Migraine versus Tension Headaches

Who knows the difference between a migraine headache and a tension headache?  Most likely the person who has experienced a migraine.  A regular tension headache causes pain around the entire head which may even extend into the neck and back with moderate annoying pain.  It lasts a short period of time and can be coaxed into relaxing with over-the-counter pain relievers (aspirin, ibuprofen, acetaminophen).  There are normally no other symptoms involved such as vomiting, nausea, vision blurring, or vertigo.

A migraine on the other hand is moderate to severe in nature.  This headache is caused by enlarged blood vessels that produce chemicals that cause inflammation, pain, and further enlargement of vessels.  Those who have experienced a migraine in the past know that during an attack, they may only find relief in bed for several hours or up to several days.  The pain in these episodes is stabbing, throbbing, and usually occurs on one side of the head.  Over-the-counter pain relievers do not work on the migraine normally because the sympathetic nervous system is involved.  This causes the stomach to stop processing anything consumed and passes it directly into the small intestine.  Therefore pain relief medications won’t work with migraine.

Causes of Migraine

Women are affected more so than men.  Many believe that hormones cause migraine headaches.  Some migraines seem to be triggered by foods such as MSG in Chinese food, chocolate, red wine, smoked fish, or large amounts of caffeine.  Loud noises, bright lights, odors or perfumes, smoking or exposure to smoke, stress, alcohol, and anxiety may also trigger attacks.  They tend to run in families and usually appear by age 10 or sometimes later in life.  Women may get them when they are pregnant.

These types of headaches can be preceded by a group of warning symptoms that begin before the actual headache (called aura) and identify an upcoming migraine.

Migraine Treatment

There is no specific cure for migraine headaches.  Prevention and management are the best ways to handle them, and keeping a headache diary will to help identify triggers and foods that you may want to avoid.  Your physician may prescribe medicine to help reduce the frequency or severity of the headaches including blood pressure meds, antidepressants, and seizure medications.  Botulinum toxin type A (Botox) injections have been used to reduce migraine attacks if they occur more than 15 times per month.

Migraine trigger diary
Migraine trigger diary may help prevent an attack.

Although over-the-counter pain relievers may help to reduce the pain of a migraine, there are drawbacks to their use.  Taking these medicines more than three days a week may lead to rebound headaches.  These are headaches that keep coming back because of overuse.  Too much acetaminophen can damage your liver, and too much ibuprofen can be irritating to your stomach.  Doctors can sometimes prescribe injections, suppositories, and nasal sprays that may be of some relief.

When Do I Contact a Physician?

Keep in mind that migraine headaches are risk factors for strokes.  That risk increases in people who have the attacks that occur with aura.  Therefore people who fall into this category should avoid other stroke-causing factors such as smoking, eating unhealthy foods, and taking birth control pills.

Call 911: 

  • When you have headache combined with speech, vision, or loss of balance, especially when you have not had these with migraine in the past.
  • If you are experiencing the “worst headache” you have ever had.
  • When the headache starts suddenly.

Schedule An Appointment With Your Doctor:

  • When the pattern of your headache changes or the pain is different.
  • If you headaches are more severe when lying down.
  • If treatments that once worked no longer are effective.
  • If you are taking birth control pills and have migraines.
  • If you are having side effects from your medications.

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