden onset of headache symptoms in adults over 50.
These concerning symptoms may warrant further evaluation with an MRI or cat scan. Always seek medical guidance from your healthcare provider.
R. Joshua Wootton, Franz J Wippold II, Mark A. Whealy, “Evaluation of headache in adults,” UptoDate, updated April 6, 2020.
Frederick R Taylor, “Tension-type headache in adults: Pathophysiology, clinical features, and diagnosis,” UptoDate, updated November 17, 2018.
Jonathan H Smith, “Acute treatment of migraine in adults,” UptoDate, updated April 7, 2020.
F. Michael Cutrer, “Pathophysiology, clinical manifestations, and diagnosis of migraine in adults,” UptoDate, updated November 15, 2019.
Valencia Higeura and Kristeen Cherney, “Tension Headaches,” Healthline, September 26, 2019, https://www.healthline.com/health/tension-headache
Mayo Clinic, “Tension Headache,” https://www.mayoclinic.org/diseases-conditions/tension-headache/symptoms-causes/syc-20353977
Mayo Clinic, “Migraine,” https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207 Mayo Clinic, “Migraine with Aura,” https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/symptoms-causes/syc-20352072