Headache or migraine: how to tell the difference


Headaches are one of the most common health troubles. Usually, they go away by themselves or after taking a painkiller. Some headaches, however, can severely affect the daily lives of those inflicted. These are migraines. Here is some information to help get your head around this issue!

Headache or migraine, that is the question…

Headaches sometimes tell you about your lifestyle: your life is too hectic, you aren’t getting enough sleep, you have poor posture at work, or you’ve had too much to drink. Often, the headache is talking to you, and you answer by taking a painkiller which, most of the time, makes it go away without further ado. Yet for some, less fortunate people, this pain is a backdrop to their daily lives. In this case, we say they suffer from migraines.

It is important to distinguish between headaches, technically known as cephalalgia, and migraines. There are several types of headaches. We will start by describing the three most common: tension headaches, cluster headaches, and migraine headaches.

  1. Tension headaches:
    This type of headache may be occasional or chronic. Symptoms are of mild to moderate intensity. Pressure (or a feeling of tightness) is felt around the forehead and temples; sometimes it is accompanied by neck pain. This type of headache does not cause nausea or vomiting.
  2. Cluster headaches:
    This type of headache may occur from once every two days to eight times a day; it lasts from a few minutes to several hours. The pain is very intense, penetrating but not pulsating, and is located on just one side of the head. The pain may be accompanied by tears, congestion and sweating.
  3. Migraine headaches:
    These may occur once a year and up to three times a day. The pain, of moderate to high intensity, lasts from a few hours to a few days (usually between 4 and 72 hours). It is a pulsing headache (feeling of your heart beating in your head), is located on just one side of the head and is often accompanied by nausea, vomiting, and hypersensitivity to sound and light.

Migraine frequency

Migraines affect about 7% of men and 18% of women, representing about 12% of the general population. They also affect children and adolescents in a proportion of 5 to 10%, but the problem is often under-diagnosed in their case. Migraine episodes usually begin in childhood or early adulthood, become increasingly rare after age 40, and often disappear after age 50.

Scientists are still not sure why some people get tension headaches, cluster headaches or migraines, while others never suffer from them. The intense headache of the migraine appears to be triggered by a series of reactions of the nervous system involving, among other things, the blood vessels, the neurotransmitters and inflammation.

Advance signs of a migraine

There are a number of signs that may indicate an oncoming migraine. They usually appear a few hours or up to two days before the episode. They include:

  • fatigue
  • stiff neck
  • hunger cravings
  • yawning
  • mood swings
  • increased sensitivity to light, smells and noise

About 20% of people who suffer from migraines experience a neurological phenomenon called aura. It lasts from 5 to 60 minutes and precedes the migraine. It can take different forms:

  • visual effects: decreased vision, flashes, double vision
  • numbness in the face, tongue or a limb
  • language difficulties

Migraine triggers

Triggers may be food or non-food related. Here are a few examples:

  1. Personal or environmental triggers:
    • stress
    • hunger or skipping a meal
    • change in sleeping pattern
    • change in atmospheric pressure
    • noisy environment or very bright lights
    • insufficient or excessive physical activity
    • strong smells (perfume, tobacco, etc.)
    • hormonal changes
    • certain medications
  2. Food triggers (most frequent):
    • alcohol, especially red wine and beer
    • coffee and soft drinks
    • aged cheeses
    • aspartame, sulfites and monosodium glutamate
    • chocolate
    • deli meats
    • fermented or marinated foods


The first step in preventing migraines is to figure out what factors or situations trigger the episodes. A migraine diary will allow you to keep track of the circumstances surrounding each migraine episode (foods consumed, symptoms, psychological state, environmental conditions, etc.).

Then, some lifestyle changes may be required, by taking care to:

  • reduce your stress level
  • not skip any meals
  • maintain healthy sleeping habits
  • exercise regularly


If you have a simple headache, an over-the-counter painkiller will most likely be sufficient to relieve the pain. However, if your headaches are intense, recurrent or accompanied by symptoms before, during or after, then you may be getting migraines. It is important to consult a doctor for a diagnosis.

If you suffer from migraines, over-the-counter painkillers may not be sufficient. If this is the case, your doctor will prescribe a more powerful medication, specifically designed for migraines (known as anti-migraine medication). If your migraines are overly frequent, your doctor may prescribe another, preventive medication, to be taken regularly every day in order to reduce the frequency and the intensity of your migraines.

Whatever medication you use to relieve your headaches or your migraines (painkillers, anti-migraine or preventive medication), your pharmacist can inform you of its benefits, directions for use, side-effects and risks of interactions with other medications you are taking. Make use of his or her expertise.

In short, a migraine is much more than a passing headache! If you are not sure exactly what type of pain you are suffering from, don’t rack your brains: consult your doctor for a diagnosis. Then, you can take the necessary steps to reduce the impact of migraines on your well-being and quality of life. By doing so, you may more often hear yourself say, “You know what, dear? Tonight, I don’t have a headache…”

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