Migraine and tension headaches can disrupt daily life but differ in severity and symptoms. Migraine is more likely to cause debilitating pain, while tension headaches are generally milder but persistent.

Migraine and tension headaches are among the most prevalent types of headaches. However, they differ significantly in their symptoms, causes, and impact on daily life.

Migraine is a complex neurological disorder characterized by intense, throbbing pain, typically on one side of the head.

Additionally, people with migraine frequently experience nausea, sensitivity to light and sound, and, in some cases, visual disturbances known as auras. These episodes can last for hours or even days, severely disrupting a person’s ability to function.

Conversely, tension headaches usually manifest as a dull, aching pain affecting both sides of the head. While generally less debilitating than migraine, tension headaches can still cause considerable discomfort and are linked to stress, posture issues, and muscle strain. They may also last for several days.

Understanding the distinctions between these two types of headaches is essential for accurate diagnosis and effective treatment, as the approaches to managing each can vary significantly.

This article examines the difference between migraine and tension headaches and their causes, symptoms, and treatment options.

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The table below illustrates the similarities and differences between the two conditions:

MigraineHeadache
Pain locationoften one-sided, can shift sidesboth sides of the head, typically around the forehead
Pain typethrobbing, pulsatingdull, aching, pressure-like
Intensitymoderate to severemild to moderate
Duration4 to 72 hoursTrusted Source30 minutes to 7 daysTrusted Source
Associated symptomsnausea, vomiting, sensitivity to light and soundrarely any associated symptoms
Triggersstress, hormonal changes, certain foods, sleep disruptionstress, posture, eyestrain
Auracommon, involves visual disturbances, tinglingnot present
Response to physical activityoften worsens with activityusually does not worsen with activity

Migraine can cause various intense and debilitating symptoms, includingTrusted Source:

  • throbbing or pulsating pain, typically on one side of the head
  • nausea and vomiting
  • sensitivity to light (photophobia) and sound (phonophobia)
  • visual disturbances or aura, such as flashing lights or blind spots
  • worsening of pain with physical activity
  • fatigue and irritability
  • difficulty concentrating

Learn more about migraine.

Tension headaches are generally less severe than migraine but can still cause significant discomfort. Symptoms includeTrusted Source:

  • a dull, aching pain that affects both sides of the head
  • a sensation of tightness or pressure around the forehead or back of the head
  • tenderness in the scalp, neck, and shoulder muscles
  • mild to moderate pain that does not worsen with physical activity

People do not typically experience nausea or vomiting with tension headaches.

Learn more about tension headaches.

The causes of migraine and tension headaches can differ, although some triggers may overlap.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Migraine

The cause of migraine is not fully understood but is believed to involveTrusted Source abnormal brain activity that affects nerve signaling, chemicals, and blood vessels in the brain.

This disruption leads to a complex series of events, including the dilation of blood vessels and the release of inflammatory substances in the brain, which contribute to the pain and other symptoms associated with a migraine.

Experts link migraine to genetic factorsTrusted Source, and it runs in families. Females are three times more likely to experience migraine than males, and symptoms often relate to hormonal changes.

People with other medical conditions are also more likelyTrusted Source to experience migraine, including those with:

Migraine also has triggers, including:

  • stress
  • certain foods such as chocolate, caffeine, or alcohol
  • sleep disruptions
  • environmental factors such as bright lights or strong smells

Tension headache

As with migraine, the exact cause of tension-type headaches is not fully understood, but several theories existTrusted Source. One is that certain tight spots in muscles, called myofascial trigger points, might be responsible.

These trigger points in muscles around the head and neck can cause pain when pressed and lead to headaches when overly tight or stressed. This tension could reduce blood flow and release chemicals that increase pain.

Another theory involves the body’s autonomic nervous system, which controls heart rate and sleep. Sleep issues can lead to increased stress on the body, which might trigger headaches.

Tension headaches are commonly associated with:

  • stress
  • anxiety
  • posture issues
  • muscle strain
  • eyestrain

Unlike migraine, specific foods or environmental factors are less likely to trigger tension headaches.

Diagnosing migraine and tension headaches involves a thorough review of the individual’s medical history, symptom patterns, and possible triggers. Healthcare professionals may ask about headaches’ frequency, duration, intensity, and associated symptoms.

In some cases, imaging tests such as MRI or CT scans may help rule out other potential causes of headaches, such as tumors or structural abnormalities in the brain.

Treatment for migraine and tension headaches involves a combination of lifestyle changes, medication, and sometimes alternative therapies.

Migraine treatment

Healthcare professionals treat migraine through medications tailored to the severity and frequency of the attacks.

For immediate relief during a migraine, doctors may recommend triptans, which specifically target migraine pathways, or NSAIDs (nonsteroidal anti-inflammatory drugs) to reduce pain and inflammation. Stronger prescription pain relievers may help when these options are insufficient.

Newer treatments includeTrusted Source calcitonin gene-related peptide (CGRP) antagonists.

For individuals who experience frequent migraine, healthcare professionals may prescribe preventive medications, such as beta-blockers, anticonvulsants, or antidepressants, to reduce the frequency and intensity of migraine over time.

Lifestyle modifications are also important, such as regular sleep, stress management, and dietary changes, if necessary.

Tension headache treatment

People may findTrusted Source that over-the-counter pain relievers such as NSAIDs, acetaminophen, or aspirin are effective.

Additionally, relaxation techniques, physical therapy, and stress management strategies can help reduce the frequency and severity of tension headaches.

Preventing migraine and tension headaches involves identifying and avoiding triggers, along with adopting healthy lifestyle habits.

For migraine, people should:

  • Keep a headache diary to track triggers.
  • Maintain a regular sleep schedule.
  • Manage stress as much as possible.
  • Avoid trigger foods.

For tension headaches, the following may help:

  • Use good posture.
  • Take regular breaks from screens.
  • Use stress reduction techniques.
  • Manage anxiety.
  • Maintain a regular sleep routine.
  • Ensure adequate hydration.

FDA-approved medications for preventing migraine includeTrusted Source:

  • erenumab
  • eptinezumab
  • galcanezumab
  • fremanezumab

Migraine and tension headaches are common issues that differ in symptoms, causes, and treatment.

Migraine headaches are generally more severe, often accompanied by nausea, light sensitivity, and throbbing head pain. In comparison, tension headaches usually cause milder, pressure-like pain on both sides of the head.

Migraine often requires targeted medications or preventive therapies to reduce the frequency of attacks. People can usually manage tension headaches with over-the-counter pain relievers, stress reduction techniques, and lifestyle modifications.