Migraine vs. Headache: How to Tell Them Apart

Written by Robin Madell | Published on March 27, 2013
Medically Reviewed by George T. Krucik, MD, MBA on March 27, 2013

If you’re suffering from pain in the head, you may be suffering from a primary or secondary headache, or a migraine. This slideshow runs through basic differences between these types of pain.

Know Your Headaches

When you feel pain coming on in any region of your head, you’re likely dealing with a headache. However, different types of headaches produce different symptoms. How can you tell them apart? Headaches are often distinguished by their cause. Learn more about how to know when it’s a migraine or another type of headache.

Primary Patterns

Headaches are generally classified into two main types: primary headaches and secondary headaches. A migraine, which is a disabling, recurring headache that frequently occurs only on one side of the head and often results in other symptoms, is one type of primary headache. Other primary headaches include cluster and tension headaches. Tension-type headaches are the most common headache, and are often experienced as mild, dull pressure without other accompanying symptoms. Cluster headaches, which are less common than migraines or tension headaches, usually bring severe pain (sometimes described as “stabbing” pain) behind one eye, and may be accompanied by redness and nasal congestion.

Secondary Sources

The other main type of headache is called a secondary headache. These headaches, while relatively rare, are more serious than primary headaches. That’s because they are often caused by other serious health problems or underlying conditions, such as brain aneurysms or tumors, dysfunctions of the spinal fluid, or inflammatory diseases. In order to treat secondary headaches, a doctor must first diagnose and treat the underlying condition that’s caused the headache.

How Can You Tell?

It’s important to know what type of headache you have so that you can seek proper treatment. While a doctor can help diagnose your headache, you can probably make the assessment yourself by knowing the symptoms. A migraine headache can be quite severe, causing intense pulsing or throbbing sensations in one area of your head. Other distressing symptoms include nausea, vomiting, and light or sound sensitivity. Secondary headaches are generally distinguished by neurological symptoms that accompany a very severe headache—your doctor can give you a neurological examination to rule out a secondary headache.

Distinguishing Factors

If you’re not sure whether your headache is a migraine or another type of primary or secondary headache, examine your symptoms carefully. According to the Department of Health and Human Services (HHS), when it comes to primary headaches, both migraine and general tension headaches can bring mild to moderate levels of pain. Migraines and secondary headaches can result in sudden and very severe pain. If in doubt about the type of head pain you are dealing with, see your doctor.

Quality Counts

A steady ache can result from either a tension headache or a migraine. To help determine if you have a migraine, pay attention to the quality of your pain. If it’s merely distracting, it’s likely a tension headache. But if you start to feel intense pounding or throbbing that becomes debilitating, you’re probably suffering from a migraine.

Location, Location, Location

Where you feel your pain can also contain clues as to what type of headache you have. While both migraines and general tension headaches may sometimes be felt on both sides of your head, often migraine headaches are located on one side of your head. A distinguishing factor of migraine headaches is that, unlike cluster headaches, they tend to result in unilateral pain, meaning pain on one side of the head. However, migraines can, in fact, cause pain anywhere in the head, including behind the eye or ear on one side of the head, or in one or both temples.


If you’re still not sure what type of headache you’re dealing with, examine your other symptoms. If you feel nauseous, experience vomiting, or see an aura (such as flashes of light, blind spots, or see shapes or bright spots) before your headache sets in, you’re most likely experiencing a migraine. Migraines can also cause sensitivity to light or sounds, which is rare in a tension headache.

How Does Your Headache Respond?

Depending on the type of headache you have, it may respond differently to treatment with drugs. For example, medications used for migraine treatment generally don’t help tension headaches. However, some over-the-counter drugs that help soothe tension-type headaches are also effective in treating migraines. If your headache does not respond to treatment and continues to steadily worsen, that could be a warning sign for a secondary headache—your doctor can provide a diagnostic assessment to be sure.

The Difference Is Clear

Both general tension headaches and migraines can occur at regular intervals, so the frequency of headaches is usually not an indicator of which type you have. However, there are many other differences that make migraine headaches stand out as distinct from other primary headaches, as well as from secondary headaches. Assess your symptoms, the quality and location of your pain, and how your headache responds (or does not respond) to treatment. If in doubt, speak with your doctor, who can help diagnose and treat your headaches.

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