Migraine vs Headache
A headache is any pain in the head — a broad category that includes everything from tension headaches to dehydration headaches to the headache caused by a hangover. A migraine is a specific neurological condition with characteristic features: typically throbbing pain on one side, sensitivity to light and sound, often nausea, and sometimes visual aura. All migraines involve headache; not all headaches are migraines.
Last reviewed on 2026-04-27.
Quick Comparison
| Aspect | Migraine | Headache |
|---|---|---|
| Category | A specific neurological condition | A general symptom of many causes |
| Pain quality | Throbbing, often one-sided | Varies — pressure, tightness, dull ache |
| Duration | Hours to days, untreated | Minutes to days |
| Light/sound sensitivity | Common | Less typical |
| Nausea | Common | Uncommon |
| Aura | Sometimes (visual or sensory disturbance before pain) | No |
| Triggers | Sleep changes, stress, hormones, certain foods, weather, screens | Stress, dehydration, posture, eye strain, alcohol, illness |
| Common types | Migraine with aura, migraine without aura, chronic migraine | Tension, sinus, cluster, medication-overuse, exertional |
Key Differences
1. Symptom versus condition
A headache is a symptom — pain in the head. The cause might be tension, dehydration, alcohol, a sinus infection, a fever, eye strain, or many other things. The headache itself isn't a diagnosis.
A migraine is a diagnosable neurological condition with a recognisable pattern. The current view is that migraines involve abnormal brain activity that affects nerves and blood vessels, with genetic susceptibility playing a major role.
2. Pain character
Headache pain ranges widely. Tension headaches feel like a tight band; sinus headaches press in the face; dehydration headaches are dull and global.
Migraine pain is classically throbbing or pulsating, often on one side of the head, and severe enough to interfere with daily activity. Many migraine sufferers can't work through one in the way they could push through a tension headache.
3. Associated symptoms
Most ordinary headaches involve only the headache itself. Sensitivity to light and sound is mild or absent.
Migraines typically come with a cluster of symptoms: photophobia (sensitivity to light), phonophobia (sensitivity to sound), nausea (sometimes vomiting), and sometimes osmophobia (sensitivity to smells).
4. Aura
Ordinary headaches don't produce aura.
About 20–30% of migraine sufferers experience aura — visual disturbances (zigzag lines, blind spots), sensory changes (tingling), or speech symptoms — typically lasting 20–60 minutes before or during the headache.
5. Triggers
Headaches often have direct, identifiable triggers: dehydration, alcohol, eye strain, fever, posture, allergies.
Migraine triggers can be subtler and individual: sleep changes (too much or too little), stress (or release from stress), hormonal changes (especially menstrual cycle), specific foods (chocolate, aged cheese, processed meats are commonly cited but vary), weather changes, bright or flickering lights, screens.
6. Treatment
Headaches generally respond to over-the-counter pain relievers, hydration, rest, and addressing the underlying cause.
Migraines often need migraine-specific medications. Acute medications (triptans, gepants, ditans) work on migraine-specific pathways; preventive medications (taken daily) reduce frequency for chronic sufferers. CGRP-targeting drugs are a major recent advance.
When to Choose Each
Choose Migraine if:
- Describing the broader category of head pain.
- Cases where the cause is clearly something specific (dehydration, hangover, sinus infection).
- Most occasional, ordinary head pain that responds to OTC analgesics.
Choose Headache if:
- Recurrent severe headaches with associated symptoms (light/sound sensitivity, nausea).
- Headaches preceded by visual or sensory aura.
- Long-lasting (4–72 hour) episodes that disrupt daily life.
- Anyone with a personal or family history of migraine — both increase likelihood.
Worked example
Someone gets a dull headache after staring at a screen all day; water, a break from the screen, and an OTC pain reliever resolve it within a couple of hours — a tension headache. Their colleague has been getting recurring throbbing pain on one side of her head, lasting 8–12 hours, with nausea and a need to lie in a dark room. After a year of ignoring it and three episodes a month, she sees a clinician and is diagnosed with migraine — a separate condition with its own treatment options.
Common Mistakes
- "A bad headache is just a migraine." Severe pain alone doesn't make it a migraine. The pattern of symptoms and recurrence matters for the diagnosis.
- "Migraines are just headaches with attitude." They're a distinct neurological condition. Treating them as ordinary headaches under-treats them.
- "OTC pain meds always help migraines." Sometimes; for many sufferers, migraine-specific medications work much better, especially when taken early in an attack.
- "If you don't have aura, it's not a migraine." Most people with migraine don't experience aura. Migraine without aura is the more common form.
This is general educational information, not personalised advice. See the disclaimer for the full note.