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Headache or migraine? Know the difference

Woman rubbing her temples - Headache vs migraine
Most common causes of a primary headache include lack of sleep, skipping meals, overuse of caffeine, dehydration and lack of exercise.

Editor’s note: This post was revised to clarify how sleep can offer migraine relief.

Headaches are common and can occur for different reasons. But certain types of headaches suddenly can happen and cause enough pain that some people have difficulty tolerating them. These types of headaches are known as migraines.

What makes a migraine different from a regular headache? Certain signs and symptoms separate the two and also can signal when a headache is much more than a migraine.

More than a “common headache”

A migraine simply is a type of headache.

Julie Smith, a child neurology registered nurse at Marshfield Clinic, says before a migraine is diagnosed, the provider has to evaluate the patient and see if he or she has what’s called a primary or secondary headache.

“A primary headache is what people are used to,” Smith said. “Migraines, tension headaches, and cluster and chronic daily headaches are primary headaches. It’s the secondary ones we really have to watch for because they have an organic cause. It can be an infection, trauma or problems in the structure of the brain.”

4 criteria that signal it’s a migraine

For a primary headache, there can be a number of causes. Most common causes include lack of sleep, skipping meals, overuse of caffeine, dehydration and lack of exercise. Doctors also should ask about stress.

For it to be a migraine, the headache has to meet certain criteria:

  • The onset of pain is sudden and happens quickly.
  • Headache pain usually is pounding or throbbing in nature and often is associated with nausea or vomiting.
  • Light, sound or smell sensitivity can be triggers.
  • Usually the pain will peak (comes quickly), and then will fall (ends).

Children also can get migraines, but they experience them differently from adults. Adults usually get migraines on one side, while children can get them on both sides of the head.

Sleep can offer relief

“I always suggest that at the onset of pain, take some medication and go to bed,” Smith said. “Sleep is the best thing you can do for a migraine.”

Sometimes, sleep isn’t an option. Using their best judgment, parents should encourage kids to attend school and help them learn how to work through migraines. Have a treatment plan in place so if your child does get headaches at school, he can lie down for 30-45 minutes to see if it gets better.

Other treatments that can help include taking acetaminophen, ibuprofen and other non-steroidal anti-inflammatories. Headaches and migraines also can be treated by eating regularly, avoiding caffeine and drinking plenty of fluids.

When it’s more than a headache or migraine

Smith said some headaches shouldn’t be ignored. These include “secondary” headaches.

“If you have a headache that’s so severe it’s the worst headache you’ve ever had in your life, go to the doctor immediately,” Smith said. “Also, go if you have visual changes, your speech is slurred, or you experience signs of other neurological problems.”

Fever accompanied with neck stiffness, a constant headache with vomiting and differences in gait and speech also are signs you should go to the doctor.

If your child is complaining about a headache and is under age 5, or if your child is waking up with headaches and vomiting profusely, go to the doctor.

“There could be underlying structure abnormalities, or an infection such as meningitis or encephalitis,” Smith said. “So it’s better to be safe and get it checked out.”

If you have headaches or migraines, or if you think it’s more than a headache, contact your doctor and schedule an appointment.

13 responses to “Headache or migraine? Know the difference”

  1. David

    Currently, who are the physicians that treat migraines at the Marshfield clinic?

    1. Jacob Zipperer

      Hello David,

      Thank you for reaching out. Here is a list of Marshfield Clinic Health System doctors who specialize in this area: https://www.marshfieldclinic.org/doctors/search/?k=%22migraine%20headache%22&ek=Migraine%20Headache

      Thank you and hope that helps,
      Jake

  2. Lyn H.

    Kristen/Julie

    Sending a child to school w/a migraine is/can cause a lot of issues! The symptoms that goes w/them are a bit to handle. Are the teachers, students, office staff, janitorial team and school nurse going to accept the throwing up, groans and tears due to the pain, being in a dark quiet area for 30-45 minutes for the headache to improve. I've never had a migraine that improved in that amount of time. The pain the migraine produces is so extreme that you don't want to move the body in anyway. Are the above people going to be willing to clean up the vomit, urine, change the child's clothing and carry her/him to the nurse's station? The first thing that will take place is call the parent(s). Child needs to be picked up!. If you have had a child that has migraines, it is very draining and generally impossible to make them comfortable. As for the adult having migraines when I get them…there is no release of the pain. The only way I get thru them is taking something that will knock me out 4-6 hrs.and hopefully the stomach will keep it down. Yet, there has been migraines that will not respond to the medication and my body is exhausted that I just sleep and HOPE that when the body awakes there is enough relief to now "work thru it" and pray that goes that easy.

  3. Karen Moe

    Obviously, Marshfield Clinic is not the place to go with a migraine. Have you ever lied in bed and wondered if you could call 911 for a headache, and then admit that in order to do that, you would have to move. My headaches were so severe that even the thought of moving caused greater pain.
    I had a plan at school for my daughter. The nurse would give her aspirin and have her lie in the office for 30 minutes. Then she would call me to come and get her. Kerrie was never able to "work through" her headaches.

  4. Kathleen

    I agree with these other comments… this article is poorly written. It does not even begin to communicate the significance of migraine and how it affects those of us who suffer from this disease. Yes, disease. The term migraine headache is a misnomer… Headache is one symptom of migraine. In fact younger children who suffer from migraine often do not have headaches, but rather abdominal symptoms. Those of us who experience these powerful and debilitating headaches need more than just sleep. Your follow-up comments about not allowing children to use their headaches as an excuse to avoid going to school is absurd. Any child suffering from migraine headaches is not trying to avoid school. All they want is for the pain to stop. Lying down for 30-45 minutes is not likely to improve the headache. Children and adults who suffer from migraine headaches should be under the care of a "headache specialist", not necessarily a neurologist. Migraine headaches affect more people than diabetes and more hours of work are lost every year than any other medical conditions. If you are going to post an article about an issue it needs to well written and explain/depict the information more accurately. Respectfully and Sincerely submitted.

  5. Janet Knutson

    I have had migraines for 60 years. As a kid I had nausea, loss of vision,severe headaches. Maybe for 2 days. To bed in dark room. At 73 I still get them in clusters. Aspirin and diet coke is the best.

  6. Laura

    There are so many additional causes of migraines that weren't even touched on. I understand that there is no way to touch on everything but this article made me feel that migraines are really no big deal! As someone that has had migraines for 40 years they are a big deal. I have tried to explain and educate numerous employers over the years, I always look for new info to share. Unfortunately this isn't an article I would be able to share.

  7. Roxanne Gronski

    You may claim that Julie provided clarification but at no point did I read the words "When sleep is an option". How very irresponsible of you to say, and believe, that. Obviously you have never had a migraine, or watched your daughter, have a headache so bad that they are throwing up. Next time I will just tell myself, and my daughter, to just "work through it"!
    My mother taught me that if I'm wrong to admit it and that my words should not need "clarification". I guess that must not have been taught to everyone..

    1. Kirsten Shakal, Shine365 Editor

      I apologize, Roxanne. The story has been updated. Thank you for sharing your concerns. -Kirstie

  8. LuEtta Antenne

    I have suffered with migraines for over fifty years. There is no way, if my child had a migraine, would I insist they "push through" and go to school or anywhere but to bed. That is a truly irresponsible thing to say, people. You apparently have never had a migraine headache.

    1. Kirsten Shakal, Shine365 Editor

      Hi, Luetta. Apologies for the confusion. To clarify, Julie said when sleep is an option, that is the most effective way to go. However, it's best not to let it become a routine "excuse" for a child to miss school. You, as the parent, and your child's doctor know your child's health best, and ultimately it is your decision.

      Julie added it is also important to have a treatment plan available at school since headaches are short lived for some children. If you have a plan in place where they can lie down and rest for 30-45 minutes at school to see if the headache improves, you may be able to avoid school absences.

      I hope that helps. -Kirstie

  9. Roxanne Gronski

    I am confused. Your article states “I always suggest that at the onset of pain, take some medication and go to bed,” Smith said. “Sleep is the best thing you can do for a migraine.” Yet the last statement in that section says: "Parents and providers should push kids to go to school and teach them to work through migraines."

    The article also states that Migraines most often come with headache pain usually is pounding or throbbing in nature and often is associated with nausea or vomiting.

    I am sorry but if I, or my child, has a migraine, I am not asking them to go to school and learn how to work through it! Terrible statement and very contradictory.

    1. Kirsten Shakal, Shine365 Editor

      Hi, Roxanne. As I shared with Luetta in her comment, Julie provided clarification on this:

      When sleep is an option, that is the most effective way to go. However, it's best not to let it become a routine "excuse" for a child to miss school. You, as the parent, and your child's doctor know your child's health best, and ultimately it is your decision.

      Julie added it is also important to have a treatment plan available at school since headaches are sometimes short lived. If you have a plan in place where your child can lie down and rest for 30-45 minutes at school to see if the headache improves, you may be able to avoid school absences.

      -Kirstie

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