Migraine vs Tension Headache: How to Tell the Difference
Tension headaches usually cause a dull, tight band-like pressure on both sides of the head, while migraines typically cause throbbing pain, often on one side, with nausea and sensitivity to light or sound. Knowing which one you have helps you choose the right self-care and know when to see a doctor.
Side-by-Side Comparison
- Dull, steady pressure like a tight band
- Both sides of the head, with neck and shoulder stiffness
- Mild to moderate; you can usually carry on
- Rarely causes nausea or vomiting
- Moderate to severe throbbing, often one-sided
- Nausea, vomiting, or sensitivity to light, sound and smells
- Gets worse with movement, so you want a dark, quiet room
- May start with an aura beforehand
| Feature | Tension headache | Migraine |
|---|---|---|
| Pain type | Dull, pressing, tight | Throbbing, pulsing |
| Location | Both sides | Often one side |
| Severity | Mild to moderate | Moderate to severe |
| Nausea or light sensitivity | Uncommon | Common |
| Effect of activity | Usually no change | Often worse |
Common Triggers
Sleep and migraines are closely linked, which we cover in best ways to avoid migraines and insomnia. Stress is another common driver; see how stress and anxiety cause insomnia.
What Can Help at Home
- Rest in a quiet, dark room during a migraine
- Drink water and eat regular meals
- Cool cloth on the forehead, or a warm compress on a tight neck
- Keep a regular sleep schedule
- Keep a headache diary to spot triggers
- Taking pain relievers on many days each month, which can cause medication-overuse headache
- Skipping meals or sleep
- Ignoring changing or worsening headaches
Over-the-counter pain relievers help some people. Follow the label, ask a pharmacist if unsure, and talk to a doctor if you need pain relief on many days.
- A sudden, severe “worst ever” headache
- Headache after a head injury
- Headache with fever and a stiff neck, confusion, weakness, trouble speaking or vision loss
- New headaches after age 50 or headaches that keep getting worse
Looking for migraine and headache care?
Explore our migraine categories. Please consult a doctor before using any medicine.
Migraine medicinesTreatment of migraineFrequently Asked Questions
Can a tension headache turn into a migraine?
They are different conditions, but some people have both and the symptoms can overlap.
Is a migraine just a bad headache?
No. Migraine is a neurological condition with a pattern of symptoms beyond pain.
Can dehydration cause headaches?
It can be a trigger for some people, so drinking enough fluids is sensible.
More Reading
Sources: National Institute of Neurological Disorders and Stroke (NINDS), “Headache Information Page”; American Migraine Foundation; Mayo Clinic patient information on migraine and tension headache.