Tension, Migraine, and Cluster Headaches: What Are the Differences?

More than 45 million Americans have problems with headaches each year. People complain about headaches more than they complain about any other type of ailment, and about 8 million of them venture to the doctor’s office in search of help for their headache pain.

If you have headaches, you may be frustrated when over-the-counter painkillers don’t completely relieve your pain. To get effective relief from headaches, you first have to know what type you have. The main types of headache are:

• Tension headache
• Migraine
• Cluster headache

At Advanced Medical Care in Brooklyn and Queens, New York, our experienced neurologists specialize in diagnosing and treating all types of headaches. We provide advanced diagnostic techniques and treatments to help you find relief.

Do you know what kind of headache you have? The descriptions below may help you determine your headache type.

What is a tension headache?

A tension headache is the most common type, afflicting about 80%-90% of people at least once over their lifetime. The pain usually ranges from mild to moderate. Most people describe the discomfort as equivalent to having a tight band around their head.

Even though tension headaches are common, their causes aren’t well understood. Usually tension headaches come in two types: episodic and chronic.

Episodic tension headaches can last anywhere from 30 minutes to an entire week. They’re still considered episodic as long as you have fewer than 15 headaches per month.

If you have more than 15 headaches per month, however, you have chronic tension headaches. Sometimes chronic tension headaches are difficult to distinguish from migraines. In fact, you can have both chronic tension headaches and migraines, which may complicate treatment.

Painkillers and other medications may help you manage the discomfort of tension headaches. However, it can also be helpful to identify triggers that may set off your headaches, such as excess stress.

It can also help to adopt lifestyle changes, such as eating a healthy diet and getting plenty of exercise. Other therapies that help you relax, manage stress, and reduce tension headaches include biofeedback and cognitive behavioral therapy (CBT).

What is a migraine?

One in seven people are affected by a type of primary headache disorder called migraine. A migraine is considered a primary headache because it’s not the result of another underlying condition or disease. Unlike other types of headaches, migraines have symptoms that indicate sensory disturbances, too, such as:

• Seeing flashing lights
• Seeing halos around objects
• Feeling extremely fatigued
• Feeling nauseated
• Vomiting
• Dizziness
• Tinnitus (ear ringing)
• Temporary vision loss
• Loss of appetite
• Tender scalp
• Being extra sensitive to light, sound, or smells
• Rarely, diarrhea or fever

Typically, you begin to experience symptoms such as visual changes about 24 hours before you feel the pain of a migraine. A migraine usually lasts for several hours but can last longer. If you get a migraine at least 15 days per month, you’re diagnosed with chronic migraine.

Even within the category of a migraine headache, different subtypes of migraine influence the best treatment choice for you. Depending on your symptoms and frequency, we may recommend: 

• Preventive medicines
• Pain medication
• Nerve blocks
• Physical therapy
• Acupuncture

We may also recommend periodic Botox® injections to prevent or lessen the severity of chronic migraine attacks.

What is a cluster headache?

A cluster headache is the rarest and most painful type of headache. It generally strikes just one side of your face, usually around the eye, and it tends to be severe. Cluster headaches appear sequentially, in “clusters,” that can last from 1-3 hours each. 

Only 69 out of 100,000 people suffer from cluster headaches, and men tend to get cluster headaches more than women do. Cluster headache symptoms differ slightly from tension headaches and migraines, and include:

• A sudden onset of pain
• Pain that reaches peak after 15 minutes
• Pain behind the eye
• Pain on one side of face
• Red or watery eyes
• Nasal congestion
• Sweaty forehead
• A drooping or swollen eyelid

When you’re in the middle of an attack, your doctor may administer oxygen therapy for 15-20 minutes. Medication can also subdue an attack by constricting your blood vessels. Other medications help by preventing cluster attacks. 

Before trying to treat your headache, find out what type it is and what therapies it’s most likely to respond to. Contact Advanced Medical Care to work with our experienced team so you can get individualized, effective headache relief.