You’ve got a pounding head, you feel a bit sick, and you’re squinting at your phone thinking: is this a migraine, or just a bad headache?
It’s a fair question, and it matters. A migraine isn’t simply a “worse headache.” It’s a neurological condition with its own pattern, its own symptoms, and its own treatments. Knowing what you’re dealing with helps you get relief faster and helps you spot the rare headaches that need urgent care.
This guide explains the difference between a migraine and a headache, how the main types compare, and the warning signs to take seriously.
This article is general information, not medical advice. If you’re worried about your symptoms, speak with a doctor.
Is Migraine Different from a Headache?
Yes. “Headache” is the umbrella term for pain in the head. A migraine is one specific type of headache, and it comes with extra symptoms beyond the pain itself.
The clearest way to tell a migraine from a regular headache is by those secondary symptoms. Migraines are typically throbbing on one side of the head and can come with sensitivity to light and noise, nausea or vomiting, dizziness, and sometimes auras.
Auras are visual disturbances such as zigzag lines or shimmering lights. They usually appear 5 to 15 minutes before a migraine strikes, but can occur up to 24 hours beforehand.
A typical tension headache, by comparison, is a dull ache that lets you carry on with your day, even if unpleasantly. A migraine can stop you in your tracks. If you’re experiencing recurring migraines or headaches, a GP can assess your symptoms and discuss appropriate migraine and headache treatment.
Migraine vs Normal Headache: A Quick Comparison
| Feature | Migraine | Tension Headache | Cluster Headache | Sinus Headache |
|---|---|---|---|---|
| Pain feels like | Throbbing or pulsing | Band-like pressure or tightness | Stabbing, piercing, burning | Dull pressure |
| Where | Often one side | Both sides or across the forehead | One side, around or behind one eye | Cheeks, nose bridge, forehead |
| Other symptoms | Light and sound sensitivity, nausea, sometimes aura | Usually none of these | Watery, red eye and blocked nose on the same side; restlessness | Blocked nose, sometimes fever |
| How long | Hours, sometimes days | 30 minutes to several days | 15 minutes to 3 hours, often daily in a “cluster” period | Tied to the sinus illness |
| Severity | Moderate to severe | Mild to moderate | Excruciating | Mild to moderate |
Sources for the details above: cluster headaches occur in a series, each lasting 15 minutes to 3 hours, with eye tearing and nasal congestion on the affected side. Tension headaches often feel like a band squeezing around the head. Throbbing pain is associated with migraine, while pressure or “vice-like” pain is typical of tension headaches.
Migraine vs Tension Headache
Tension headaches are the most common type. They involve mild to moderate pain, often with band-like tightness on both sides of the head. Migraine tends to be one-sided, throbbing, and accompanied by nausea or light sensitivity.
Migraine vs Cluster Headache
Both are usually one-sided, but they behave very differently. Cluster headaches affect about 1 in 1,000 adults, are brief but severe, and can recur several times a day.
They’re around six times more common in men than women. Someone with a migraine often wants to lie still in a dark room. Someone with a cluster headache is often too restless to sit down.
Migraine vs Sinus Headache
Here’s a surprise: many “sinus headaches” are actually migraines. Migraines can cause a blocked or runny nose too. One neurologist points out that clear, runny mucus can suggest migraine, while thickened, yellowish mucus points more toward a sinus infection. Real sinus headaches are usually related to a sinus infection and can come with fever, so see a doctor if you’re unwell.
How to Tell if You Have a Migraine or a Headache
Ask yourself:
- Is the pain throbbing rather than tight or dull?
- Is it worse on one side?
- Do light, sound, or smells bother you?
- Do you feel nauseous or want to be sick?
- Does it stop you from doing normal things?
- Did you notice visual changes beforehand?
If you answered yes to several, it’s more likely a migraine. Keeping a simple diary of when headaches strike, how long they last, and what helps gives your doctor a lot to work with. Migraine follows a recurring pattern and can be diagnosed clinically, without an MRI or other tests.
Red Flag Warning Signs for Headaches
Most headaches aren’t dangerous. Around 80 to 90% of headaches are primary headaches, meaning they aren’t caused by another condition. But a small number are “secondary” headaches, caused by something else that needs investigating. Doctors use the SNOOP checklist to spot them.
Five warning signs never to ignore:
- A sudden, explosive headache. A thunderclap headache hits instantly and feels like the worst pain imaginable, possibly indicating an aneurysm.
- Headache with fever and a stiff neck. This can point to meningitis, an infection of the membranes around the brain and spinal cord.
- Headache with neurological symptoms. New weakness, numbness, vision loss, double vision, speech difficulty, confusion, or seizures alongside a headache need urgent attention.
- A new headache after 50, or a headache that’s changing. A new headache over 50 might be giant cell arteritis or glaucoma, and a change from your usual pattern is worth checking.
- A headache after a head injury. This could signal a concussion, bleeding in the brain or a skull fracture.
Other flags include headaches that are worse when lying down or bending over, or that get progressively worse over time. Positional headaches can point to a cerebrospinal fluid leak, while triggers like straining can suggest raised pressure in the head.
If you have any sudden, severe, or “worst ever” headache, or a headache with the symptoms above, go to an emergency department or call your local emergency number (000 in Australia). Don’t wait to see if it settles.
What Illness Usually Starts with a Headache?
Headache is a common early symptom of many illnesses, most of them mild, such as colds, flu, dehydrationtion and viral infections. The serious ones to keep in mind are meningitis, stroke or bleeding in the brain, and giant cell arteritis in older adults. That’s why a headache keeps matter: fever, stiff neck, weakness, confusion or vision changes change the picture completely.
How to Tell if a Headache is Neurological
Strictly speaking, migraine itself is a neurological condition, so you can’t tell by pain alone. What you’re really asking is whether the headache is a sign of something more serious in the brain or nervous system. That’s suggested by the red flags above: sudden onset, neurological symptoms, fever, or a pattern that’s new or worsening. If in doubt, get it checked.
What Will a Neurologist Do for a Headache?
A neurologist starts by listening. Expect:
- A detailed history: when it started, what it feels like, how often, what triggers or relieves it
- A neurological examination: checking reflexes, vision, strength, coordination, and sensation
- A headache diary, often
- A treatment plan: acute treatment for attacks, and preventive options if they’re frequent
Imaging isn’t automatic. You might need a scan if your doctor can’t diagnose the headache from your history and examination, if the exam finds something abnormal, or if your headaches are unusual.
It’s worth seeing a specialist if you have frequent migraines, your usual medication isn’t working, or you’re taking painkillers often. One guide suggests four or more migraine days a month, or needing painkillers more than two days a week, as signs to seek specialist care. Frequent painkiller use can itself make headaches worse, so it’s worth raising with your doctor.
Which is better for headaches, a brain CT scan or an MRI?
Neither is universally better. They answer different questions.
- CT scan: fast, widely available and excellent at detecting bleeding, fractures, and major structural changes, which is why it’s usually the first step in emergencies like a sudden severe headache.
- MRI: slower but far more detailed, and better suited to problems that develop over time, such as persistent headaches or suspected inflammatory disease. It also uses no radiation.
For recurring headaches without red flags, a thorough history from a doctor is a more effective first step than scanning. And a negative CT doesn’t always close the case, so further work-up may still be recommended. Your doctor will choose the scan based on urgency and what they’re trying to rule out.
Frequently Asked Questions (FAQ)
What's the difference between a migraine and a headache?
A migraine is a neurological condition that causes recurring attacks of moderate to severe, often throbbing pain, usually with nausea, vomiting, or sensitivity to light and sound. “Headache” is a broader term for any head pain, and the most common type, a tension-type headache, feels like a dull, tight pressure on both sides of the head without those extra symptoms.
Migraine attacks typically last from 4 to 72 hours, often affect one side of the head, and can make routine activity difficult. Some people also get aura beforehand, such as flashing lights, zigzag lines or tingling. Tension headaches are usually milder, ease within hours, and rarely stop you from carrying on with your day. Other headache types, including cluster headaches and those caused by dehydration, illness or medication overuse, have their own patterns.
Symptoms can overlap, so only a doctor can confirm the cause. A GP can assess your symptoms through a telehealth consultation and advise on treatment and whether further testing is needed.
Can a migraine feel like a sinus headache?
When should I worry about a headache?
Most headaches are harmless and settle with rest, fluids and simple pain relief, but you should get urgent help if a headache is sudden and severe, often described as the worst of your life. Call 000 or go to the nearest emergency department if a headache comes with fever and a stiff neck, confusion, drowsiness, weakness or numbness, difficulty speaking, vision loss, a seizure, or follows a head injury.
Do I need a scan for migraines?
Most people with migraines don’t need a scan. Migraine is usually diagnosed from your symptoms, pattern of attacks and medical history, and a normal neurological examination. Brain imaging such as a CT or MRI is generally only recommended when something suggests a different cause.
A GP may refer you for a scan if your headaches change suddenly or become progressively worse, start after the age of 50, or come with new neurological symptoms such as weakness, numbness, confusion, seizures or changes in vision. Aura that is unusual, lasts longer than an hour, or is always on the same side may also prompt further testing, as can headaches that wake you from sleep or follow a head injury.
A GP can assess your symptoms and history through a telehealth consultation and arrange an in-person referral for imaging if clinically appropriate.
How do I know if it's a migraine or a headache?
A migraine is a specific neurological condition, usually causing moderate to severe throbbing pain, often on one side of the head, along with symptoms like nausea, vomiting, or sensitivity to light and sound. A tension-type headache is more common and typically feels like a dull, tight band of pressure on both sides of the head, without those extra symptoms.
Other features that point towards migraine include pain that gets worse with movement, attacks lasting from 4 to 72 hours, and visual disturbances such as flashing lights or zigzag lines (aura) before the pain starts. Tension headaches are usually milder and rarely stop you from carrying on with your day.
Symptoms can overlap, and only a doctor can confirm the cause. A GP can assess your symptoms, discuss triggers and treatment options, and advise whether further testing is needed. This can often be done through a telehealth consultation.
How to make migraine go away?
What is your body lacking when you have a migraine?
A migraine isn’t caused by your body lacking one particular nutrient or vitamin. It is a neurological condition involving changes in brain activity, nerve signalling and blood vessels, and the exact cause isn’t fully understood. Genetics, hormonal changes and sensitivity to certain triggers all play a role.
Some research suggests magnesium, riboflavin (vitamin B2) and coenzyme Q10 may help reduce migraine frequency in some people, but this doesn’t mean a deficiency is the cause. Common triggers include dehydration, skipped meals, poor or irregular sleep, stress, hormonal changes, alcohol and bright lights, so these are worth looking at first.
HelloGP - Disclaimer
This article is for general information only and does not replace professional medical advice. Telehealth is not suitable for emergencies. If you have an emergency or are at immediate risk, call 000 or visit your nearest emergency department.