Migraine is a type of headache disorder that often causes throbbing pain, nausea, and sensitivity to light or sound. It can last for hours or days. Tension headaches more often feel like steady pressure, while cluster headaches cause intense pain around one eye and sinus-related pain usually comes with nasal symptoms. Pain location alone cannot tell the cause. A sudden, severe headache or headache with neurological symptoms needs urgent care.
What makes a migraine different from an ordinary headache?
A migraine is a neurological condition, not simply a headache that hurts more than usual. It can affect how a person feels, sees, and functions during an attack. Head pain is common, but nausea, vomiting, and sensitivity to light or sound can be just as disruptive. Some people need to stop their usual activities and rest in a quiet, dark room.
According to Mayo Clinic, migraine pain often feels throbbing or pulsing and commonly affects one side of the head, although both sides can be involved. An untreated attack typically lasts between four and 72 hours. Physical activity may make the pain worse, and some people experience temporary changes in vision or sensation before or during an attack.
Other headache types can cause substantial discomfort, too. The difference is often found in the combination of symptoms, how quickly the pain starts, how long it lasts, and whether similar episodes follow a recurring pattern. No single feature, including pain intensity or location, reliably separates every migraine from every other headache.
How do migraine, tension, cluster, and sinus headaches compare?
These common headache patterns provide useful context when describing symptoms to a healthcare professional. They are examples rather than a checklist for diagnosing yourself.
1. Migraine: throbbing pain with other symptoms
- Pain often throbs or pulses and may affect one side of the head or both.
- Light, sound, and sometimes smells may become difficult to tolerate.
- Nausea or vomiting may occur.
- Ordinary movement or physical activity may worsen the discomfort.
- An attack may continue for several hours or up to three days if untreated.
- Some people experience visual changes, tingling, or difficulty speaking as part of an aura.
Migraine does not always involve a severe headache. Some people have less intense pain or experience migraine symptoms without the typical combination of features. Others notice warning signs, such as unusual tiredness or changes in mood, before the headache begins. Aura is not present in everyone, and new neurological symptoms should not automatically be assumed to be migraine.
2. Tension headache: pressure or tightness
A tension-type headache commonly feels like a tight band around the head or steady pressure across the forehead and temples. The pain often affects both sides and may come with tight or aching muscles in the scalp, neck, or shoulders. It generally does not worsen with ordinary activities such as walking, and it is less likely than migraine to cause strong sensitivity to both light and sound.
According to Cleveland Clinic, tension headaches can last anywhere from 30 minutes to a week, although many last four to six hours. Stress, poor sleep, neck strain, and prolonged eye strain may be associated with these headaches. A tension headache can still interfere with work, study, or everyday tasks, particularly when episodes occur frequently.
One important distinction is the overall symptom pattern. Pressure on both sides without nausea may fit a tension-type pattern more closely, while throbbing pain with nausea and marked light sensitivity may be more consistent with migraine. However, there can be overlap, and people may experience more than one type of headache.
3. Cluster headache: intense pain around one eye
Cluster headaches often cause very intense, sharp, burning, or stabbing pain around one eye or temple. The pain is typically on one side and may occur alongside symptoms on that same side, such as a red or watery eye, a drooping eyelid, or a blocked or runny nostril. Some people feel restless during an attack rather than wanting to lie still.
Cleveland Clinic notes that cluster headache attacks often reach their peak quickly and typically last around 15 minutes to three hours. Episodes can recur several times in a day and may follow a pattern over weeks or months before settling for a period. This short, repeated pattern differs from the longer attacks often seen with migraine.
Because cluster headaches can cause severe pain and affect the eye and surrounding area, a new pattern of one-sided eye pain should be medically assessed. A painful red eye or a change in vision also warrants urgent evaluation rather than being assumed to be a primary headache disorder.
4. Sinus headache: facial pain with signs of sinus inflammation
Sinus-related pain is usually felt as dull pressure or aching in the forehead, cheeks, behind the eyes, or around the bridge of the nose. It may feel worse when bending forward or moving the head suddenly. When the pain is caused by sinusitis, other symptoms can include nasal congestion, postnasal drip, cough, fever, or fatigue.
According to Cleveland Clinic, migraine and sinus-related headaches can be confused because symptoms and the location of facial pain may overlap. Nasal symptoms alone do not establish that a headache comes from the sinuses. A healthcare professional can assess whether sinus inflammation or another headache disorder better explains the symptoms.
If facial pressure occurs with a persistent or worsening illness, or sinus symptoms do not improve, seek medical advice. The appropriate treatment depends on the underlying cause, so it is important to distinguish a sinus infection from migraine or another headache type.
Does the location of headache pain tell you what is causing it?
Location can offer a clue, but it cannot identify the cause on its own. Migraine may affect one side of the head, both sides, the forehead, or the area around the temples. Tension headaches often feel more widespread or band-like. Cluster headaches characteristically affect the area around one eye, while sinus-related discomfort often involves the forehead and cheeks.
These patterns are not exclusive. Migraine can cause facial pressure or symptoms that resemble sinus problems, and pain on one side can occur with several headache disorders. A headache that changes sides, spreads across the head, or feels different from previous episodes also needs to be considered in context rather than judged by location alone.
How long does each type of headache last?
The timing of an episode is another useful detail to track. Migraine attacks commonly last four to 72 hours when untreated. Tension headaches can persist for minutes or extend over several days. Cluster headaches are usually much shorter, often lasting minutes to a few hours, but may recur repeatedly in a day. Sinus-related pain may continue while the underlying sinus inflammation or infection persists.
These time ranges describe common patterns, not strict limits. Treatment can change the course of a headache, and an episode that falls within a typical duration does not by itself establish a diagnosis. The number of headache days, the intervals between episodes, and changes over time may be equally useful when a clinician evaluates the problem.
What information helps a doctor distinguish migraine from other headaches?
Healthcare professionals usually consider the full history of the headache, the symptoms that accompany it, a physical and neurological examination when appropriate, and any signs that suggest another cause. Tests are not always needed for a typical, established headache pattern, but further evaluation may be appropriate when symptoms are unusual or concerning.
Keeping a headache diary can make the history easier to explain. Record when each episode begins and ends, where the pain occurs, whether it throbs or feels like pressure, and whether movement makes it worse. Note nausea, vomiting, visual changes, light or sound sensitivity, nasal symptoms, sleep patterns, possible triggers, menstrual timing when relevant, and any medication used.
Arrange a medical appointment if headaches are recurring, becoming more frequent or painful, interfering with daily activities, or not improving with usual measures. It is also important to get a new or changed headache pattern evaluated, especially when the symptoms are difficult to interpret or treatment decisions are needed.
When is a headache an emergency?
Most headaches are not caused by a life-threatening condition, but some symptoms require immediate medical attention. Seek emergency care for a headache that starts suddenly and becomes severe within seconds or minutes, particularly if it is the worst headache you have experienced.
Mayo Clinic's headache guidance also identifies warning signs that can accompany serious conditions. Seek emergency care if a headache occurs with new weakness or numbness, confusion, difficulty speaking or walking, fainting, a stiff neck with fever, or significant vision problems. A headache following a head injury also needs prompt assessment, especially if symptoms are severe or worsening.
Do not assume that a sudden or unfamiliar headache is migraine simply because some symptoms resemble previous attacks. New neurological symptoms, a major change in the usual pattern, or a rapidly worsening headache call for medical assessment. If you are unsure how urgently symptoms need attention, contact a healthcare professional promptly.
What is the most useful way to tell these headaches apart?
Look at the overall pattern rather than one symptom. Throbbing pain with nausea and sensitivity to light or sound may occur with migraine; steady, band-like pressure is common with tension headaches; short, intense attacks around one eye with tearing or nasal symptoms may occur with cluster headaches; and facial pressure accompanied by signs of sinus inflammation may be sinus-related. These distinctions can help guide a clinical conversation, but assessment is needed when symptoms recur, change, or remain unexplained.