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Pain Management

Migraine vs Tension Headache: How to Tell the Difference + the Best Way to Speed Relief

Experts share the top targeted remedies to ease the ache now, plus block future flare-ups

When your head is pounding, it’s hard to think about anything besides getting rid of your headache ASAP. But before you reach for a pain reliever, it’s important to understand whether you’re dealing with a migraine or a tension headache. Why? It’ll help you pinpoint the most effective remedy to ease the ache. That’s why we asked the experts how to differentiate between a migraine vs tension headache — and the best way to get relief from each.

Migraine vs tension headache

A migraine and a tension headache are two different types of headaches. In other words, a migraine isn’t just a bad tension headache.

“Many people believe the primary difference is just the intensity of the pain,” says Vernon Williams, MD, board-certified neurologist, pain management specialist and founding director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. But the mechanism of a migraine is different from a tension headache, and the two types of headaches have different characteristics and symptoms.

What is a tension headache?

When it comes to a migraine vs tension headache, the latter is typically characterized by a dull pressure or tightness. The exact cause isn’t fully understood, but experts believe that tension in the muscles of the face, head and neck may play a role. Tension headaches tend to come on gradually, and you may feel a “band” of pain around your forehead or the base of your skull. The pain may subside in as little as half an hour, but tension headaches can sometimes linger for up to a week.  

A woman in an orange shirt holding her hand to her temple with either a migraine vs tension headache

Related: MD Reveals the Best Remedies for Headaches That Involve Pain Behind The Eyes

What is a migraine?

Migraines are less common than tension headaches. A study in Neurology suggests around 17% of women will experience at least one migraine in a year. Women are three times as likely as men to get migraines, with prevalence peaking around middle age. As with tension headaches, experts are still working to understand the exact cause of migraines. But research suggests they’re caused by a brain disorder that affects sensory processing.

Migraines are characterized by a throbbing or pounding pain, often on one side of the head. This pain is typically more severe than tension headaches, and may last anywhere from a few hours to three days. However, one crucial difference between a migraine vs tension headache is that migraine symptoms may go beyond head pain. (Learn how a migraine can cause sinus pressure and make you wake up dizzy, too.)

Look for these telltale symptoms

If you’re wondering whether your headache may be a migraine, there are a few additional symptoms that can help to clue you in.

“With a migraine, you are usually experiencing nausea, sensitivity to lights and sounds and pain around the temples or eyes,” says Lauren Thayer, RN, registered nurse at Health Canal. Some people experience visual disturbances like wavy lines or flashing lights before or during a migraine, Thayer adds — a symptom known as aura. Migraine aura may also cause tingling, numbness, ringing in the ears or difficulty speaking clearly.

Note: Migraine aura symptoms can be similar to stroke symptoms. If you’re experiencing these symptoms, it’s important to talk to your doctor to rule out anything more serious.

An illustration of colorful zig-zag lines, which can signal a migraine
Wavy lines or flashing lights in your vision can signal an oncoming migraine.smartboy10/Getty

How to soothe (and prevent) a migraine

While it’s true that many headache remedies ease discomfort regardless of the underlying cause, there are a few pinpointed strategies that are especially helpful for soothing a migraine.

Sip a cup of coffee

Caffeine narrows the blood vessels, which can relieve migraine pain. “Some headache medications actually contain caffeine as an ingredient,” Thayer says. However, moderation is key. Research suggests consuming more than 200 mg of caffeine per day may induce headaches for some people. And caffeine can be a migraine trigger for some people. If you notice that your cuppa seems to be causing headaches rather than relieving them, adjust your coffee habits accordingly. (Coffee packs a payload of other health benefits, too. Here’s how chlorogenic acid in coffee balances your blood sugar to ward off diabetes.)

Place an ice pack here

You might be tempted to put an ice pack on your head when a migraine strikes, but placing it on your throat can bring more relief. That’s according to scientists at the University of Hawaii, who found that an ice pack on your neck cools the blood flowing to the brain, soothing inflammation and easing pain within 5 minutes.

A teal ice pack with white lid on a striped background used to ease a migraine
Karl Tapales/Getty

Related: Ginger Tea Can Dramatically Relieve Migraine Pain + 3 Other Migraine Self-Care Strategies That MDs Recommend

Block future migraines by tracking your triggers

If you get migraines relatively often, but you’re not quite sure what’s causing them, Dr. Williams recommends keeping a journal. When you feel a migraine coming on, write down any details that may help you identify triggers. Based on the most common culprits, you may want to make note of:

  • Anything causing emotional stress
  • Any sleep issues or changes to your sleep schedule
  • The weather
  • Where you are in your menstrual cycle
  • Exposure to bright lights or strong smells
  • What you ate or drank recently (or conversely, if you were dehydrated or skipped your morning coffee)

“After a few entries, you may begin to see a pattern emerge,” Dr. Williams says. “It’s worth the effort.”

Also smart: Checking pre-packaged foods and drink labels for aspartame. Research suggests it’s a common migraine trigger. This artificial sweetener (also known as Equal, NutraSweet or Sugar Twin) can be found in some sugar-free sodas, chewing gums, gelatin, coffee creamers and syrups. If you get migraines often, consider cutting out foods that contain this ingredient.

Related: Experts Reveal the Best Tea for Headaches That Soothe Pain Naturally

How to soothe (and prevent) a tension headache

The one good thing about a tension headache? It’s often far easier to treat that a migraine. Here’s what can help.

Massage with mint

Peppermint a powerhouse tension headache reliever. And simply massaging diluted peppermint oil into your temples works as well as some meds to ease tension headaches, research suggests. The cooling compound in peppermint, menthol, prevents muscle contractions in the head and neck that trigger tension headaches. Plus it improves blood flow to the area to relieve tightness and pain. To use, simply mix 3-5 drops of peppermint essential oil into 1 Tbs. of vegetable oil and gently rub the mixture into your temples using your fingertips. (Interested in more ways a gentle massage can provide relief? See how a masseter muscle massage calms head pain, too.)

An amber vial of mint essential oil beside a fresh sprig of mint on a while towel, which is used to treat a tension headache

Try an OTC pain reliever

“Tension headaches are usually easily treated with over-the-counter medications such as ibuprofen, acetaminophen or aspirin,” Thayer says. Some OTC headache medications combine aspirin, acetaminophen and caffeine for added relief. But others are just repackaged versions of standard pain relievers, so read the list of active ingredients carefully.

Block future tension headaches by skipping a nightcap

If you like to unwind with a glass of wine at night, that could be contributing to your tension headaches. Not only is alcohol itself a common trigger for tension headaches, but drinking alcohol within four hours of bedtime can also interfere with your sleep quality. That’s key, since sleep disturbances are another top cause of head pain.

When to visit your doctor

If you’re experiencing frequent or severe headaches, don’t think you have to just tough it out. Talk to your primary care physician, or schedule an appointment with a headache specialist who can help you find an effective treatment plan. This is especially important if you’re experiencing migraines, which may escalate if they’re not treated appropriately, Dr. Williams cautions.

For more ways to soothe head pain:

MD Reveals the Best Remedies for Headaches That Involve Pain Behind The Eyes

Study: Ginger Tea Can Dramatically Relieve Migraine Pain + 3 Other Migraine Self-Care Strategies That MDs Recommend

Dentists: This Simple Jaw Massage May Ward Off Your Tension Headaches and Migraines

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

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