What’s the difference between migraine and headache?

Migraine is a type of headache. The term headache is a symptom of a broad spectrum of conditions that describes the pain or discomfort to the head. When a condition that is identified causing this pain, like a brain infection, ruptured blood vessel or intracranial mass, the headache condition is termed secondary headache. Migraine, like many other syndromes is a primary headache syndrome. This means that there is no identifiable cause on the brain, face, head or neck clearly causing the condition.

Migraine may occur in a variety of different patterns in different people. Sometimes the “pain” is not experienced classically as pain may occur in other parts of the body. There may be an experience of “pressure” or “squeezing” or “pulsating”. This may fluctuate in intensity, rest behind the eyes one side or both sides of the head. There may also be pain or discomfort in bright environments and with excess noise. Nausea or abdominal upset may occur during a migraine episode. The typical scenario of a disabling severe headache with all the above features comes to mind when migraine is mentioned. However, migraine patterns do vary, and not seeking treatment and advice early may lead to further worsening of migraine frequency and severity.

Whilst headache has broad definition in the neurology field, it is common parlance to refer to mild and brief head tightness and pain as an “ordinary headache”. These “ordinary headaches” for many people are probably what is actually termed a Tension-type Headache. There are band-like headaches that are mild to moderate, and typically lack the features of migraine and are often self-limiting. However, they may not always be mild, and in my clinical practice, these two primary headache syndromes commonly co-exist.