Is It a Headache or a Migraine? Know the Difference


Chris Iliades, MD

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Woman with headache

Almost everyone gets headaches. But how do you know if your headache is a migraine?  Migraine headaches are common. They affect about 12% of the population. Even if you get migraines, you probably get other types of headaches, too. To tell which is which, it helps to learn if you are at higher risk for migraines. Two things that increase the chances that your headaches are migraines: being a woman and having a family history of migraines. 

If you are female, your migraine risk is three times greater than that of a male. In fact, up to 30% of women will have migraines at some point. And, because migraines tend to run in families, if one of your parents has ever had migraines, your risk for migraines is about 50%. If both your parents have had migraines, you have about a 75% chance of having them. 

Migraine Headache Symptoms

Migraine symptoms can be similar to other headache symptoms. However, certain symptoms make it more likely that your headache is a migraine. Your headache is probably a migraine if: 

  • Your headache pain is moderate to severe. 
  • The pain gets worse when you move around. 
  • You have additional symptoms like light sensitivity, nausea and vomiting.
  • Your pain feels like throbbing or pounding, and it's worse on one side. 
  • Your headache lasts for four hours or longer.
  • Light, odors, or noise make your headache worse.
  • Your headache is bad enough to keep you from normal activities like work or school. 

The Migraine Aura

You may have heard that a classic migraine headache has a warning sign called an aura. That is true, but only 15% to 20% of people have classic migraines. Most migraines do not have auras. If you do have an aura, know that the aura: 

  • May occur before, during or after your headache
  • May include visual changes, dizziness, strange odors or sensations, weakness, or numbness
  • Does not last longer than one hour

Other Headaches

Several other types of headache are often confused with migraines: 

  • Tension headaches. These are the most common type of headache. Stress often triggers tension headaches. A tension headache feels like a tight band around your head, with pain on both sides.
  • Sinus headache. This type of headache may be mistaken for a migraine because the pain is often on one side of your head and increases with movement. If you have a sinus headache, you almost always have other symptoms of sinus infection, such as a stuffy nose and swelling around your nose and eyes.
  • Cluster headache. This may be confused with a migraine because the pain is severe and on one side. Men get cluster headaches more often than women do. This headache can include facial swelling, stuffy nose, and watering eyes.

Diagnosing Migraines

Doctors do not use specific tests to tell if you are having migraines. Your doctor will make the diagnosis by asking you about your symptoms, doing a physical exam, and ruling out other causes for your headaches. 

Your doctor may ask you to keep a headache diary. In it, you record your symptoms and keep track of what was going on before your headache. This information will help your doctor diagnose, prevent and treat your headaches.

Many people with migraines can identify certain migraine triggers. Your migraine triggers could include stress, foods, food additives or preservatives, missing meals or sleep, or even changes in the weather. Knowing your triggers may help you avoid some of your headaches.

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