Is it a migraine or tension headache?

Nearly everyone experiences a headache at some point, with some becoming severe enough to be classified as migraines. In many cases, what seems like a migraine is in fact the more common tension headache. What causes these headaches and is there a way to prevent them? Nathanael Benitez, DO, explained how to tell if it’s a migraine or tension headache causing your pain and discomfort.

Tension headache vs. migraine

The most common type of headache is called a tension headache. This type of headache generally is characterized by a dull pressure and is caused by muscle contractions in the head and neck. These headaches can be brought on by a variety of foods, activities or other stressors.

“A tension headache is usually experienced in a ‘band-like’ pattern around the head and can feel like someone is squeezing a tight band around the temples and base of the skull,” Dr. Benitez said.

Migraines affect 38 million Americans and vary widely among patients. They may vary from one episode to another in an individual patient, but they typically involve one of the following characteristics:

• An intense pulsing or throbbing, rather than the dull pressure that is associated with tension headaches
• Pain on only one side of the head
• Pain that grows worse when you move
• Sensitivity to light and sound
• Nausea, vomiting or dizziness
• Visual disturbances such as temporary blind spots or visual auras

Patients with a migraine likely will experience one or a combination of the above symptoms, but not all of them.

“Migraines still are not well understood, and research into their causes and mechanisms continues,” Dr. Benitez said. “Basically, a migraine is a complicated disorder caused by the way nerve impulses interact with one another. Chemicals released during these interactions irritate certain parts of the brain, leading to the various types of pain and discomfort.”

There are many more triggers for migraines than for tension headaches, and they include:

• Bright lights
• Changes in sleep patterns or not enough sleep
• Drinking alcohol
• Eating sweets or processed foods
• Some odors such as strong perfumes or cigarette smoke
• Changing hormones (in women)
• Loud noises
• Missing meals

“Most tension headaches can be relieved by over-the-counter medications such as Tylenol, Advil or Aleve, but migraines are often not relieved by these meds,” Dr. Benitez said.

How to prevent migraines

If you experience migraines, try to learn what triggers bring them on and avoid those triggers. Making some changes to your diet also may help you avoid migraines. Try eliminating one or more of the following from your diet:

• Alcohol
• Chocolate
• Cheese
• Caffeine
• Processed meats

When to seek care for headaches

“A person experiencing severe headaches should begin by talking to their primary care doctor about the issue,” Dr. Benitez said. “They may be able to offer suggestions or treatments that can help manage headaches and improve quality of life.”

Depending on the severity of the issue and the success of suggested medications or treatments, your doctor may refer you to a specialist for further testing to nail down a potential cause.