Is It a Migraine or a Headache? How to Tell the Difference

Head pain affects almost everyone at some point. For many, it’s an occasional nuisance. For others, it’s a chronic, disabling condition that disrupts daily life. Understanding whether you’re dealing with a standard headache or a migraine is the first step toward effective treatment, say experts at Baptist Health Brain & Spine Care.

Maria Vera Silva, M.D., a neuro-ophthalmologist at Baptist Health Miami Neuroscience Institute, and Pablo Ezequiel Ravenna, M.D., a neuro-ophthalmologist at Marcus Neuroscience Institute, part of Baptist Health, explain how to tell the difference—and what to do if you’re experiencing migraines.

What Makes a Migraine Different?

A tension headache is the most common type of headache — and it’s very different from a migraine.

“A tension headache typically feels like a tight band around the head,” says Dr. Vera Silva. These headaches are often triggered by stress, lack of sleep, dehydration or poor posture. The pain is usually mild to moderate and affects both sides of the head, sometimes with tightness in the neck or jaw.

A migraine, by contrast, is a neurological condition — not just a severe headache.

“Migraine attacks involve a hypersensitive nervous system,” Dr. Vera Silva explains. “They can cause moderate to severe throbbing or pulsating pain, often on one side of the head, along with nausea, vomiting and extreme sensitivity to light and sound.”

Quick comparison:

• Tension headache: Dull, pressure-like pain; both sides of head; manageable
• Migraine: Throbbing pain; often one-sided; nausea, light/sound sensitivity; can be disabling

About 25 percent of people with migraines experience an aura—temporary visual or sensory changes such as flashing lights, zigzag lines or tingling sensations—before the headache begins.

Migraines also tend to unfold in phases, which can include subtle early symptoms (like fatigue or irritability), the headache itself, and a lingering “hangover” feeling afterward.

A Leading Cause of Disability

Migraines affect about 12 percent of the population, according to the U.S. Centers for Disease Control & Prevention (CDC), and women experience them at nearly twice the rate of men.

But the true impact goes beyond numbers.

“Migraines rank as a leading cause of disability worldwide,” says Dr. Ravenna. “Patients frequently miss work, school and important family events. During an attack, normal functioning can become impossible.”

Untreated migraine attacks can last anywhere from four to 72 hours. Many people need to lie down in a dark, quiet room until symptoms subside.

Are You at Risk?

Genetics play a major role in migraine risk.

“If one parent has migraines, the risk is about 40 percent. If both parents have them, it increases to 75 percent,” Dr. Ravenna says.

Other common triggers include:

• Stress and anxiety
• Hormonal changes (especially during menstruation or pregnancy)
• Skipped meals or irregular eating habits
• Weather or barometric pressure changes
• Poor sleep — too little or too much
• Bright lights, strong odors or loud noises

“Identifying personal triggers is key,” adds Dr. Ravenna. “That’s often the first step toward better control.”

When to See a Specialist

Occasional headaches can often be managed with over-the-counter medications. But certain symptoms signal the need for medical evaluation.

Dr. Vera Silva recommends seeing a specialist if you experience:

• Headaches more than 15 days per month
• A sudden, severe “thunderclap” headache
• Aura symptoms lasting longer than an hour
• Headaches that don’t respond to standard medications
• Weakness, numbness or difficulty speaking

“These could indicate a more serious condition or a need for a more advanced treatment plan,” she says.

Treating Migraines: Acting Early Matters

Migraine care has evolved significantly in recent years. Instead of simply enduring symptoms, treatment now focuses on both stopping attacks and preventing them.

“The goal is to reduce how often migraines happen and how severe they are,” says Ravenna. Most treatment plans include three key components:

• Acute treatments: Medications like NSAIDs or triptans taken at the first sign of symptoms
• Preventive therapies: Daily medications or monthly injections that reduce migraine frequency
• Lifestyle changes: Consistent sleep, hydration and trigger management

“Early intervention is critical,” Dr. Ravenna adds. “Treating a migraine at the first sign can make a significant difference in how severe it becomes.”

For moderate to severe migraines, doctors often prescribe triptans, which help calm overactive pain pathways in the brain. Anti-nausea medications may also be used.

Dr. Ravenna cautions against overusing pain relievers.

“If you’re taking them more than three days a week, you may develop medication overuse headaches,” he says. “A specialist can help you find a safer, more effective approach.”

Preventing Future Attacks

Prevention often starts with simple habits.

“Lifestyle modifications offer a strong foundation,” says Dr. Vera Silva. “Maintaining a regular sleep schedule, staying hydrated, eating balanced meals and managing stress can significantly reduce migraine frequency.”

Keeping a headache diary can also help identify patterns and triggers.

For patients with frequent migraines, preventive medications — including certain blood pressure drugs, antidepressants or anti-seizure medications — may be recommended to stabilize the nervous system.

New Advances in Migraine Care

“We’re in a golden age of migraine research,” says Dr. Vera Silva.

One of the biggest breakthroughs involves CGRP inhibitors, which target a molecule involved in transmitting migraine pain. These treatments are available as monthly injections or oral medications known as “gepants.”

“These therapies are highly targeted and have changed how we manage migraines,” she says.

Noninvasive neuromodulation devices, which use electrical or magnetic pulses to calm nerve activity, are also offering drug-free alternatives for some patients.

In addition, emerging research continues to explore new options. A 2025 study found that the medication liraglutide reduced monthly migraine days by more than half in patients with both chronic migraine and obesity.

“This research is promising,” Dr. Vera Silva says. “It would give us another potential tool to help patients regain control of their lives.”

The Bottom Line

Migraines are more than just headaches — they’re a complex neurological condition that can significantly affect quality of life. But with the right diagnosis, treatment and prevention strategies, they are highly manageable.

“If migraines are interfering with your daily life, don’t ignore them,” says Dr. Ravenna. “Effective help is available.”

Click here for more information about the services and specialists available at Baptist Health Brain & Spine Care.