Is it a migraine or a headache?
Last updated September 3, 2026.
Migraine: throbbing, often one-sided pain, worse with movement, lasting 4-72 hours, with nausea and light or sound sensitivity, sometimes an aura first. Tension headache: steady band-like pressure on both sides, not worsened by movement, and you can function through it. The dark-quiet-room instinct is itself a migraine tell. Trigger patterns differ: migraines track cycles, sleep changes, skipped meals, and stress letdown; tension tracks stress, posture, and jaw clenching. The distinction pays: tension responds to plain pain relievers, while migraines often need triptans taken early, and 4-plus migraines a month earns preventive therapy. The shared trap: any acute pain reliever used more than 10 to 15 days a month becomes the cause via medication-overuse headache. Neither label covers the red flags: thunderclap onset, worst-of-life pain, fever with stiff neck, or new weakness or vision loss, which are emergencies. Headaches stealing 4-plus days a month is a doctor visit, not stoicism.
What to do
- Throbbing, one-sided, nausea, light sensitivity: migraine.
- Band-like pressure, both sides, functional: tension.
- Triptans work best taken early in the attack.
- Pain relievers 10-15 plus days a month: they become the cause.
- 4-plus migraine days a month: ask about prevention.
Related questions
- How long does a migraine last?
- Can an online doctor prescribe migraine medication?
- Why do I get headaches on weekends?
- When should you go to the ER for a headache?