What is the difference between migraine and tension headaches?

Two common causes of headache pain can explain and differentiate two common types of headaches, tension-type and migraine headaches.

Tension may strain muscles of the face, neck, and scalp, leading to the tight, pressing pain sensation of tension-type headaches.

Swelling and stretching of the blood vessels in the head cause vascular headache pain. A migraine headache is the principal form of vascular headaches.

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Some headaches share characteristics of both migraine and tension headaches and don't neatly fit either category. As a result, treating them can be challenging. For instance, the more intense a tension headache gets, the more it resembles the sharp, throbbing pain of a migraine headache. Likewise, when a migraine headache becomes more frequent, its pain begins to feel like that of a tension headache. Experts now believe that headaches fall along a continuum ordered by their characteristics: the occasional tension headache is at one end and the migraine headache is at the other. In between are chronic tension headache and chronic migraine, which are often lumped together as chronic daily headache.

This doesn't mean that all headaches share the same mechanisms. Experts still generally believe that tension headaches are stimulated by muscle tightness, while migraine headaches are caused by the dilation and inflammation of blood vessels. However, if you have migraine headaches frequently, you may develop muscle tightness, which can trigger more headaches, creating a vicious cycle.