Headache and Migraine

Created: 03.08.2023

Updated 19.12.23

Approved by: General Practitioner, Dr Binita Parmar

There are over 200 different diagnoses for migraines and headaches, and not everyone knows what causes their headache. It can be challenging to navigate the various treatment options available and determine the specific type of headache one has.

How to distinguish between Migraine & Headache

It can be difficult to differentiate between regular headaches and migraines, and you should be examined by a doctor to establish a diagnosis. Migraine is a specific type of headache with distinctive features, while headaches, in general, refer to a broad category of head pain that can have various causes and symptoms depending on the specific type.

Headaches

Headaches can be painful, and in some cases, they can significantly impact your quality of life. It is especially important to seek medical attention if any headache reoccurs over time and affects your daily life. If an existing headache worsens or changes, you should also consult a doctor. The most common forms of non migrainous headaches include tension headaches, cluster headaches, and muscular headaches.

Tension headaches

Tension headaches, often called stress headaches, are the most common type of headache and are characterised by a feeling of tightness or pressure around the head and forehead. The pain is usually mild to moderate in intensity. This type of headache can be episodic or chronic and is often triggered by stress. It is also common for many people to experience migraine attacks in association with tension headaches.

Cluster headaches

Cluster headaches have no known direct cause. This type of headache involves severe pain attacks occurring in clusters, usually around or behind one eye. The pain is intense and is often described as sharp or piercing. Additional symptoms may include a red eye, tearing, a runny or congested nose, sweating on the forehead and face, a small pupil, drooping eyelid on the same side, as well as light sensitivity, restlessness, and agitation. Attacks usually come in clusters of one to eight attacks per day for four to twelve weeks.

Muscular headaches

Muscular headaches, also known as cervicogenic headaches, are headaches that occur on one side of the head, and the pain originates from bone structures or soft tissues in the neck. Although the cause lies in the neck, patients often experience pain in the head. The headache is specifically localised on one side of the head. This type of headache shares many similarities with migraines, but patients will not respond to migraine medications.

Migraine

Migraine is one of the most common headache types leading to seeking medical attention. However, it is estimated that the majority of people suffering from the condition have not received a formal diagnosis from a doctor. This means that many people are unaware that the headache they experience is, in fact, a migraine, and that effective treatment options are available.

Migraine is a condition that varies in frequency and intensity throughout a person's life, and it can also vary significantly from one person to another. While some individuals may experience migraine attacks several times a month, others may have far fewer attacks occurring sporadically. The intensity of the pain can also range from mild to severe.

One of the characteristic features of migraines is the presence of several other symptoms in addition to headaches. Some common symptoms include irritability, low mood, fatigue, neck pain, and a feeling of hunger. Many people also experience nausea, vomiting, sensitivity to sound and light during a migraine attack.

The prevalence of migraines increases from puberty to the age of 40. Migraines have a global prevalence of around 1 in 7 people. Migraine is two to three times more common in women.

Migraine attacks

Almost 20% of the population will experience one or more migraine attacks during their lifetime. These attacks can last from a few hours up to 3 days. They are characterised by pulsating head pain, usually located in the front, at the forehead/temples, on one side at a time. The attacks are often accompanied by nausea, vomiting, and sensitivity to light and sound.

10-20 % of those with migraines experience what is called an aura. The aura occurs before the migraine onset as a warning sign. When a person experiences an aura, they may have visual disturbances, see flashing lights, experience tinnitus, feel numbness in the body, or have difficulties speaking.

A diagnosis of chronic migraine is given when a person has a headache at least 15 days a month for over 3 months, of which at least 8 of these days are migraine days.

Triggers of Migraine

Migraine is a complex disorder believed to result from the interplay of genetic and environmental factors. There is still much that is not fully understood about the underlying causes. Therefore, it is important for people experiencing recurrent or severe headache attacks to seek medical attention for a thorough evaluation and proper diagnosis. Common triggers for migraines are hormonal fluctuations, contraceptive pills and oestrogen, certain heart medications, excessive use of painkillers, hunger, lack of sleep, stress or relaxation after stress, strong sensory stimuli, strong odours, and active and passive smoking.

An accurate diagnosis is crucial for developing an effective treatment plan for migraines. There are various treatment approaches, and the doctor will assess the patient's individual needs and symptoms to determine the most appropriate treatment method.

Treatment of Migraine and Headache

The treatment of migraines and headaches may involve a combination of medication and lifestyle changes. Acute attacks can be treated with pain-relieving medications and specialised migraine medications known as triptans. Preventive medications may also be prescribed for individuals with frequent and severe migraine attacks.

In addition to medications, lifestyle changes can help reduce the frequency and severity of migraine attacks. This may include maintaining a regular sleep routine, avoiding triggers such as stress, certain foods, or beverages, and practising relaxation techniques such as yoga or meditation.

It is essential to raise awareness about migraines and inform those who suffer from the condition that help and treatment are available. By seeking medical assistance and receiving a proper diagnosis, people with migrainous headaches can explore different treatment options to better manage the condition and improve their quality of life.

Headache Diary

To gain better control over your headaches and migraines, we recommend our patients use a headache diary. A headache diary can help identify triggering causes for your head pain. It helps you keep track of the frequency, intensity, and duration of attacks, as well as medication usage and its effects. You can find various headache diaries available in-app versions. By using a headache diary before your medical evaluation, it will be easier to assess your headaches and make a diagnosis.

When to seek urgent help

Seek urgent help if you experience these symptoms:

worsening of headache or fever
sudden headache with maximum intensity within 5 minutes
new-onset neurological symptoms
reduced level of consciousness
headache triggered by coughing or physical exertion
marked change in the type of headache