Tension Headaches vs Migraines: Differences & Treatments
Often when we feel head pain, it is hard to distinguish whether we are feeling a tension headache vs a migraine.
Any head pain often causes concern, especially if you don’t understand why you are experiencing a headache. Understanding the type of headache you have will help you determine whether you should seek medical attention or if you can manage and prevent these headaches at home.
If you have a headache along with dizziness, blurry vision, slurred speech, and a general feeling that something is wrong, visit your nearest emergency room as soon as possible.
What Is a Tension Headache?
A tension-type headache (TTH), previously known as a stress headache, is one of the most common headaches people experience. A tension headache can be described as a dull pain felt on both sides of the head. If you experience pressure around your head and pain in the shoulders, jaw, and neck area, this is likely a tension headache.
Tension headaches can be painful, but they usually don’t affect your daily activities as much as migraines do. These headaches shouldn’t cause blurry vision or affect your balance and strength. However, tension headaches can last for weeks at a time.
There are two main types of tension headaches, episodic and chronic tension headaches. An episodic tension headache happens fewer than 15 times a month and the pain starts slowly while gradually getting worse during the day.
Chronic headaches occur more than 15 times a month and while the pain may decrease or increase through the day, it is always present.
Causes of Tension Headaches
Tension headaches can be triggered by several factors, although researchers are unclear on the exact cause of tension headaches.
Apart from triggers, tension headaches can be caused by neck problems. These problems start in the neck and shoulders and refer the pain to the head. Neck problems can be caused by various factors including tension from stress or structural problems.
Whiplash from a car accident is another common cause of tension headaches. TTH from whiplash can occur shortly after the accident or years later if the injury wasn’t treated correctly.
Triggers
If you are experiencing TTH, take note of when the headache occurs and note down any possible triggers. Here are some of the common triggers that lead to episodic or chronic tension headaches.
● Stress
● Anxiety and/or depression
● Fatigue
● Alcohol
● Hormones
● Smoking
● Eyestrain
● Dehydration
● Skipping meals
● Caffeine
● TMJ (jaw clenching/pain)
● Caffeine
● Muscle strain
What Is a Migraine?
A migraine, which is more than a headache, is signified by debilitating throbbing or pulsating pain, usually on one side of the head. Migraines are often experienced along with nausea, vomiting, and extreme sensitivity to external stimuli, including light, sound, and smells.
There are different types of migraines that affect people differently and they can happen more than once a week or some people may only experience them occasionally. Warning symptoms, known as aura, can signal the start of a migraine. These symptoms are often visual disturbances.
When experiencing a migraine, it will likely affect your daily activities, resulting in disturbed work and sleep patterns. Migraine sufferers often seek out a dark and quiet room to reduce the severity of the migraine.
Migraines can progress through four stages, although not everyone will experience each stage. The four stages are:
● Prodrome – one or two days before a migraine, warning signs appear, such as mood changes, neck stiffness, and increased urination
● Aura – This stage appears before or during a migraine attack. You may experience visual interruptions such as seeing bright spots, shapes, or flashes of light
● Attack – the attack phase is when you feel a throbbing pain in your head, nausea, and light sensitivity
● Post-drome – When a migraine attack ends, you may feel fatigued, drained, or even have a sense of euphoria
Causes of Migraines
Doctors and researchers are not entirely certain of the exact cause of migraines, although it is believed that migraines are related to vascular changes in the head and neck. These changes occur due to swelling or dilation of blood vessels in these areas.
Migraines can also be hormone-related and occur during certain phases of a woman’s cycle. The common phases linked to migraines in women are during their period, when pregnant, and during ovulation.
Triggers
Migraines are closely linked to specific triggers that can be tracked to help ease the symptoms of migraines and prevent future attacks.
● Weather changes
● Hormones
● Alcohol
● Stress
● Certain food additives
● Medications
● Smoking
● Sleep changes
● Sensory stimuli
● Physical exertion
Symptoms of Tension Headaches vs Migraines
Tension-type headaches can often be mistaken for migraines and vice versa. While these two types of head pain have common symptoms similar to other headache disorders, there are a few indications that distinguish one from the other.
When to Seek Urgent Medical Attention
Headaches and migraines are common and usually not a sign of any life-threatening causes. However, head pain can signal underlying issues that require immediate medical attention.
If you experience any of the following symptoms along with extreme head pain, it is recommended that you seek urgent medical assistance.
● Dizziness
● Blurry vision
● Slurred speech
● Difficulting swallowing food and drink
● Difficulty moving one side of the body
● Numbness of the face and tongue
● Tingling in the limbs, face, or neck
● Nausea and vomiting
● Ringing in the ears
How to Treat Tension Headaches
TTH can go away on its own or with some home remedies. However, the best treatment for tension headaches includes lifestyle changes, exercises to relieve tension, and consistent avoidance of your triggers.
Home Remedies
Try these methods at home to ease the discomfort of a tension headache. If these methods don’t ease the pain and the headaches are persistent or keep coming back, seek medical attention.
Relaxation techniques including breathing exercises, meditation, or light exercise can help relieve the pain caused by TTH. A holistic approach to managing stress, anxiety, and depression will reduce the frequency and severity of tension headaches if these factors are triggers.
Drinking enough water and eating the right amounts of meals filled with nutrient-rich food will also reduce the severity and frequency of TTH, especially if these are your triggers.
Tension headaches can be managed with over-the-counter (OTC) medication, specifically nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen or Ibuprofen.
Other pain-relievers can also be used including paracetamol, aspirin, or acetaminophen. Medication shouldn’t be used for longer than the prescribed amount of time. Overuse of medication can cause and worsen headaches.
Medical Management
In severe cases, TTH can be managed with prescription medications including antidepressants, even when depression is not a cause. Any medication should be seen as a short-term solution, and lifestyle changes should be your main treatment option.
A physiotherapist can assess whether muscle tension in your neck, shoulders, or back is a factor causing your TTH. They will also assess if TMJ is another cause. If they notice heightened tension in these areas, they may suggest a few sessions to relax the muscles through massage, dry needling, as well as exercises and stretches to promote posture correction.
How to Treat Migraines
Migraines can be treated with pharmaceutical and non-pharmaceutical interventions. However, if your migraines are severe and negatively impact your day-to-day activities, it is recommended that you consult your doctor. Your doctor will determine if there are any underlying issues of concern.
Medical Management
Migraines are commonly treated with abortive or preventive medication. Abortive medications constrict blood vessels back to normal to ease the throbbing sensations. This medication will also reduce the effects of other symptoms such as nausea and light sensitivity.
Preventative medication is prescribed in cases where the migraines are severe and occur regularly. This medication is usually taken daily to prevent migraines from starting.
When treating migraines it is important to speak to your doctor to find out the best treatment solutions for your specific needs.
Short-term Home Management
While most migraines are severe enough to require medical assistance, sometimes it is not possible to acquire medical help. In these cases, you can use these methods to reduce pain until you can visit your GP.
Reduce stimulus as much as possible, this includes light, sound, and smells. Stop using any devices such as your phone or TV and find a quiet and dark space to rest. Stay hydrated by drinking plenty of water while you wait.
To prevent further migraines, you can keep track of your triggers and avoid these wherever possible. Keep a migraine diary to track any possible triggers when your migraines appear.
Final Thoughts
Tension headaches cause dull pain and pressure around your head and are often referred from your back, neck, or shoulders. Migraines cause severe pain along with other symptoms including sensitivity to stimuli, nausea, and vomiting.
If you experience a headache for more than a few days you should speak to your doctor to find out what is causing your pain.
If you are experiencing tension-type headaches, you can also visit your nearest physiotherapist to treat tension in your neck, back, and shoulders to offer long-term pain relief.
