A pulsing sensation starts in your temples and radiates through the bridge of your nose, making you feel like there’s an invisible vice grip pressing down on you. Every sound is amplified, every light is intensified, and it feels like no amount of pain relief will make it go away. 

Sound familiar? 

Everyone gets headaches, but how do you tell if it’s just a passing headache or the start of a migraine? Migraines are intense, throbbing headaches that can last anywhere from 4 to 72 hours and are often accompanied by nausea, vomiting, sensitivity to light and sound, and other symptoms.

But there are two primary types of headaches: migraines and non-migraines. To make sure you’re treating the right type, it’s important to differentiate between them.

Common types of headaches

While migraine and typical headaches often have overlapping symptoms, there are three that are the most common.

  • Tension headaches are usually caused by stress, muscle tension, poor posture, or lack of sleep. These headaches are sharper and feel like they originate from the base of the skull or the temple area, usually accompanied by pressure.
  • Cluster headaches are less common but more intense than tension headaches. They’re characterized by sharp, stabbing pain that typically occurs on one side of the head and may be accompanied by redness in the eye, nasal congestion and a runny nose.
  • Sinus headaches are caused by inflammation of the sinuses due to allergies, infections, or other conditions that affect the sinuses. Here the pain resides in the forehead or around the eyes and cheeks as well as a stuffy or runny nose, congestion and postnasal drip.
difference of symptoms between a migraine and types of headaches

Symptoms of a migraine typical occurs on one side of the face or head. Headaches, however, can come in a variety of symptoms that often last shorter than a migraine. These include cluster, sinus, and tension headaches. (Image by Nick Ng)

What is a migraine?

A migraine, however, is far more complex. It gives you multiple symptoms and not all are accompanied by the characteristic head pain. Migraine headaches often present severe, throbbing, pain that affects one side of the head, which can make your condition far more debilitating than a regular headache. Some people may have pain in their jaw and/or lower back as their symptoms.

Migraines are divided into four distinct phases:

  • Premonitory (or prodrome): In this phase, you may experience mental or physical changes, such as fatigue and irritability.
  • Aura: the most common symptoms are visual disturbances, such as blind spots and light flashes, but sensory issues, motor control and speech are also common.
  • Headache:  this phase can last anywhere from a few hours or a few days.
  • Postdrome: In this phase, you may feel exhausted and off with symptoms ranging from feeling drained of energy to gastrointestinal issues and can last days following the attack.

What causes a migraine?

The exact cause of migraines is not yet known, but research suggests that genetics and environmental triggers play a role in their onset. There seems to be a significant correlation between mental health, specifically in those with depression, anxiety, and stress, but here we get caught in a chicken-or-the-egg conundrum. Are these factors triggers or symptoms?

young asian woman having migraines from stress

Migraines can be caused by social factors that influence psychological and biological stressors that can make your symptoms worse. (Image by Nick Ng)

Known migraine triggers can vary greatly, but some of the more common triggers are:

While the exact biological mechanisms of a migraine is not fullyunderstood, some researchers think that the trigemnal nerve and ganglion play a significant role in developing a migraine.

simple illustration of how the brain and nerves in the face and jaw contribute to a migraine

A simplified depiction of the trigemnial nerve and its projections to the vasculature of the brain and face. Ascending nociceptive signals from the trigeminal ganglion goes into the brain stem, activating and sensitizing second-order trigeminal neurons.
Then this process activates third-order trigeminal neurons in the thalamus, which relays the information to the somatosensory cortex and other part of the brain. Identifying the ways that trigger migraines have led to treatments and therapies that target this system. (Image by Nick Ng)

Various migraine symptoms, such as nausea, vomiting, and changes in the autonomic nervous system (ANS), indicate that there are disruptions in how the central nervous system (CNS) process sensory information coming from the peripheral nerves of the face, jaw, and eyes. Triggers like the ones mentioned earlier activate pain pathways by increasing parasympathetic activity.

Stress may also activate other pathways that contribute to migraine. In rodent models, researchers found that sympathetic nerve activity that involves the release of norepinephrine, influences nociception by affecting sensory nerves and fibroblasts in the dura of the brain

Also, the release of stress-related hormones, such as corticotropin-releasing hormone (CRH) and dynorphin, and neuropeptides (e.g. calcitonin gene-related peptide (CGRP)), which activates the kappa-opioid system, may also contribute to stress-induced migraines. These physiological mechanisms involve networks that connect to specific neurons in the brainstem and may activate pain receptors in the dura and blood vessels through the release of CGRP from the parasympathetic nerves.

simplified illustration of how various hormones affect migraine symptoms via the periipheral nerves and trigemal ganglion

Migraine triggers, such as stress, activate nociceptive pathways via the parasympathetic nervous system (PNS). These pathways stem from the hypothalamus and send nociceptive signals to the superior salivatory nucleus (SSN). This cascades into a series of physiological events that lead to dilation of the blood vessels in the dura mater. (Image by Nick Ng)


simplified illustration of how various hormones affect migraine symptoms via the periipheral nerves and trigemal ganglion

Migraine triggers, such as stress, activate nociceptive pathways via the parasympathetic nervous system (PNS). These pathways stem from the hypothalamus and send nociceptive signals to the superior salivatory nucleus (SSN). This cascades into a series of physiological events that lead to dilation of the blood vessels in the dura mater. (Image by Nick Ng)

[Further exploration: Does Ehlers-Danlos Syndrome Cause a Migraine Attack?]

Episodic vs. chronic headache and migraine

On some days, the slightest noise is enough to trigger a painful migraine. Trying to make sense of what’s happening brings us to the concept of episodic vs chronic headaches. 

Episodic attacks are when symptoms are less than 15 days per month, while chronic migraine is 15 or more days per month of migraine symptoms.

Chronic migraine tends to be more debilitating than episodic because of the longer duration and greater frequency of attacks. It can be caused by a variety of underlying medical conditions, such as fibromyalgia, depression, or a physical injury. An episodic migraine is typically caused by a combination of lifestyle and environmental factors.

According to the American Migraine Foundation, if you answer “yes” to any of the following questions, then it may be time to seek help.

  • Are migraines interfering with your life?
  • Are your headaches frequent?
  • Do you have migraines more than not?
  • Are migraines distinguishing characteristics?
  • Are you self medicating too often?

Treatment for migraines and headaches

There are a lot of treatments for migraine headaches, but some of the most popular are:

  • Over-the-counter medications: non-steroidal anti-inflammatory medications (NSAID) such as ibuprofen (Advil) and naproxen (Aleve) are often used to treat migraine headaches. Though we do not know much about migraines, we do know that inflammation can cause pain.
  • Prescription medications: certain prescription medications, such as triptans and ergots, can be used to treat migraine headaches.
  • Triptans are serotonin receptor agonists that work by targeting the brain’s trigeminal nerve, which plays a role in the onset of migraines.
  • Ergots can help prevent inflammation from inflammatory disorders and constrict blood vessels, which also helps to relieve pain.
  • Exercise: regular exercise has been found to reduce the frequency of migraine attacks, as well as improve overall quality of life in those with chronic migraines. Exercise researchers have not yet been able to find why exercise helps, only that there are significant correlating factors. 

Exercise can help to reduce both stress and anxiety levels while decreasing insomnia. All of which are common triggers for migraine headaches. All of these cause us to carry more tension in our muscles, including hitching our shoulders up toward our ears or clenching of the jaw.

  • Meditation or meditative exercises: Taking time to practice mindful breathing, yoga or other meditative exercises can help to reduce stress levels and improve overall well-being. Studies have found these practices are effective in reducing the frequency of migraine attacks by addressing the underlying stress, similar to the effect that exercise has.
  • Sleep: Lack of sleep or sleep disturbances can often trigger migraine headaches therefore addressing sleep issues and correcting them will eliminate a potential trigger. Sleep affects all of the systems of the body and allows us to heal
  • Dietary changes: Reduce the consumption of foods that are known triggers like salt, fat,  caffeine, and alcohol, can help lower the frequency of migraine attacks.
  • Cognitive behavioral therapy: Cognitive behavioral therapy (CBT) has been found to be a beneficial treatment for those with chronic migraine headaches. It helps to identify and address any physical or emotional triggers that may be contributing to the migraine attacks as well as develop strategies for managing pain and stress levels. 

Does massage therapy work for migraines and headaches? 

Massage therapy can help reduce migraine and headache symptoms by stimulating the parasympathetic nervous system, which can increase oxytocin production and lower blood pressure. Furthermore, studies have found that people who receive massage for migraines often experience longer-term benefits, with a significant decrease in how often migraine attacks happen for up to six months after treatment.

However, some forms of massage are contraindicated among certain populations and require additional skill and knowledge, such as pediatric massage, oncology, or prenatal massage. Be sure to discuss any potential risks and benefits with a medical professional before starting any new treatment regimen.

Resources for migraines

If you’re looking for additional support, here are some organizations that may be able to help:

Lindsay Jones massage therapist
Lindsay Jones, LMT
Website | + posts

Lindsay is a licensed massage therapist and a mother of three, who specializes in rehabilitation with emphasis on prenatal and postnatal care.

After graduating from the National Holistic Institute in San Jose, Calif., she went on to study how pain affects the body and how it can be alleviated during the constant changes of pregnancy and early motherhood.

In her free time, Lindsay has a deep love of all forms of art from storytelling and music to sewing and painting.