Tension headaches produce a steady pain across your forehead or in the back of your head Table 01 Figure 01. The pain may take over your whole head or radiate down your neck and shoulders. Some people say tension headaches produce the sensation of having a tight band around your head. The pain typically occurs during the day (typically in the late afternoon), and may resolve by evening.
The throbbing pain of a migraine begins abruptly in your eye or temple, and may spread to other areas of your head. Migraine headaches can cause nausea and vomiting and, as a result, have earned the nickname “sick headache.” Often, people with migraine headaches experience mood changes before the headache starts. In about 15% or cases, people with migraines may see flashing or jagged lights, develop a blind spot, or see distorted images about 30 minutes before the pain starts (auras). Occasionally, tingling in an arm or leg occur before the headache. Not all migraine sufferers get auras, and those who do don't necessarily get them each time. It is possible to experience an aura, but not develop a headache afterwards. Once the headache starts, you may become sensitive to strong smells, bright lights, and loud noises. Migraine headaches generally last from one to three days.
Figure 01. Tension and Migraine Headache Pain
Table 1. Symptoms of Tension and Migraine Headaches
Tension headache Migraine headache Dull, constant pain across forehead, in back of head, or throughout head Pain begins during the day and gets progressively worse Gripping pressure in head Nausea and vomiting Throbbing or pulsating pain on one side or both sides of head Visual disturbances Pain in neck and shoulders Tingling in arm or leg Mood changes Sensitivity to light, noises, and smells
Women are more prone to headaches than are men. Tension headaches, which usually begin in adulthood, affect slightly more women than men. Women also suffer more from migraine than men: about 20% of women and 10% of men in the U.S. have migraines. This discrepancy is due to the fact that estrogen is a powerful trigger of more intense headaches.
Migraines sometimes run in families, and appear to have a genetic component. One extremely rare type of migraine-familial hemiplegic migraine—has been traced to an abnormality on chromosome 19.
A doctor will suspect this type of migraine if you have a close relative (i.e., a parent or sibling) who also has migraine headaches.
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