Migraine vs. Headache: How to Tell the Difference

Why the Difference Matters

"Is this a migraine, or just a headache?" is one of the most common questions people ask about head pain — and it's a good one, because the answer genuinely shapes what helps. The key thing to understand up front is that "headache" is a broad category, and a migraine is one specific type within it. Saying you have a headache describes that your head hurts; identifying which kind starts to explain why, and that's what points toward the right care.

Different headache types respond to different things. What eases a tension headache may do little for a migraine; what helps a neck-driven headache is different again. So learning the patterns is worthwhile. But one honest caveat before we start: this is a guide to understanding, not a self-diagnosis tool. Headache types overlap, many people have more than one, and a few patterns need urgent care. The aim here is to help you describe your symptoms accurately to a provider — not to hand you a label. The broader family of headaches has many members, and sorting them out is a job for a careful history and exam.

What Makes a Migraine a Migraine

A migraine is a neurological condition, not just a stronger headache. Its signature is the combination of the pain and its companions. The headache phase of a migraine is often:

• Throbbing or pulsing, rather than a steady squeeze
• One-sided, though it can spread or switch sides
• Moderate to severe — enough to interrupt what you're doing
• Worse with movement, so you instinctively want to hold still

And crucially, it usually travels with extras that set it apart: nausea (sometimes vomiting) and a strong sensitivity to light, sound, and smells. Some people also get an aura — temporary visual or sensory symptoms — before or during the attack, which we cover in migraine with aura. A migraine also tends to unfold in phases rather than arrive all at once, described in the stages of a migraine. It's that whole package — the throbbing, one-sided pain plus the nausea and sensitivity — that most clearly marks a migraine.

Tension Headaches

A tension headache is the everyday headache most people picture. Its pattern is almost the opposite of a migraine's:

• A steady, dull pressure rather than a throb
• Often felt as a band around the whole head, on both sides
• Mild to moderate — annoying, but usually not disabling
• Generally without the nausea and light sensitivity of a migraine
• Frequently tied to stress, fatigue, or holding one position too long

Because a tension headache is milder and more diffuse, people often push through it. The overlap with migraine mostly comes when a tension-type headache is unusually strong, or when someone has both patterns.

Sinus Headaches

A sinus headache is pain and pressure people attribute to the sinuses — across the forehead, cheeks, and around the eyes. A genuine sinus headache usually comes with an active sinus infection, which means:

• Facial pressure that worsens when you bend forward or lie down
• Thick, discolored nasal discharge
• Often a fever and a general sense of being unwell

Here's the catch that matters for this comparison: migraines can masquerade as sinus headaches. A migraine can cause facial pressure, a stuffy or runny nose, and watery eyes — all of which feel sinus-related. So if "sinus headaches" keep recurring without an infection, that's a detail worth raising with a provider, because it may point toward migraine instead.

Cervicogenic (Neck-Driven) Headaches

A cervicogenic headache is head pain that actually starts in the neck — the joints, muscles, and nerves of the upper neck referring pain up into the head. It's the type most directly in a chiropractor's wheelhouse, and it has a fairly recognizable signature:

• Pain that usually stays on one side
• Aching that begins at the base of the skull and spreads toward the forehead or temple
• Neck stiffness that travels with the headache
• Pain that's provoked or worsened by certain neck positions or movements

The strong link between the head pain and neck movement is the biggest clue. Because it can feel one-sided, it's sometimes mistaken for a migraine — but it isn't driven by the neurological triggers a migraine is, and it responds to care aimed at the neck. Our full guide to cervicogenic headaches covers this type in depth.

A Side-by-Side Comparison

Putting the four together highlights how their signatures differ:

• Migraine — throbbing, often one-sided, moderate to severe, worse with movement, with nausea and light/sound sensitivity, sometimes aura.
• Tension headache — steady pressure, both sides, a band around the head, mild to moderate, without nausea or light sensitivity.
• Sinus headache — pressure over the forehead and cheeks, worse bending forward, with infection signs like fever and discolored discharge (and easily confused with migraine when those signs are absent).
• Cervicogenic headache — one-sided, starts at the base of the skull, travels with neck stiffness, provoked by neck movement.

Describing Your Symptoms to a Provider

The most useful thing this comparison can do is help you give a clear, specific account of your head pain — which is often what points a provider toward the right diagnosis. When you're seen, it helps to be ready to describe:

• Where the pain sits, and whether it's one-sided or all over
• What it feels like — throbbing, pressure, a band, a deep ache
• How severe it gets, and whether it stops you from your usual activities
• What comes with it — nausea, light or sound sensitivity, neck stiffness, nasal symptoms, or aura
• What brings it on or eases it — stress, certain foods, neck positions, movement, time of day
• How it unfolds — sudden or gradual, and whether it changes as it goes

How Chiropractic Care Fits In

A word on scope: migraine is a medical condition that often needs medical management, sometimes with a physician or neurologist. Chiropractic care doesn't replace that. Where it fits is the neck-tension component of head pain — most directly with cervicogenic (neck-driven) headaches, and as a supporting piece when a migraine has a genuine neck contribution.

At Thrive Chiropractic in Troy, MI, that care typically includes:

• Upper cervical care to restore motion to stiff joints at the top of the neck
• Soft-tissue and massage therapy to ease tension across the neck, shoulders, and base of the skull
• Posture and ergonomic guidance to reduce the daily strain that feeds neck-related head pain

Part of the value is simply sorting out what's contributing. A careful exam helps tell a neck-driven headache — which chiropractic care can address at its source — from a migraine that needs medical management, so the care actually matches the problem instead of guessing.

When to Seek Prompt or Emergency Care

Most headaches, including most migraines, follow a familiar pattern and aren't dangerous. But some headache symptoms are warning signs of something serious and need urgent medical attention right away — regardless of which "type" your past headaches have been.

Short of an emergency, it's worth a medical evaluation whenever your headaches change in pattern, become more frequent or severe, or stop responding to what usually helps. For the everyday one-sided headaches that flare with neck positions and travel with neck stiffness, a chiropractic evaluation is a natural fit — you can schedule a visit with Dr. Rubinstein whenever you're ready.

Frequently Asked Questions

The questions Dr. Rubinstein hears most about telling headaches apart — how to know if it's a migraine or a regular headache, whether a headache can turn into a migraine, whether "sinus headaches" are often migraines, and whether you should try to diagnose your own — are answered in the FAQ section on this page. If your situation isn't covered there, the team is glad to talk it through before you come in.