Ask the Doc: What’s the difference between a migraine and a headache?

A migraine headache is different from other types of headaches. Before we get to an explanation of the differences, there are a few things we need to get straight:

1. Migraine is a neurological condition, in the same kind of way that epilepsy is a neurological condition. People with migraine (or epilepsy) are not affected by the condition all the time but there are times when they are affected by the symptoms of their condition. Some people say ‘a migraine’ to refer to the times their migraine symptoms (usually the headache part) are affecting them.
2. Migraine affects males and females. In childhood, migraine is just as common in boys as in girls. During and after puberty, migraine becomes more common in females. Even so, nearly one in eight Australian men have migraine.
3. Lots of people with migraine don’t know they have it, which means they’re not receiving effective treatment and are probably suffering more than necessary.
4. Migraine is one of the greatest causes of health burden worldwide, with large personal costs for individuals.

Most people experience a headache every now or then. On any given day, around one out of every seven people has a headache.

There are lots of different causes and lots of different types of headaches. The most common type of headache is known as ‘tension-type headache’, which affects two in five people and feels like a band of pressure around the head. They can be caused by things like hunger, lack of sleep, stress, anxiety and depression.

There are a few things that make migraine different from other headache disorders:

• A typical migraine headache involves a moderate-to-severe pulsing or throbbing pain, whereas other headaches are a milder, dull pressure.
• Migraine headaches are mainly felt on one side of your head.
• Migraine headaches are only one of the symptoms of migraine, and occur as one phase of a migraine ‘episode’ or ‘attack’. The phases of migraine are:
  1. A ‘premonitory’ phase when non-painful symptoms (e.g. tiredness, difficulty concentrating) give a strong feeling a headache is coming
  2. An ‘aura’ phase, that occurs in a minority (around 15%) of people with migraine
  3. The headache phase
  4. A ‘postdromal’ phase, which some people call a ‘migraine hangover’
  5. An ‘interictal’ phase, in between attacks when there are no symptoms

If you think you have migraine, or if you have headaches that are more severe or more frequent than usual, you should see your doctor. Getting a correct diagnosis of the type of headache you have is the first step to finding a treatment that will help you to manage it.