Duration of Pain
One way to distinguish the difference between a tough headache and a migraine is by how long it lasts. Cluster headaches tends to occur in “cluster periods” that typically last 6-12 weeks.4 During the cluster period headaches usually occur every day, sometimes several times a day. A cluster headache may only last 15 minutes to up to three hours, around the same time each day, often after you go to bed.4 Tension headaches can last anywhere from 30 minutes to a full week, but the pain is often dull and manageable, if unpleasant.5
Migraine attacks, on the other hand, last roughly four to 72 hours, and even once they have passed, the sufferer may experience after-effects of what is referred to as the post-drome. This includes energy depletion, confusion, dizziness, and mood changes, for up to 24 hours following the migraine attack.6
Location, Location, Location
Where it hurts can give you a clue as to which type of head pain you are experiencing. Migraines typically are characterized by throbbing on one side of the head.7 Cluster headaches may be felt in or around one eye (or more generally, one side of the head) and the pain often radiates to other areas of your face, head, neck and shoulders.4 Sinus headaches, as the name suggests, are concentrated around the bridge of the nose, cheekbones, and forehead. Tension headaches, meanwhile, can be experienced as pain across the entire forehead, which is often described as a band being squeezed around the head.13
Migraines may be distinguished from bad headaches by their secondary symptoms, which can include sensitivity to light and noise, nausea or vomiting, dizziness, weakness, and auras. Visual auras—such as geometric lines, bright light, or shiny waves that a person typically sees in the 5 to 15 minutes before a migraine strikes, but an aura can occur up to 24 hours beforehand. Aura occurs in approximately 15 percent of migraine sufferers.8, 9, 10
Those who suffer from cluster headaches may also experience associated symptoms, such as excessive tearing, redness in the eye on the affected side, and stuffy or runny nose.4
Whether it’s a migraine or bad headache, how you experience head pain is highly individualized. Keeping a journal of the intensity, duration, pain location, and accompanying symptoms can help you gain a better understanding of your experience, along with which type of headache you have. To further understand your head pain, please talk to your doctor.