Search guides
Migraine vs tension headache
Migraine and tension-type headache can both cause head pain, but symptoms, disability, and treatment needs often differ.
Migraine and tension-type headache can overlap, and a person can have both. Tracking the pattern helps a clinician decide what is happening.
What points toward migraine?
Migraine often causes moderate-to-severe throbbing or pulsing pain, nausea, vomiting, light sensitivity, sound sensitivity, smell sensitivity, aura, and worsening with routine activity. Attacks can last hours to days.
Migraine can also cause fatigue, brain fog, neck stiffness, dizziness, food cravings, and post-attack "hangover" symptoms.
What points toward tension-type headache?
Tension-type headache is often described as tightness or pressure on both sides of the head. It is usually mild to moderate and is less likely to include nausea, vomiting, aura, or strong light and sound sensitivity.
Tension-type headache can still be painful and disruptive. The difference is not whether someone is "really" suffering; it is which pattern best fits and which treatment plan is most appropriate.
Why the difference matters
Migraine and tension-type headache may need different treatment plans. If headaches are frequent, worsening, disabling, or changing, bring a diary to a clinician rather than guessing from symptoms alone.
What to track
- Pain location and quality
- Severity
- Nausea or vomiting
- Light, sound, or smell sensitivity
- Aura or neurologic symptoms
- Whether activity worsens pain
- Medication response
- Frequency and missed activities
When to seek urgent care
Get urgent help for sudden severe headache, fever with stiff neck, confusion, seizure, head injury, new weakness, new speech or vision symptoms, or a headache that is clearly different from your usual pattern.
Sources
- MedlinePlus: Migraine
- Mayo Clinic: Headache causes
- Mayo Clinic: Migraine symptoms and causes
Migraine Manager is a personal health journal, not a medical device. It does not diagnose or treat any condition. Always follow your clinician's advice for diagnosis, medication, and treatment decisions.
Key terms
People Also Ask
Related migraine questions
What points toward migraine?
Migraine often causes moderate-to-severe throbbing or pulsing pain, nausea, vomiting, light sensitivity, sound sensitivity, smell sensitivity, aura, and worsening with routine activity. Attacks can last hours to days. Migraine can also cause fatigue, brain fog, neck stiffness, dizziness, food cravings, and post-attack "hangover" symptoms.
What points toward tension-type headache?
Tension-type headache is often described as tightness or pressure on both sides of the head. It is usually mild to moderate and is less likely to include nausea, vomiting, aura, or strong light and sound sensitivity. Tension-type headache can still be painful and disruptive. The difference is not whether someone is "really" suffering; it is which pattern best fits and which treatment plan is most appropriate.