Excedrin.com > Headache Center > Headache Resources

What Type of Headache
Do You Have?

Your headaches... how to recognize what kind you have

Effective pain control depends on knowing whether you have a tension headache or a migraine. This article will provide a rundown of the two most common headache types, focusing on how to tell the difference.

Tension-type headaches account for about 90% of all headaches.

Symptoms. These commonly include a dull, steady, non-throbbing pain, usually on both sides of the head. The pain can be mild to severe. Sometimes it feels as if your head is in the grip of a vise or that you are wearing a tight band across your forehead and temples. Pain may also extend into the neck and shoulders.
Duration. Occasional tension headaches can last from 1-2 hours to all day, or longer. Often they occur in the late afternoon or evening, as a result of accumulated stress during the day. Chronic tension headaches may occur every day, or almost every day, for months or years. They may last from several hours to all day.
Causes. Emotional stress is the leading trigger of tension headaches, particularly among chronic sufferers. But tension headaches may also be triggered by physical causes such as arthritis, poor posture or staying in one position for long periods of time.
Treatment. Tension headaches may be effectively treated with over-the-counter (OTC) pain relievers, rest, ice packs and effective stress management. If chronic tension headaches occur every day or almost every day it is important that you consult a doctor immediately. Your doctor may recommend a prescription medication or—since hidden depression can be a factor in chronic daily headaches—psychotherapy.

Migraine headaches are much less common, but when they strike they can be disabling.

Symptoms. Migraines produce moderate to severe pounding or throbbing pain, commonly on one side of the head. Migraine pain is often accompanied by nausea, vomiting, dizziness and sensitivity to light and/or sounds. About 10-15% of migraine sufferers exhibit warning symptoms known as auras before their attacks. An aura is a type of visual disturbance which causes sufferers to see flashing spots, colors, lines or shapes in their field of vision—or temporarily to have only partial vision. 70% of migraine sufferers are women.
Duration. Migraines vary widely in duration, from a few hours to 3 days. Auras typically last about a half hour and then subside before the pain begins. Migraines may occur only occasionally or several times a week. The average is 1-3 attacks per month.
Causes. There are several theories about what causes migraines, all of which agree that these headaches are biologically based. Also, the tendency to develop migraines is an inherited one—up to 90% of sufferers have a close relative who is also afflicted.
Triggers. Many factors can trigger migraines in predisposed individuals, including certain foods, alcohol, the menstrual cycle, caffeine, changes in the weather or sleep patterns, skipped meals, some medications and, of course, stress. Bright lights, cigarette smoke, intense heat or loud noises may also bring on an attack. The use of oral contraceptives or menopausal hormones is also linked to migraines.
Treatment. Avoidance of triggering factors and effective stress management is the first line of defense for migraine sufferers. Occasional or milder attacks may be managed with rest or ice packs, but migraine sufferers typically require prescription medication for effective relief. Some of these are administered during an attack, while others are taken on a regular basis to decrease or prevent the occurrence of migraines. Biofeedback may also be helpful.

Other types of headaches you may have heard of include:

Cluster headaches. These are relatively uncommon, but cause excruciating, sharp-as-a-knife pain around one eye. Attacks occur daily in clusters of weeks or months, then disappear completely for months or years. 90% of sufferers are males, most aged 20-30.
Rebound headaches. These may occur in patients whose persistent headache pain causes them to overuse headache medication. This may cause symptoms to worsen instead of improve. See your doctor if you are taking maximum recommended doses without relief.
Sinus headaches. These are relatively uncommon, contrary to television commercials. Most people who think they have sinus headaches actually suffer from tension headaches or migraines.

For additional information, contact the American Council for Headache Education (ACHE), 875 Kings Highway, Suite 200, Woodbury, NJ 08096. ACHE offers general information about headache and help with organizing headache support groups. Also available: referrals to doctors in your area who belong to AASH, the American Association for the Study of Headache.

« Back to Articles Index