Updated 04 September 2020

SEE: Do you have a headache or a migraine?

Just because your headache is excruciating doesn’t mean it’s a migraine. Here’s how to tell the difference.

Headaches vary in severity and location. While headaches are not necessarily linked to another illness or condition, they can be excruciating and a sign of something more serious.

People often confuse a severe headache with a migraine. Although the two have overlapping features such as the type of pain and the location, there are differences in triggers, and migraines have extra accompanying symptoms.

What is a headache?

According to Health24, a headache is an infrequent annoyance that can occur above the ears or eyes, at the back of the head to the base of the skull. The pain will dissipate with the use of a pain killer. Headaches can either be primary (such as a tension or cluster headache), or secondary (caused by e.g. infection, illness, injury). Headaches can be cured quickly. The pain is also less localised and can occur in various areas of the head. Headaches can be divided into:

  • Tension headaches
  • Sinus headaches
  • Cluster headaches

And a migraine?

A migraine on the other hand, is a throbbing pain that can last 72 hours or more. The pain is also accompanied by symptoms such as:

  • Nausea
  • Vomiting
  • Extreme sensitivity to light and sound
  • Flashing sensation in front of the eyes
  • Partial blindness or blind spots

Most migraines originate in the arteries of the scalp, the jaw or neck muscles, and the pain is more localised to one specific area of the head.  Migraines are often worsened by even the slightest physical activity or movement and can disrupt your daily routine. Normal pain killers will not bring relief. Migraines are classified as:

  • Migraine with aura, or
  • Migraine without aura

Although the true causes of migraines have not been established yet, there are several triggers that can bring on a migraine such as:

  • Certain foods (alcohol, chocolate, cheese, foods containing MSG)
  • Loud noises
  • Strong smells
  • Insufficient sleep
  • Stress
  • Smoking

It is important to note that people often mistake sinus headaches for migraines as sinus headaches tend to be more localised than other varieties. But a sinus headache will not occur with the telltale symptoms of a migraine. If you do have migraines, there are several medication options to explore.

Read more:

New migraine drugs show great promise 

When to see a doctor for your headaches

Causes of headaches


Ask the Expert

Headache expert

Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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