Migraine or Headache?
Discover how to tell the difference between migraines and headaches
Migraine or Headache? When you have severe head pain it can be very difficult to tell which of these two you are actually experiencing. Knowing how to tell the difference will help you get faster relief and also prevent migraines or headaches in the future.
While there are over 200 different types of headache, neck (vertebrogenic) and tension headaches account for the majority of headaches that people experience. In this blog we will use the word “headache” to describe these two types.
What are Migraines and Headaches?
Migraines are a moderate to severe pain on one side of your head that is usually described as a pulsating or throbbing sensation. They can be so debilitating that they can prevent you from performing any form of daily activity.
Migraines occur in approximately 15% of all Australians and occur more often in women then in men. They occur most often during your twenties and thirties and are relatively infrequent once you turn forty, however they can also occur in childhood and adolescent years.
A headache is defined as a pain that is experienced in the front, sides and top of the skull and in the top of the neck. They can also be felt as a tight band around the head. Over 60% of all Australians suffer from frequent headaches that affect their quality of life.
What are the Symptoms of Migraines and Headaches?
A migraine attack is divided into four phases and you may experience symptoms associated with one, some, or all of these phases.
Migraine Phase 1 : Prodrome
The symptoms of this phase can last for 1-2 days before the migraine and include these symptoms:
- Fatigue, sleepiness or frequent yawning
- Irritability or hyperactivity
- Neck pain and stiffness
- Mood and behaviour changes
- Difficulty finding words , speaking or concentrating
- Gastrointestinal disturbances
Migraine Phase 2: Aura
Auras only occur in 20-25% of migraine episodes and last approximately 20 minutes. They usually occur just before the migraine attack. The symptoms include:
- Visual disturbances (blurry vision, wavy lines or brief flashes of light)
- Loss of speech control, dizziness and vertigo
- Hypersensitivity to touch
- Tingling, burning, or numbness in the face or extremities
Migraine Phase 3: Attack
The symptoms of the this phase of the migraine can last from 4 to 72 hours. Alll migraine sufferers will experience one or more of these symptoms. They include:
- A unilateral (one sided) headache that is a pulsating or throbbing pain
- The pain is worse with activity
- Nausea and or vomiting
- Sensitivity to light, sound and or smells
- Loss of appetite and upset stomach
- Nasal congestion and or runny nose
Migraine Phase 4: Postdrome (Recovery)
These symptoms of this phase can last for 1-2 days and include:
- Having trouble thinking clearly or feeling alert
- Mood changes ranging from depression and irritation to euphoria
- Sensitivity to light and or sound
- Changes in speech
The most common symptoms of headaches are:
- Pain in the forehead, temples and the base of the skull
- The pain is felt as a dull pressure or tightening sensation in the head
- Pain and tight muscles in the neck and shoulders
- Occasional sensitivity to light or sound
- Fatigue irritability and difficulty concentrating
What Causes Migraines and Headaches?
Whilst the exact cause of migraines is not known we do know they are caused by an abnormal interaction between the brain and the blood vessels that supply it.
Specific regions of the brain become hypersensitive to normal stimuli (emotions, sensory inputs, chemicals or environmental changes) which increases the blood flow to the brain causing swelling and pressure on nearby nerves. These changes are what actually causes the throbbing sensation associated with migraines.
Headaches are caused by muscle contractions in the upper neck and head caused by physical, emotional or chemical stresses. The most common causes are physical stresses such as poor spinal movement, poor posture and activities such as long periods using a computer. Other common causes are eye strain, fatigue, emotional stress or poor sleep.
There is a strong genetic link with people who suffer migraines with over 70% of people who experience migraines having a family history of the disorder.
What Triggers Migraines and Headaches?
There are many known triggers for migraines, which vary dramatically between each person. Finding the triggers for your migraines can be difficult because some triggers will not cause an attack every time. In some people a number of triggers need to combine to cause a migraine but each on its own won’t set off an attack.
The 4 types of migraine triggers are:
1. Dietary Triggers
- Certain wines, beers and spirits
- Chocolate, citrus fruits, aged cheeses and cultured products
- Monosodium glutamate (MSG)
- Caffeine (coffee and tea) withdrawal
2. Environmental Triggers
- Bright or flickering lights including bright sunlight
- Strong smells e.g. perfume or chemical smells
- Travelling (especially flying)
- Changing weather conditions
3. Hormonal Triggers
- Menstruation, Ovulation and Menopause
- Oral contraceptives
- Hormone replacement therapy (HRT)
4. Physical and Emotional Triggers
- Emotional stress
- Abnormal sleep patterns
- Back and neck pain
- Vigorous exercise
The most common headache triggers are:
- Abnormal spinal function and posture
- Poor office ergonomics or lighting
- Emotional stress
- Eye strain or dry eyes, fatigue
- Skipping meals and poor sleep patterns
- Changes in hormone levels
What is the Treatment for Migraines and Headaches?
Migraines are most commonly treated by:
- Making changes to your diet including eliminating any foods that trigger migraines
- Maintaining good spinal function
- Hot or cold compresses to your head or neck
- Stress management or relaxation training
- Non-prescription drugs such as ibuprofen, aspirin and paracetamol
- Prescription medications such as anti-nausea medicines, anti -depressants, muscle relaxants, hypertension drugs, antiepileptic medications and botox
Headaches are most commonly treated by
- Restoring good spinal movement
- Acetaminophen, aspirin or ibuprofen
- Heat therapy
- Lifesytle changes
Can You Have a Migraine and a Headache at the Same Time?
Yes you can! A Mixed Tension Migraine is when you actually experience a migraine and a headache at the same time.
There are two ways that this is believed to occur:
- The changes in the blood vessels that occur during a migraine cause changes in the functioning of the cervical spine triggering a headache at the same time.
- The abnormal spinal function that causes the headache also stimulates the neurology in the upper spine causing a migraine attack.
Mixed tension migraines sufferers will experience both headache and migraine symptoms which will vary from person to person.
So How can I Tell a Migraine From a Headache?
There is no single indicator as to whether you are experiencing a migraine or a headache. Only a complete review of your symptoms, pain triggers and examination responses to treatment will separate the two.
The most common differences are:
- A migraine will usually be felt on one side of the head where as a headache will be on both.
- A migraine will be felt as a sharp stabbing pain while a headache will be a dull pressure feeling
- The pain from a migraine will be felt in or around the eye and face whereas a headache will be felt in the back, sides and front of the skull
- Strenuous activity will aggravate a migraine but not a headache
- You can have sensitivity to light sound and smells with a migraine but not with a headache
- A migraine can cause nausea and vomiting while a headache may cause some nausea but is rarely associated with vomiting
- A migraine will be associated with mood changes such as feeling depressed or overjoyed whereas a headache will not cause these changes
- A migraine can cause nasal congestion, gastro-intestinal disturbances and a loss of appetite, a headache will not cause these symptoms
- A migraine will be associated with feelings of confusion, lethargy, difficulty finding words or concentrating, however a headache will not cause these changes
- Auras such as blurry vision and flashing lights can occur before a migraine but not a headache
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