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How to Tell If It’s a Headache or a Migraine

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If you are prone to getting headaches, you may be wondering about the difference between a regular headache and a migraine. Both suck, but a migraine is definitely worse. So how can you tell which kind you’re suffering from?

A regular headache feels like “a dull, cap-like pressure,” said Julia Jones, a neurologist at Houston Methodist Hospital. “They usually don’t interfere with activities, and they don’t bother people enough to go see the doctor.”

A migraine, on the other hand, “is typically a throbbing or pulsatile pain on one side of the head that progresses or gets worse with time,” Jones said.The pain from a migraine tends to build slowly over time, lasting from 4 to 72 hours, with symptoms including light or sound sensitivity, nausea, and vomiting. Just moving will make the pain worse. About a third of people will also experience aura before the onset of their migraine, including visual disturbances such as flashes of light. Migraines make going about your daily activities very hard, if not impossible.

Keep a headache diary to log your triggers 

If you are pretty sure migraines are your problem, it helps to know your triggers. For many, these can include heat, stress, or certain foods. For women, hormones are a common trigger, with migraines often happening during a specific time during their cycle.

Figuring out your triggers can be complicated, as their effects aren’t always immediate. “A migraine can be cooking for up to 72 hours before you get that pain,” Jones said. The period preceding the onset of pain is called the premonitory phase, and can include symptoms such as a stiff neck or jaw, mood changes, excess yawning, fatigue, or gastrointestinal disturbances.

For these reasons, it helps to keep a headache diary, noting when you get a headache along with details of what you were doing during the days preceding it. Hopefully. you’ll start to notice patterns, and you’ll be able to fend off your migraines before they start. However, even when you’re doing everything right and avoiding your known triggers, you may still get migraines.

Maintaining balance helps with migraine management 

When life starts to get a little unbalanced, whether from a disruption in your sleep schedule, missing a meal, or dealing with a lot of stress, “you are more likely to tip into that headache,” Jones said. The reason for this seems to be the role the hypothalamus, which maintains functions such as body temperature, thirst, hunger, sleep and our emotional state, plays during a migraine.

“When they do PET scans for nitroglycerin-induced headaches, they see stronger functional connections in the hypothalamus to the pain centers and autonomic centers in migraine patients, compared to those who don’t have migraines,” Jones said. “That’s why having that homeostasis really helps a lot.”

Preventative medicine may be necessary

The occasional migraine—one or two a month—can often be treated with over-the-counter pain relievers, such as ibuprofen or aspirin. Excedrin Migraine is sometimes more effective, and combines acetaminophen, aspirin, and caffeine. (Drinking a cup of coffee can also help.) But taking over-the-counter medications too often can lead to rebound headaches.

If your migraines grow more frequent or are unresponsive to over-the-counter drugs, your primary care physician will likely have experience in treating them. Depending on their frequency, your doctor may need to prescribe something stronger, either to relieve symptoms during a migraine, prevent them from starting, or a combination of the two. And if you’re dealing with migraines for more than 6 to 8 days out of the month, a referral to a neurologist experienced in treating migraines may be in order.

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