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Nearly everyone has a headache at some point—some worse than others. But if the pain is really intense, is it a migraine? Well, it’s not quite so simple. There are actually many different types of headaches, which often have specific causes, triggers, symptoms and treatments. Some “mixed headaches” have a combination of symptoms and don’t fall neatly into one specific category. Understanding these differences will help you figure out if you’ve got a doozy of a headache or if you really do suffer from migraine pain.
“People often mistake migraine for any headache. Migraine is a very common type of headache, but definitely not all headaches are migraines,” explains Sourabh Lahoti, MD, a neurologist affiliated with Coliseum Medical Centers in Macon, Georgia. “Migraine is a very distinct form of headache.”
1. Headaches can have a number of causes.
Intense headaches can develop for a number of different reasons. One common culprit: stress. If you’re anxious, the muscles in your shoulders, neck and jaw tend to tighten. This can lead to a tension headache, which is often described as a vice-like band of pain around the head. Poor posture, which puts strain on the head and neck muscles, eyestrain and jaw clenching can also lead to a tension headache. The likelihood that you’ll develop this type of head pain increases if you’re sleep-deprived or hungry.
Cluster headaches are another type of severe and recurring head pain. They are much less common than tension headaches or migraines but significantly more intense and debilitating. The pain, which is usually on one side of the head near the eye or temple area, has been described as “burning,” or “like a hot poker in the eye.” Cluster headaches have even been called “suicide headaches” since just the anticipation of the pain has prompted some people to take their own lives.
Cluster headache is actually a rare disorder, involving a nerve that controls sensation in the face. As its name implies, this type of head pain consists of a group of attacks. People may develop a series of intense headaches up to eight times per day for a period of weeks or months. The pain may disappear completely, only to return later. This period of remission can last for months or even years. Cluster headaches, which are also associated with red or watery eyes, nasal congestion, restlessness and facial flushing, are more common among men.
Sinus headaches are a third type of head pain, which can result from a viral or bacterial infection. They can cause throbbing facial pain and pressure over the cheeks, across the forehead or behind the eyes. Sometimes the pain can be on just one side of the head. These headaches may be accompanied by fever—but not always. People with a sinus headache are usually congested and have cloudy or colored nasal discharge. They may also have watery or red eyes. Many people with a migraine mistakenly believe they have a sinus headache.
So how can you tell if you’ve really got a migraine vs. another type of headache? Here are five migraine facts:
2. Migraine is a brain disorder that isn’t well understood.
Unlike headaches that stem from an infection, stress or stiff muscles, migraines are more of a mystery. Scientists are still working to understand what exactly causes this neurological disease, categorized by recurring, disabling headaches.
“The research so far has shown that migraine is associated with an inflammatory process that results from an interaction between nerve endings and blood vessels in the brain,” Dr. Lahoti explains.
Whether or not you get migraines may also come down to your DNA. In fact, about 90 percent of migraine sufferers have at least one close relative who is also affected. This type of headache is also much more common among women, which is likely due to hormonal changes.
3. Migraines have specific symptoms.
There is a group of specific symptoms that are typically associated with migraines. People with these headaches usually develop the following:
- Severe, throbbing pain (usually on one side of the head) that usually lasts for 4 to 72 hours
- Nausea or vomiting
- Sensitivity to light or sound
Aside from cluster headaches, migraines are usually much worse than other types of headaches. They tend to stop people in their tracks. In many cases, the pain prevents people from getting out of bed, going to work, attending school or engaging in other normal daily activities, Lahoti explains.
“Migraine is a disabling headache,” he says. “It leads to loss of work days and individuals suffering from migraine are usually in their peak productive years of life because it usually affects adults between the ages of 25 and 55.” It’s important to note, however, that even children can experience migraines.
There are also some red flags that an intense headache may be associated with a more serious health issue or emergency that requires immediate medical attention. These warning signs include:
- An excruciating headache that develops very suddenly
- Headaches accompanied by weakness and numbness on one side of the body
- Headaches that begin later in life, after 50 years of age
- Headaches that get worse after lying down
- Headaches associated with significant changes in vision or vision loss
4. Migraines usually have specific triggers.
Hunger and sleep loss may increase the risk for a tension headache, but the inflammatory process that leads to a migraine is often initiated by exposure to specific triggers. Some known migraine triggers include:
- Certain foods, such as cheese, red wine, chocolate, cured or processed meats
- Stress or anxiety
- Hunger, skipped meals or low blood sugar
- Hormonal shifts
- Some medications, including oral birth control pills and certain over-the-counter pain medications
- Sudden changes in the weather
- Changes in sleeping patterns or poor sleep
- Loud noises
- Bright or flashing lights
- Motion sickness
- Tobacco use
Keeping a daily journal can help identify possible migraine triggers. “If people are able to identify and avoid their triggering factors, they may be able to avoid getting a migraine without using any medications,” Lahoti says.
5. Migraines are often predictable.
Many people can tell when they are about to get a migraine. It can start as a mild headache, which becomes more intense over time. Up to 24 hours before the onset of a migraine, people can also develop food cravings or mood swings. They may experience increased yawning or start retaining fluid, as well.
Sometimes migraines, which usually develop in the morning, are preceded or accompanied by visual cues, including flashes of lights and wavy lines. People may also develop blind spots or tunnel vision. These headaches, known as migraine with aura, account for only about 30 percent of migraines.
Some people may also develop tingling or numbness in their hands or feet before they get a migraine, Lahoti notes. Others may have slowed speech or trouble finding the right words, he adds.
6. Migraines require treatment.
Migraine is a leading cause of disability around the world, affecting many otherwise healthy adults and children. There is no cure for migraine but there are effective treatments, which can help improve quality of life, according to Lahoti. “If people get the right medical care it should make a big difference in their life,” he says.
Unfortunately, only a small percentage of the 39 million Americans who suffer from migraine pain ever seek out help, Lahoti points out.
Migraine treatment focuses on prevention and relief. In its early stages, migraine pain may be eased by resting, moving to a quiet, dark room, placing a cold compress on the forehead and drinking plenty of fluids. In some cases, a small amount of caffeine could also help.
There are also medications that can help reduce the frequency and severity of more intense migraines, which is particularly important for people who suffer from chronic migraine pain.
“If somebody's getting frequent migraine headaches, maybe once every week or a couple of times every week, those patients could be started on prophylactic medications which they would take every single day, regardless of if they're having a headache or not,” Lahoti says. “In most cases, we've found success with these medications and can prevent migraine headaches.”
People who experience migraines may also need to make some lifestyle adjustments, which may include getting regular exercise, easing stress, avoiding certain foods, staying well hydrated, avoiding the overuse of certain medications or not taking them at all and going to bed and waking up at the same time each day.
