Migraine vs. headache: What’s the difference?

Brain Health

by Avery Saporito, MD

Apr 16, 2025

When that familiar discomfort starts creeping across your head, do you reach for the medicine cabinet without giving it much thought?

Understanding whether you're experiencing a regular headache or a migraine can make all the difference in how you treat it, which can be the key to finding relief.

But where to start? Let’s take a closer look at the different types of headaches, each one’s unique symptoms and your treatment options.

The 3 different types of headaches

Not all head discomfort is the same. But headaches, when they do happen, generally fall into two main categories: primary and secondary. Primary headaches occur on their own as independent conditions, while secondary headaches can be the result of another underlying issue, such as an illness or injury.

Most of us experience primary headaches from time to time, and there are three main types of primary headaches, each with distinct characteristics.

 

1. Tension-type headache

Tension-type headaches are the most common type that people experience, and they have these characteristics:

  • Affect both sides of the head
  • Produce mild to moderate pain
  • May be accompanied by tension in the neck and shoulders
  • Don't usually cause nausea or sensitivity to light and sound
  • Don't worsen with physical activity

Many people describe tension headaches as feeling like a tight band around the head. These headaches can be triggered by stress, dehydration, poor posture or eye strain.

2. Migraine

Migraines are more than just severe headaches—they're a neurological condition with a unique set of symptoms:

  • Often moderate to severe in intensity
  • Typically affect one side of the head
  • Have a distinctive pulsating or throbbing quality
  • Tend to worsen with physical movement
  • Frequently accompanied by nausea, vomiting, and sensitivity to light or sound

Some people notice early warning signs before a migraine starts, known as an “aura.” This might look like flashing lights, zigzag lines or other changes in your vision. While it can feel a little strange, an aura can actually be helpful—it can be a sign to take action early, which might even stop the migraine from fully developing.

Unfortunately, migraines without an aura are more common and strike without any warning at all.

3. Trigeminal Autonomic Cephalalgias (TACs)

Though rare, the third category is known as Trigeminal Autonomic Cephalalgias headaches, or TACs. These are often the most severe type. Symptoms of TACs include:

  • Extremely intense discomfort focused on one side of the head, often around the eye or temple
  • Accompanied by "autonomic" symptoms like tearing, eye redness, droopy eyelid, ear fullness or facial flushing

Cluster headaches are the most common type of TAC, and can be triggered by alcohol, smoking, bright lights, certain foods and heat.

Understanding the patterns

How often you experience headaches plays a crucial role in diagnosis and treatment approaches.

It is helpful to pay attention to whether you have:

  • Episodic pattern: Headaches that occur fewer than 15 days per month
  • Chronic pattern: Headaches that occur 15 or more days per month for at least three months

To be diagnosed with chronic migraines, someone must experience a certain number of headache days that include typical migraine symptoms—like nausea, or sensitivity to light and sound. These symptoms help doctors understand the type of headaches you're having and guide the best treatment plan. 

It’s why many providers recommend keeping a headache diary to track how many days you experience headaches, what the triggers are and any symptoms you experience. It can be a useful tool to decipher a migraine vs. headache.

What triggers the shift from chronic to episodic?

Several factors can cause occasional headaches to become more frequent:

  • Medication overuse: Taking pain relievers too frequently can actually lead to more headaches, creating a vicious cycle
  • Stress: Ongoing tension and anxiety can increase headache frequency
  • Major life changes: Disruptions to routine or significant life events can impact your headaches
  • Head injuries: Even mild trauma can trigger a change in headache patterns
  • Common migraine triggers: For some, things like certain foods, weather patterns and changes in barometric pressure, or hormonal fluctuations

Early intervention is key because once headaches become chronic, they can be more challenging to treat effectively.

When should you consult a doctor?

Many people live with headaches without seeking help and can even find relief fairly quickly with over-the-counter medications or at-home treatments, but there are clear signs that it's time to talk to a healthcare provider:

  • Your headaches are affecting your quality of life
  • You find yourself planning activities around your headaches
  • You're missing family gatherings, social events or work due to headaches
  • You experience headaches at least once a week

The good news? It is possible to have the life you want—free of headaches and migraines.

Taking control of your headache health

If you're experiencing an increasing number of headaches or you feel they are getting worse, don't wait to seek help. Working with a healthcare provider early or understanding what might be triggering your headaches can prevent occasional headaches from becoming more chronic and disabling.

Remember that while over-the-counter medications can provide temporary relief, they aren't a long-term solution, especially if you find yourself reaching for them regularly. A proper diagnosis can lead to more effective treatment strategies tailored to your specific headache type.

To get specialized care for headaches and migraines, find out if you’re eligible for the Virtual Headache Care program to develop a care plan that’s right for you.

About the Author

Avery Saporito, MD, is a neurologist on the medical staff at Baylor Scott & White – Dallas. Dr. Saporito is a provider for Baylor Scott & White’s Virtual Headache Care program.

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