How to tell a headache from a migraine

There are many different kinds of headache and each has its own distinctive symptoms. The most common is the tension headache. The pain is dull and heavy, as if a band is being tightened around your head. Tension headaches tend to worsen as the day progresses and can last several days. The cause, as the name suggests, is usually stress, and painkillers may not help. Instead, try lowering stress levels, perhaps through relaxation techniques, yoga or meditation.

Identifying migraines
Migraines are very different. They last between four hours and three days, commonly affect only one side of the head and are often characterised by a throbbing or pulsating pain. The headache may be accompanied by nausea, sensitivity to light or sound and neurological problems such as difficulty in focusing or speaking. When it is preceded by visual disturbances – hallucinations, starbursts or flashing lights – it is known as migraine with aura. Menstrual migraines are those that always occur just before or during a period.

If you suddenly start to experience frequent headaches, you should visit your GP to check out the cause: different types of headache are managed and treated in different ways. Around 60 per cent of migraine sufferers have never consulted their doctor, probably because they believe that nothing can be done. However, new products are frequently being launched.

There is no test for migraine and nobody knows its exact cause, though it is now thought to originate in the brain stem and be due to some kind of hypersensitivity. Peter Goadsby, professor of clinical neurology at the National Hospital for Neurology and Neurosurgery in London, describes migraine as an inherited predisposition to headache attacks that strike at particular times in the sufferer’s life and are provoked by external factors (known as triggers). The most significant of these he believes, is change.

‘The migrainous brain does not seem to tolerate variation as well as everybody else. If you have a tendency to headache, extremes of behaviour – such as skipping meals, sleeping in late or getting up too early, too much stress or, paradoxically, too much relaxation – can aggravate that tendency.