Migraine vs. Tension Headache: How to Tell the Difference
- Dr. Kayle Martinsen
- Jul 17
- 2 min read
Not every bad headache is a migraine, and not every migraine feels the way people expect. Since the two are treated differently, it's worth knowing what actually separates them.
Tension-Type Headache
Pain on both sides of the head, often described as a tight band or dull pressure
Mild to moderate intensity that usually doesn't stop you from going about your day
Lasts anywhere from 30 minutes to several days
Doesn't typically come with nausea, vomiting, or sensitivity to light and sound
Doesn't usually get worse with routine physical activity like climbing stairs
Migraine
Often one-sided, throbbing or pulsing pain
Moderate to severe intensity that can be disabling
Lasts 4 to 72 hours if untreated
Frequently comes with nausea, vomiting, or sensitivity to light and sound
Tends to worsen with routine physical activity
Sometimes preceded by aura, such as flashing lights or zigzag lines in your vision
Why It's Not Always This Clear-Cut
In practice, this distinction gets messier than the lists above suggest. Migraine symptoms can overlap considerably with tension-type headache, especially in milder migraine attacks, and there's currently no blood test, scan, or biomarker that can confirm either diagnosis. It's also common for the same person to experience both types at different times, and frequent headache sufferers often have a mix of the two. Research following adolescents over time found that a confirmed diagnosis of either migraine or tension-type headache tends to be fairly stable, but a probable, less clear-cut diagnosis is much less reliable.
Why the Distinction Still Matters
Even with the overlap, figuring out which type, or mix of types, you're dealing with matters, because they don't respond to the same treatments. Migraine-specific medications generally don't help tension-type headache, and the triggers worth tracking down look different for each. If your headaches don't fit neatly into either box, or you're not sure which one you're dealing with, that's worth a proper evaluation rather than guessing.
If migraines, or headaches that might be migraines, are a regular part of your life, our migraine treatment approach starts with figuring out what you're actually dealing with. Schedule an appointment online or email asawellnesscenter@gmail.com.
This information is for general education and isn't a substitute for a diagnosis from your doctor. See a physician promptly for a headache that's sudden and severe, the worst of your life, or comes with fever, confusion, vision loss, or weakness.
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