Headaches and migraines are often lumped into the same category– by people who’ve never suffered a migraine, that is!
The fact of the matter is that they are actually very different, both in terms of the average pain levels and by medical definition. A headache is an unpleasant pain in your head that can cause sensations of aching and pressure. The most common form of headache is a tension headache. Cluster headaches and sinus headaches (which aren’t actually headaches, but mimic the symptoms of one) also exist. However, the two are frequently left out of the equation when comparing migraines and “normal” (tension) headaches.
A migraine, on the other hand, is far more complex. There are several theories on the mechanism of a migraine and we continue to study migraines to find out more. A migraine is a complicated disorder caused by nerve impulses interacting with one another and the release of chemicals that irritate certain parts of the brain. These parts include the cerebral cortex and trigeminal nerve (the largest part of the cranial nerve).
How Common Are Migraines?
Neither headaches nor migraines are what anyone would call rare. However, headaches are far more common. Did you know that almost everyone will experience at least one headache in their lifetime? And most people would consider only one headache in a lifetime lucky!
Migraines are less common, but still affect 38 million Americans. While this is hardly a statistic to sneeze at, migraines somehow remain largely misunderstood.
What Triggers an Attack?
Migraines and headaches are different from the very start, and this includes their respective triggers and risk factors. The most common triggers for tension headaches are:
- Sleep deprivation
Headaches are also a known symptom of dehydration, including the hangover that can come after a night of drinking alcohol.
There are far more triggers for migraines. These include:
- Bright lights
- Changes in sleep patterns, including lack of sleep
- Drinking alcoholic beverages
- Eating sweets or processed foods
- Exposure to odors (strong perfume, cigarette smoke, etc)
- Hormone changes (in females)
- Loud noises
- Skipping meals
Though the triggers are mostly different, headaches and migraines have a major risk factor in common: they plague far more women than men. According to the Office on Women’s Health, 3 out of 4 individuals who experience migraines are women. The journal Current Pain and Headache Reports estimates that migraines affect 18 percent of all women. Many medical experts believe women suffer more migraines than men because of hormone changes due to their menstruation cycles and menopause.
Migraines are also known to run in families, which indicates that they may be at least partly genetic. Being significantly overweight can also increase a person’s risk of migraine. Obesity isn’t a trigger in and of itself, but it can cause a regular headache to progress into a full-fledged migraine.
What Are Migraine Symptoms Like?
This is arguably the most important section of the article! In fact, it best answers our title: why migraines are so much worse than headaches.
While they are brought on by different triggers and have different risk factors, one of the biggest reasons migraines are so different from headaches is that, simply put, the symptoms are much more intense.
A tension headache usually ranges from dull pressure to the sensation of a tight squeeze. Individuals with migraines, on the other hand, experience a type of pain they report as:
Another aspect of the pain level is that headaches–while painful and inconvenient–will not put you totally out of commission in the same way a migraine can. A migraine might cause pain so blinding that you miss a day of work because you simply have to stay in a dark, quiet room. This is typically not ever the case with a tension headache.
Migraines and headaches not only differ in level of pain, but also in location of the pain. You likely have a tension headache if you’re experiencing:
- Pain throughout your head
- Pain at the base of your neck
- Or pain across your forehead
On the other hand, the following locations may be signs you’re having a migraine:
- Pain on only one side of you head
- Pain behind your eye
- Pain near your eye
(Note: these are also known cluster headache locations, but cluster headaches are rare.)
Though there might sometimes be exceptions to this rule, a migraine typically lasts far longer than a regular headache. A tension headache develops and resolves within a day, sometimes within an hour. Migraines usually last at least several hours and can even last for days on end.
One way to know for sure that you’re experiencing a migraine rather than a headache is if it comes with symptoms other than head pain. This is an “all squares are rectangles but not all rectangles are squares” type of situation. Basically, if you have a severe headache that comes with an aura or other accompanying symptoms, you can be fairly certain it’s a migraine. On the other hand, many individuals with chronic migraine don’t ever experience anything besides head pain. So don’t assume that you don’t have a migraine just because there is no aura or other symptom!
So what is an aura and what are other possible accompanying symptoms?
If you experience nausea, an upset stomach, or even vomiting before or during the head pain, it is very likely a migraine rather than a mere headache.
Examples of visual auras include:
- Bright flashing lights
- Dots in your field of vision
Examples of other auras are:
- Pins and needles feeling in your arms and/or legs
- Temporary loss of language
- Temporary vision loss
- Speech problems
Remember, auras aren’t actually that common, so please don’t rely on them as the only “evidence” that you have a migraine rather than a bad headache. Since a migraine can (and frequently does!) occur without aura, the best way to figure things out is to talk to your doctor.
Four Phases of Migraine
Not all migraines come with these four phases, but it’s always good to know what they are. Like auras, the other potential phases may help you identify your head pain as a migraine.
During this pre-migraine time frame, your body might let you know things aren’t quite right. This could include the following symptoms in the days leading up to your actual migraine:
- Changes in your digestion
- Changes in your mood
- Unusual food cravings
- Increased thirst (and consequently increased urination)
- Neck and shoulder aching
The various auras we discussed earlier can occur during their namesake phase. You may experience visual or non visual auras the day of your migraine, usually a couple hours before the attack phase begins.
The third phase is when the horrible, intense migraine pain begins. In addition to the pain, many people experience a sensitivity to:
Exposure to any of these stimulations of the senses will usually make the pain worse. Sometimes migraines also come with nausea and lightheadedness. The attack phase of the migraine usually lasts anywhere from four hours to three days.
Even once the pain has passed, a lot of individuals feel a continued sensitivity to light and sound for the next day or so. Also, you may feel like all you want to do is sleep! Being in extreme pain is taxing on your body, so this exhaustion and weakness is its way of demanding recuperation.
What Can You Do to Prevent Migraines?
A migraine might leave you feeling helpless, but you do have options. A healthy diet helps decrease triggers and lowers your risk of obesity (which, as mentioned earlier, can increase your chances of a regular headache to progressing into a migraine).
Here are some foods and drinks to be wary of:
- Alcoholic beverages
- Processed meats
Alcohol and chocolate are the two most commonly reported triggers, and the other listed items may put you at risk because of certain headache-triggering chemicals. The American Migraine Foundation has a longer article about migraine diet that you can read here.
Remember, migraine management is important for more reasons than the pain. Current Pain and Headache Reports has estimated that individuals with chronic migraines miss an average of five work days in a three-month period. People with regularly occurring migraines also make less money on average than those who do not experience these debilitating episodes. Needless to say, being proactive about your migraines will help numerous areas of your life!
There are a variety of headaches one might experience, but most would argue migraines are by far the worst. (Though some cases of cluster headache might give migraines a run for their money.)
If you have a loved one who suffers from chronic migraine, please do your best to be understanding. Many people with migraines don’t appreciate the comment, “I get headaches too!” because it’s a bit like comparing a bruised shin to a broken leg.
If you experience migraines, we conduct clinical trials here in DeLand that you could qualify for. If you live in Central Florida and are interested in learning more, please feel free to get in touch!