It can often be difficult in differentiating a migraine from a headache. Here’s why the two are different and how you can treat both pains.
When experiencing pain or pressure in your head, it is often difficult to tell whether it’s a headache or a migraine that you’re experiencing. Knowing the difference is extremely important and can help you find faster relief through the right treatment.
So, is that throbbing ache you are experiencing in your temples just an ordinary headache? Maybe not. The Migraine Foundation estimates that approximately 12% of the population, including children, suffer from migraines. However, migraines are under-diagnosed or misdiagnosed in most cases. Figures from the United States show that less than 5% of those who are affected, are accurately diagnosed and treated.
Therefore, before dismissing your pain as just another headache, it is important to know the differences in symptoms, as a more accurate diagnosis is crucial to pain management and prevention.
What is a headache?
Headaches are pains in the head, often described as pressure or aching, that can range from mild to severe in intensity. This pain can occur in the forehead, temples, and/or the back of the neck.
There are many different types of headaches. The most common types are:
Tension headaches are the most common type of headaches of them all. The pain typically associated with this type of headache usually spreads across both sides of the head, mostly originating from the back of the head and traveling forward.
The most common causes of tension headaches are stress, hunger and eyestrain. Other causes include depression, lack of sleep, poor posture and clenching of the jaw. Tension headaches can cause chronic pain.
Cluster headaches are usually extremely painful. What distinguishes them from other types of headaches is that they occur in “clusters” meaning that they are usually experienced in cycles of headache attacks that are then followed by headache-free periods. In some cases, these attacks are felt daily, sometimes even at the same time(s) every day.
Cluster headaches occur as a result of the blood dilation in the blood vessels inside the brain that takes place when hormones serotonin and histamines are being released. Underlying causes include: exposure to bright lights, physical exertion, and changes in altitudes.
Sinus headaches are usually confused with migraines. As the name alludes, this type of headache co-occurs with sinus infection symptoms such as congestion, cough, fever, and stuffy nose.
What are migraines?
Most of the time, people associate the term migraine with a severe headache. However, headaches are just one symptom of migraines. Other symptoms associated with migraines include:
- Pain behind one eye or ear
- Pain in the temples
- Sensitivity to light and/or sound
- Temporary vision loss
- Seeing spots or flashing lights
- Extreme fatigue
When compared to headaches in general, pain from migraine headaches can be moderate to severe. Although migraine headaches typically affect one side of the head, it is possible to have a migraine headache that affects both sides.
Migraine headache pains are also a lot more debilitating than other headaches. In fact, the World Health Organization places migraines as one of the top 10 most disabling medical conditions. The intense pain that individuals experiencing migraine headaches feel could make performing everyday tasks extremely difficult.
Migraines are often experienced in phases: the prodome phase, followed by the aura phase, the headache phase and, finally, the postdromal phase.
- Prodome phase also known as the pre-headache phase is characterised by the onset of painless symptoms that occur hours or days before the migraine headache starts. Such symptoms include mood swings, constipation, frequent yawning, stiffness of the neck, and unusual food cravings.
- Aura phase refers to sensory disturbances that occur right before or during a migraine. These disturbances can affect speech, vision or touch. However, this phase is not experienced by all migraine sufferers. Some examples of auras include numbness in the arm, slurred speech, and blurred vision.
- Headache phase refers to the phase where the headache pain is felt. The pain can be moderate to debilitating, and is potentially made worse by physical activity, exposure to smells, light or sound.
- Postdromal phase is the final phase of the migraine, when the pain subsides. In this phase, migraine sufferers can feel unwell and exhausted.
What causes migraines?
Although causes of headaches can usually be traced with ease, migraines have “triggers” rather than causes. If you suffer from migraines, you may find that there are some triggers that are associated with their onset. These triggers are different from person to person and include:
- Family history and genetics. Scientists have discovered a genetic mutation that is common among sufferers of the most typical type of migraine. Children with one parent that suffers from migraines has a 50% chance of developing migraines too, and in families with two parents that suffer from migraines, this risk increases to 75%.
- Allergies. In some people, allergies are a known trigger as they cause irritation and inflammation in the body, and an inflammation of the blood vessels is associated with migraines.
- Environmental. In many cases, migraines are triggered by environmental factors such as changes in the weather, certain foods, stress, certain smells, and lack of sleep.
- Gender and hormones. Migraines are three times more common in women than they are in men. Migraines affect over 30% of women worldwide over the span of their lifetime. This is mostly linked to menstrual cycles and the associated fluctuation in the level of hormones.
For headaches, most sufferers will be relieved through the use of over-the-counter medications such as paracetamol, aspirin, and ibuprofen. Also, since headaches are, in most cases, stress-induced, reducing stress can help relieve symptoms and reduce the risk for future headaches. Such therapies include massages, meditation, and heat therapies (applying warm compresses or taking warm showers).
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For migraines, prevention is usually the best form of treatment. This is why it is important for migraine sufferers to try and identify the triggers that are unique to them. This can be achieved by keeping a “migraine journal” to track patterns in onset, help identify triggers, keep a record of the time the headache started, what you were doing before and during, and how long the symptoms lasted.
For those suffering from serious headache pain and debilitating, persistent symptoms, it is strongly advised to seek professional medical treatment.
Doctors may recommend making changes to your diet and taking steps to reduce stress. Adopting other lifestyle changes such as exercising regularly, improving sleep habits and practicing meditation and other relaxation techniques may also prove helpful.
In the cases where over-the-counter drugs are not effective, doctors can recommend prescription drugs on a case-by-case basis. These include blood pressure medicines such as beta blockers, antidepressants, and anti-seizure medications. Botulinum toxin A (commonly referred to as Botox) injections have also been proven to help people with migraines.
Maha El Akoum, MPH, is a public health professional currently working as Head of Content at World Innovation Summit for Health [WISH].