The core difference: pain type and what comes with it

A headache is pain in the head or neck. A migraine is a neurological condition where that pain is one symptom among several others—nausea, sensitivity to light, sometimes vision changes or tingling. The pain itself feels different too: headaches are usually a steady pressure or ache, while migraines often throb or pulse on one side of the head.

The practical difference matters because treatment works differently for each. Over-the-counter pain relievers that stop a headache may not touch a migraine. And a migraine that feels like "just a bad headache" can get worse over hours, so knowing which one you have helps you plan your day and decide whether to see a doctor.

Most people get headaches. Most people do not get migraines. If you are unsure which you have, the details below will help you recognize the pattern.

Key Takeaways

  • Headaches cause pain in the head or neck; migraines cause throbbing pain on one side plus nausea, light sensitivity, or other symptoms.
  • Headaches usually last 30 minutes to a few hours; migraines typically last 4 to 72 hours even without treatment.
  • Standard pain relievers often work for headaches but may not stop a migraine, especially if you wait more than an hour after it starts.
  • Migraines sometimes come with warning signs (aura) like flashing lights or blind spots 15 to 60 minutes before the pain begins.
  • Keeping a record of your pain episodes—when they start, what they feel like, what makes them stop—helps a doctor tell the difference.

How the pain feels and where it shows up

A headache usually feels like pressure, tightness, or a dull ache. It can be on both sides of the head, across the forehead, at the back of the neck, or all over. The pain is steady. You can usually still think, talk, and move around, even if you are uncomfortable.

A migraine usually throbs or pulses. It is almost always on one side of the head—the right temple, the left side behind the eye, or one side of the back of the head. The pain is often severe enough that you want to lie down in a dark, quiet room. Many people say they cannot function during a migraine the way they can during a headache.

Some people get a migraine on the same side every time. Others alternate sides. The location can shift even within a single migraine episode.

What happens before, during, and after

Headaches usually start and peak within an hour. They respond to rest, hydration, or over-the-counter pain relief. Most clear up in 30 minutes to a few hours. You may feel tired or slightly off afterward, but you return to normal quickly.

Migraines often build slowly. Some people feel a migraine coming on 24 hours before the pain starts—they notice mood changes, food cravings, or fatigue. Then comes the aura phase (if you get one): 15 to 60 minutes of visual disturbances like flashing lights, zigzag lines, blind spots, or tingling in your arm or face. Then the throbbing pain arrives, usually on one side. The whole episode lasts 4 to 72 hours, even if you take pain medication. After it ends, you may feel exhausted or mentally foggy for a day.

Not everyone with migraines gets an aura. Some people go straight from feeling fine to severe pain. But if you do get an aura, that is a strong sign you have migraines, not headaches.

The symptoms that come along with the pain

Headaches cause pain and sometimes mild sensitivity to light or sound, but that is usually it. You do not feel sick to your stomach. You do not have to avoid your normal activities.

Migraines come with other symptoms:

  • Nausea or vomiting (sometimes severe enough that you cannot eat or drink)
  • Sensitivity to light—you want the room dark or you wear sunglasses indoors
  • Sensitivity to sound—normal conversation or background noise feels painful
  • Sensitivity to smell—certain odors trigger nausea or make the pain worse
  • Tingling or numbness in the face, lips, or hands
  • Difficulty concentrating or finding words
  • Dizziness or vertigo

You do not need all of these to have a migraine. Most people get three or four of them together. The combination is what sets migraines apart from headaches.

What triggers each one

Headaches usually have an obvious cause: stress, tension in your neck and shoulders, skipping meals, dehydration, or not enough sleep. Remove the cause and the headache often goes away.

Migraines can be triggered by stress, but also by specific foods (aged cheese, cured meats, chocolate, caffeine withdrawal), hormonal changes (menstrual cycle, birth control, hormone therapy), weather changes, strong smells, lack of sleep, or too much sleep. Some people notice a pattern—migraines always happen the day after they drink red wine, or always during their period. Others cannot identify a clear trigger. The triggers are often unpredictable, which is one reason migraines are harder to prevent than headaches.

How to track what you have

The most useful thing you can do is write down what happens when you get pain. Note the date, time it started, what the pain felt like, where it was, how long it lasted, what you took for it, whether it worked, and what else you felt (nausea, light sensitivity, vision changes). Do this for three or four episodes.

A pattern will usually emerge. If every episode is a steady ache that goes away in an hour, you probably get headaches. If episodes are throbbing, one-sided, last many hours, and come with nausea or light sensitivity, you probably get migraines. If you see an aura before the pain, that is almost certainly a migraine.

Bring this record to your doctor. It is more useful than trying to remember details from memory, and it helps your doctor recommend the right treatment.

When to see a doctor

See a doctor if you get headaches more than 15 days a month, or if a headache feels different from your usual ones—worse, longer, or with new symptoms. These can signal a condition that needs treatment.

See a doctor if you think you have migraines, especially if they are frequent, severe, or changing. A doctor can confirm the diagnosis and discuss options to prevent them or stop them faster. If you have never had a migraine before and suddenly develop one, or if a migraine is accompanied by fever, stiff neck, confusion, or vision loss, seek urgent care—these can be signs of something else.

Frequently Asked Questions

Can a migraine feel like a regular headache?

Yes. Some migraines are less severe than others, and a mild migraine might feel like a bad headache. The difference is usually the other symptoms—nausea, light sensitivity, or how long it lasts. If you get the same type of pain episode repeatedly and it always comes with nausea or lasts many hours, it is probably a migraine even if the pain itself is not severe.

Do migraines always hurt on one side?

Most of the time, yes. But some people get migraines that hurt all over the head or in the center. The one-sided throbbing is common, not universal. Other symptoms—aura, nausea, light sensitivity—matter more for diagnosis than the exact location of pain.

Can stress cause a migraine?

Yes. Stress is a common migraine trigger. Interestingly, migraines often hit during the relaxation period after stress ends, not during the stressful event itself. This is sometimes called a "letdown migraine" and is one reason migraines can feel unpredictable.

Will over-the-counter pain relief stop a migraine?

Sometimes, if you take it very early—within the first hour of pain starting. Once a migraine is established, standard pain relievers often do not work well. Prescription migraine medications (like triptans) are designed to work differently and are more effective for established migraines. Your doctor can discuss which option makes sense for you.

What if I get both headaches and migraines?

Many people do. You might get tension headaches from stress or poor posture, and also get migraines triggered by hormones or food. Tracking each episode helps you and your doctor tell them apart and treat each one appropriately.