My head hurts! Is it a migraine or just a normal headache?

Do you often find yourself having trouble deciphering if the pain you’re feeling is just a bad headache or a migraine? Don’t worry — you aren’t alone. Headaches and migraines can be difficult to distinguish, even for practiced healthcare providers. 

Being a family medicine physician and migraine sufferer myself, I’ve seen the full spectrum of interesting migraine presentations. Luckily, I have some helpful information you can wrap your head around to make sense of your headaches. 

Spotting migraine symptoms  

Besides a painful headache, migraines are a complex condition that can cause a wide variety of symptoms. Other common migraine symptoms include:

• Vision changes
• Sensitivity to light or sound
• Alteration in the way things smell
• Increased sensitivity to smells
• Nausea
• Vomiting
• Dizziness

Symptoms associated with migraine headaches can vary from person to person and from episode to episode. Each migraine can be its own unique gift to the unlucky recipient. Regardless of severity, migraines can last anywhere from 4-72 hours and can have profound impacts on your work, family and social life.  

Aura or no aura?

The two most common types of migraines are migraines with or without an aura. An aura acts as an early warning sign that a migraine is starting. This often presents as visual changes such as seeing zigzag lines or flashing lights in the peripheral vision. 

Auras can be helpful signals that allow for early treatment of the migraine through medication before it becomes painful, sometimes successfully preventing the migraine from developing altogether. 

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

Thankfully, we have discovered many triggers for migraines, but keep in mind that not every trigger affects every migraine sufferer. By keeping a headache diary, you can help determine which of the following might be linked to your migraine pattern.

The most common migraine triggers 

Changes in routine 

Even welcoming changes into your life such as going on vacation or taking time off of work can trigger migraines. Try to stick with the same patterns for meals, exercise and sleep — even on the weekends or vacation.  

Stress

As hard as stress reduction is to imagine at times, trying to cut down on the worries in your life may be necessary to avoid debilitating migraine patterns. Learn to prioritize what is truly important and what can be delayed or avoided altogether. 

For me, saying “no” more often than saying “yes” was hard in the beginning but helped enough with my migraine severity and frequency that it soon became easier.  

Sleep

Both too much and not enough sleep can trigger a migraine. Prioritize keeping the same sleep schedule as often as possible. Remember, at least 7 hours of sleep nightly is preferred.

Caffeine 

Drinking more than 3 cups of anything caffeinated per day has been linked to increased migraine frequency. But if you consistently drink more than the recommended amount, don’t quit cold turkey. You will need to slowly cut down on caffeine intake to avoid triggering caffeine-withdrawal headaches.  

Hormone changes

Women are affected by migraines more often than men specifically due to changes in their female hormones — monthly menstrual cycling is often associated with migraines. The most difficult time for most female migraine sufferers are the early years of menopause.

Environment

Certain environmental changes can trigger migraines. Think traveling to a higher altitude, weather changes, strong glares or flickering lights, prolonged exposure to loud noises or bad smells. These can all cause a migraine to develop.

Diet

Missing meals triggers migraines for some, so be sure to stick to a regular eating schedule. Certain food additives such as food dyes, MSG (food preservative often found in Asian foods), nitrates (another food preservative found in hot dogs and lunch meat) and aspartame (artificial sweetener found in diet sodas/teas) have all been found to be possible migraine triggers in sensitive persons. Finally, red wine and some soft cheeses like Brie and Camembert contain tyramine, also suspected to be a possible migraine trigger. 

Related: Top migraine food triggers and how to deal with them

Screen time

Prolonged exposure to technology such as smart phones, tablets and computers can cause eye strain. Prolonged sitting in uncomfortable positions can also lead to muscle strain in the neck and shoulders. Both of these can encourage a migraine to develop. 

Exercise 

While regular exercise is generally helpful in migraine prevention, sudden changes in exercise level can have negative implications. For a person who doesn’t regularly exercise, starting boot camp or another high intensity exercise program can be a migraine trigger. Remember to take it slow when beginning any new exercise regime.  

Oral contraceptive pills

Headaches and migraines can be a common side effect of oral birth control options. Talk to your primary care physician or OB/GYN about your headache history when deciding which forms of birth control are right for you.

In recent years, many new options for both treatment and prevention of migraines have been released to the market. If the prevention measures listed above still do not bring adequate control to your migraine patterns, follow up with your primary care physician to talk about your options.

Head aching? You may be eligible for Baylor Scott & White’s Virtual Headache Care program, which offers specialized care for various headache and migraine types without a referral from your provider—all accessed via the MyBSWHealth app.