Your world grinds to a halt as a throbbing pain behind your left eye spreads, expanding until you swear you can feel your teeth pulsing. The light from your phone causes an explosion of pain, and every sound feels like an ice pick to your temple. You prepare to hide in your bedroom for the next several hours, and then your friend says it: “Why don’t you have some water? It’s just a headache, right?”
Maybe you’re not sure what’s causing the pain—it could be a migraine attack, a sinus headache, or something else entirely. What you do know? It’s much more than “just a headache.”
But to make it go away, you need to know what you’re dealing with. So, what exactly distinguishes a migraine from other types of headaches?
What all headaches have in common
It might seem obvious, but we know that most headaches and headache disorders cause head pain—the type of head pain and the accompanying symptoms differ based on what kind of headache you have.
What makes a migraine different?
Before we cover some of the many types of headaches out there, let’s talk about what a migraine is. The most well-known migraine symptom is a pounding, severe headache, usually starting on just one side of your head. But migraine symptoms typically follow a unique pattern, too.
The scientific term for the period before the headache sets in is the “prodrome. ” It can last for a few hours, or even up to a few days. During this period, it’s common to experience symptoms like:
difficulty concentrating, speaking, or reading
nausea, constipation, or diarrhea
sensitivity to light, sound, touch, and smell
Some migraine sufferers also have an aura within the hour before their headache. The aura can include:
visual disturbances, like flashing lights, blind spots, geometric shapes, etc.
sensory disturbances, like numbness, pins and needles sensations, etc.
brainstem-related symptoms, such as vertigo, difficulty speaking, ringing ears, etc. (Note: This is rare.)
retinal symptoms, usually temporary partial or total blindness in just one eye. (Note: This is rare.)
Once the headache strikes, the migraine pain can last 4-72 hours, and be debilitating.
Afterward, many people will be stuck recovering from a “migraine hangover,” or, to get scientific, a “postdrome.” The hangover can last several days and leave you nauseous, moody, thirsty or craving certain foods, unable to concentrate, and sensitive to lights and sounds.
In contrast, many of the headaches we’ll discuss below can be treated with over-the-counter anti-inflammatories, pain relievers, and lifestyle changes. With that said, while not every headache is a migraine, many headaches can still be extremely painful.
Let’s take a look...
How many types of headaches exist?
It’s hard to say how many types of headaches there are because they’re often symptoms of other conditions. In that vein, we can divide types of headaches into two categories: primary and secondary.
Primary headaches are not caused by other underlying conditions or illnesses, according to Mayo Clinic, but by overactivity or chemical changes in the brain, the nerves, blood vessels, or muscles in or around your head. Secondary headaches, on the other hand, result from other issues, like viral or bacterial infections, injuries or traumas, and dehydration, to name a few.
In other words, secondary headaches are a side effect of another condition, while primary headaches are the condition.
Migraines are considered primary headaches, along with the following headaches listed in IDHC-3, the International Headache Society’s officially recognized list of headaches:
Tension headaches typically come on slowly and involve mild or moderate (but not severe) pain that feels like a vice or band wrapping around your head. Unlike a migraine, tension headaches usually hurt on both sides of your head, and don’t bring along telltale migraine symptoms like nausea, sensitivity to light, aura, or the prodrome stage.
Tension headaches can be caused by a variety of triggers, according to Medline Plus, such as:
alcohol and caffeine
clenching or grinding your teeth
holding your head in one position for too long
sleeping in a strange position or in a cold room
straining your eyes
You can often treat a tension headache with over-the-counter pain relievers, as well as preventive treatments like acupuncture, meditation, and cognitive behavioral therapy.
According to the Genetic and Rare Disease Information Center (GARD), cluster headaches are extremely painful, marked by severe pain that gets worse over a period of 5-10 minutes, and lasts for up to three hours. They pop up in bursts (or clusters), and you can get them up to eight times a day for weeks at a time (usually 6-12 weeks). They can bring along other issues, like facial swelling or drooping, nasal dripping, and other symptoms at or near the site of the pain, reports GARD.
What causes cluster headaches? Scientists aren’t sure. But, according to Mayo Clinic, they might have to do with your body’s sleep clock. Men, smokers, and alcohol users are more likely to get cluster headaches, but they can also be genetic.
Besides these two common kinds of non-migraine headaches, the ICHD-3 lists several other types of primary headaches:
Cough headaches are temporary headaches triggered by coughing or sneezing that last just a few minutes or a couple hours and go away when the main problem (the cough, for example) is cured.
It might sound like a joke, but it’s not: If you get a severe headache on both sides of your head right before or after orgasm, you could be in the 1-1.6% of the population that experiences frustrating (but harmless, and treatable) sex headaches.
Ice cream headaches
If you have ever shouted “brain freeze!” while slurping a milkshake a little too fast, you might have had the short, stabbing headache known scientifically as a “cold-stimulus headache,” caused when cold temperatures temporarily restrict blood flow.
External pressure headaches
Harmless external pressure headaches are marked by short-lived head pain that pops up when something is literally pressing on your head, like a headband or helmet, and go away when the pressure is taken away, according to the journal Current Pain and Medical Reports.
Ice pick headaches
Very brief (often just seconds-long) ice pick headaches, also known as “primary stabbing headaches,” might happen up to three times per day, and are only a cause for concern if they're a symptom of another condition, notes the American Migraine Foundation.
A nummular headache causes severe pain on just one very specific spot, sometimes as small as a coin, that can last up to several months, or crop up in short bursts of seconds or minutes, though they are not well understood by scientists, reports a Neurological Bulletin paper.
Hypnic headaches, or “alarm clock headache,” wake you up from sleep for 15 minutes to four hours at a time, states the American Migraine Foundation, and, oddly, can often be treated with caffeine before bed.
New daily persistent headaches
New daily persistent headaches (NDPH) are just what they sound like—chronic headaches that strike nearly every day (or at least 15 days per month, for three months) in people who have never had headaches before. The Annals of Indian Neuropsychology Academy advises that this is more of a “syndrome” than a diagnosis, because it usually implies you have some other kind of headache condition, like migraines or tension headaches.
A few common ones include:
Sinus headaches can imitate migraine symptoms, like watering eyes, stuffy nose, and sinus pressure or pain. Sinus headaches, however, are relatively rare, result from sinus infections, and typically go away when the infection’s cured. In fact, many people who think they have sinus headaches actually have migraines. Telltale signs that that’s the case is that you have forehead and facial pressure over the sinuses, but no fever, changes in smell, or foul-smelling breath.
As you might guess, post-traumatic headaches result from trauma. The American Migraine Foundation notes that they’ve often described as feeling like both a tension headache and a migraine headache. While they often clear up within a few months, there’s a chance they last longer. And when that’s the case, it’s a good idea to speak to a doctor about your symptoms.
Medication-overuse headaches are also known as rebound headaches because they’re a result of taking a medication more often than your doctor recommends. According to Mayo Clinic, any medication you take for a headache (from over-the-counter pain relievers to preventive migraine drugs) can cause rebound headaches, but only if you have a headache condition. In other words, medication overuse won’t cause a headache if you didn’t already get them before. Luckily, they’ll usually go away if you stop taking the medication.
How do you know if you have a migraine or another type of headache?
The only way to be sure what kind of a headache you have is to see a doctor, but you can help your doctor make a diagnosis by keeping tabs on your symptoms with a headache diary.
You should record things like:
what your headache feels like
what other symptoms come along with it
how long your headache pain and other symptoms last
how often your headache strikes
A doctor can take a cohesive look at your headache patterns, your family history, and the results of any required tests and examinations to help you figure out what kind of headache you have—so you can get treatment.
How can you tell if you have migraines versus a different type of headache? Without the help of a doctor, it can be difficult to tell the difference between, say, chronic migraines, and another serious condition. That’s why it’s important to talk about your condition with a doctor.
The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
Photo by Aiony Haust on Unsplash.