Headache or Migraine: Which one is it?
A headache is more likely to be a migraine if it has other symptoms such as nausea, vomiting, blurry vision, or sensitivity to light, sound, or smells, in addition to head pain.
There are more than 150 types of headaches. Some are primary, such as migraine, while others are considered secondary because they come on as a result of another medical condition, such as high blood pressure or head trauma.
Is it a migraine?
About 12% of Americans get migraine headaches. This head pain is often described as throbbing or pulsating, and it tends to strike just one side of your head.
Migraines usually occur in four phases, with the headache in the third phase:
- Premonitory phase: Clues like food cravings, mood changes, lots of yawning or increased urination occur about 24 hours before the pain of migraine.
- Aura: You may see flashing lights, blurry vision or waves just prior to or during a migraine, or have muscle weakness.
- Headache: Head pain may start off slow and gradually increase.
- Postdrome: You may feel tired or confused after it goes away.
The two main types of migraines are migraine with aura and migraine without aura.
Exactly what causes migraines is not fully known yet, but researchers are working on it. Migraines can be triggered by:
- Hormonal fluctuations
- Bright or flashing lights
- Lack of food or sleep
- Certain foods
In general, migraine treatment involves medication and strategies to prevent these painful headaches from occurring and/or drugs that can relieve your symptoms once they have started.
There are several medications available to help stop migraine pain.
- Triptan drugs, a family that includes sumatriptan, naratriptan, zolmitriptan, rizatriptan, almotriptan, frovatriptan and eletriptan. These prescription drugs cause blood vessels to constrict, reducing pain. They can be given as tablets, nasal sprays or injections.
- Ergot derivative drugs, such as dihydroergotamine and ergotamine. These prescription medications bind to specific receptors on your nerve cells to dampen pain signals. They come as nasal sprays and injections.
- Over-the-counter drugs, such as ibuprofen, aspirin or acetaminophen, including some that mix in other active ingredients such as caffeine.
Anti-nausea drugs may also be prescribed to help quell the queasy feeling from a migraine.
There are a handful of drugs that are approved for migraine prevention as well, including some that were originally developed to treat other diseases such as epilepsy, including Depakote and Depakote ER (divalproex sodium) and Topamax (topiramate); high blood pressure meds, including beta blockers, such as Inderal (propranolol) or Blocadren (timolol); as well as some specific migraine prevention drugs, such as Aimovig (erenumab), Ajovy (fremanezumab-vfrm) and Emgality (galcanezumab), all of which target calcitonin gene-related peptide (CGRP), a protein that is linked to migraines.
The same Botulinum toxin A injections that are commonly used to smooth wrinkles also play a role in migraine prevention. In addition, devices that apply electrical or magnetic stimulation to your head can dampen pain signals and help treat or prevent migraines.
Avoiding any known triggers—such as skipped meals or not drinking enough water throughout the day—is an important component of a migraine prevention plan. Taking steps to reduce stress and promote relaxation can also help stave off migraine attacks. This can include regular exercise, yoga, deep breathing or even just carving out time for a walk each day.
Migraine vs. tension headaches
Tension headache and migraine can share similar triggers such as stress, but the head pain they cause differs.
Tension headaches feel like a band or vice is squeezing the entire head. They occur when your head and neck muscles grow tight.
In general, over-the-counter pain medications such as acetaminophen, ibuprofen or naproxen sodium can help relieve tension headache pain. However, overusing such pain medications may cause “overuse” or rebound headaches. Avoiding stressful situations and engaging in relaxation techniques can also help keep tension headaches at bay.
Migraine vs. cluster headaches
Characterized by severe pain in or around one of your eyes, cluster headaches often “cluster” at the same time of day or night for weeks on end. Fortunately, these headaches are relatively rare. Risks include consuming alcohol and smoking excessively. Cluster headaches are more common in men.
They are approached in the same way as migraine headaches. The goals are to prevent future attacks and treat cluster headaches that have already started.
High-dose oxygen therapy that is given through a face mask for 15 to 20 minutes can help alleviate a cluster headache. In addition, a triptan nasal spray called sumatriptan can relieve the pain of a cluster headache. Several medicines are used to prevent cluster headache attacks, including a blood pressure medication and lithium, which is used to treat bipolar depression.
The key to effective and lasting treatment is to first determine the specific type of headache.
- National Institute of Neurological Disorders and Stroke (NINDS). Headache Information Page. Dec ember 31, 2019. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. [Accessed August 13, 2021].
- U.S. National Library of Medicine MedlineP lus . Migraine. July 29, 2021. Available at: https://medlineplus.gov/migraine.html. [Accessed August 13, 2021].
- Nicolas S, Nicolas D. Triptans. Stat Pearls. July 12, 2021. https://www.ncbi.nlm.nih.gov/books/NBK554507/.
- National Institute of Neurological Disorders and Stroke (NINDS). Headache: Hope Through Research. Dec ember 31, 2019. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research. [Accessed August 13, 2021].
- U.S. National Library of Medicine MedlinePlus. Tension Headache. July 2, 2021. Available at: https://medlineplus.gov/ency/article/000797.htm. [Accessed August 13, 2021].
- Brandt RB, Doesborg PGG, et al. Pharmacotherapy for Cluster Headache. CNS Drugs. 2020; 34(2): 171–184. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018790/ .
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