Migraines vs Headaches: Key Differences, Common Triggers and When to Seek Help

Migraine is not simply a more painful version of an ordinary headache. Headache is a symptom, while migraine is a neurological disorder that can cause recurring attacks involving head pain and other symptoms. When people compare “migraine versus headache”, they usually mean migraine versus a common primary headache such as tension-type headache.

Migraine often causes moderate to severe throbbing pain, nausea, and sensitivity to light or sound, and it may worsen with routine activity. Tension-type headache more often feels like mild to moderate pressure or tightness on both sides and is not usually aggravated by normal movement. These patterns overlap, so symptoms alone cannot confirm a diagnosis.¹²

Safety first: Call triple zero (000) for a sudden severe headache or possible stroke signs such as facial droop, arm weakness or difficulty speaking. Go immediately to an emergency department for a severe headache with vomiting, confusion, neck stiffness, a seizure or sudden vision changes. Do not use this comparison to self-diagnose a new or unusual headache.³⁴

Migraine, headache and tension-type headache are not interchangeable terms

“Headache” describes pain felt in the head. It does not identify one cause. Headaches may be primary disorders, such as migraine, tension-type headache or cluster headache, or may occur because of another health problem.³

Migraine is a specific disorder with a recognisable pattern of attacks. Head pain is common during migraine, but the attack may also affect vision, sensation, speech, digestion, energy and the ability to tolerate light or sound. Some people experience migraine aura without a later headache.¹

Tension-type headache is another primary headache disorder. It typically produces a pressing or tightening sensation rather than a throbbing one. It may be the pattern someone has in mind when they say they have a “normal headache”, but a familiar label should never override new warning signs.

Our broader headache, migraine and neck-tension guide explains how the overall pattern, safety signs and effect on daily life help determine an appropriate care path.

Migraine versus tension-type headache: a practical comparison

This table summarises common tendencies, not diagnostic rules.¹²

Feature	Migraine	Tension-type headache
Pain quality	Often throbbing or pulsating	Often pressing or tightening, sometimes described as a band
Intensity	Often moderate to severe and may stop normal activities	Usually mild to moderate; activity may still be possible
Location	Commonly one side, but can affect both sides	Commonly both sides
Routine activity	Walking or climbing stairs may make symptoms worse	Normal movement does not usually make it worse
Other symptoms	Nausea or vomiting; sensitivity to light, sound or sometimes smell	Neck or shoulder soreness may occur; nausea is less typical
Aura	Some people have reversible visual, sensory or speech symptoms	Aura is not a feature of tension-type headache
Duration	An untreated attack can last about 4 hours to 3 days	Can last from 30 minutes to several days
After the pain	Tiredness, difficulty concentrating or feeling unwell may continue	A distinct recovery phase is less typical

A person does not need every feature to have migraine, and pain does not have to be one-sided. Someone can also experience more than one headache disorder. A GP can assess the history and examination findings rather than relying on one symptom.

What is migraine aura?

Aura is a group of temporary, fully reversible neurological symptoms that can occur before or during a migraine attack. It most often affects vision, but can affect sensation or speech. Examples include flashing lights, zigzag lines, blind spots, tingling or difficulty finding words. Aura usually develops over several minutes and resolves, often within an hour.¹

Not everyone with migraine experiences aura, and aura is not the same as simply feeling that a headache is about to start. Some people instead notice earlier non-aura symptoms such as fatigue, food cravings, yawning, mood changes or neck stiffness.

New neurological symptoms should not automatically be labelled as migraine aura. Stroke can also cause visual, sensory or speech changes. If symptoms are sudden, unfamiliar, prolonged, include weakness, or otherwise concern you, call 000—especially if you cannot confidently recognise them as part of a previously assessed pattern.⁴

What can trigger a migraine attack?

A trigger is a circumstance that appears to increase the chance of an attack; it is not the underlying cause of migraine. Triggers differ between people, can change over time and often act in combination. Sometimes an apparent “trigger”—such as craving a food—may actually be an early symptom of the attack.

Commonly reported possibilities include:¹⁵

• stress or the period after stress eases;
• missing meals or changes in usual eating patterns;
• too little sleep, too much sleep or a disrupted sleep schedule;
• hormonal changes, including around menstruation;
• bright or flashing light;
• alcohol or an individually identified food or drink;
• weather or temperature changes; and
• changes in caffeine intake.

Neck stiffness can occur during migraine, so it does not automatically mean neck posture or spinal alignment triggered the attack.¹ Likewise, a long screen session may coincide with missed meals, reduced movement, visual strain, stress and disrupted sleep. A diary is more useful than assuming one factor is responsible.

Trying to avoid every item on a generic trigger list can become unnecessarily restrictive. Focus on repeatable patterns in your own diary and discuss major dietary, medicine or lifestyle changes with an appropriate health professional.

How to keep a useful headache and migraine diary

Record enough detail to reveal patterns without turning every day into an investigation.

What to record	Useful detail
Timing	Start time, how quickly symptoms developed and when they ended
Pain	Location, pressure or throbbing, and severity from 0–10
Associated symptoms	Nausea, vomiting, light or sound sensitivity, aura, neck discomfort or neurological changes
Daily context	Sleep, meals, hydration, menstrual cycle, stress, screen work, exercise and illness
Impact	Whether you could work, drive, exercise, eat or sleep normally
Medicines	Name, dose, time taken, response and every day on which acute headache medicine was used
Changes	Anything different from your usual pattern

Bring the diary and a current medicines list to your GP or other appointment. Do not delay urgent care to complete a diary entry.

When should you seek help for a headache or migraine?

Call 000 or seek emergency care now

Call 000 for a sudden severe headache, particularly one that reaches maximum intensity rapidly, or for possible stroke symptoms. Use the F.A.S.T. check: facial droop, inability to lift both arms, slurred or difficult speech—time is critical, so call 000.⁴

Seek immediate emergency care for a severe headache with:³

• confusion, fainting, unusual behaviour or reduced consciousness;
• fever or marked neck stiffness;
• unexplained vomiting;
• a seizure;
• sudden blurred, double or lost vision;
• weakness, numbness, loss of balance or difficulty speaking; or
• onset after a significant head injury.

Emergency warning-sign lists are not exhaustive. If a headache is sudden, severe, rapidly changing or deeply concerning, seek urgent help.

Arrange a GP assessment

See a GP when headaches are new, recurring, becoming more frequent or severe, changing from the usual pattern, or interfering with work, sleep or other normal activities. Prompt medical advice is also important for a new headache during pregnancy or after birth, with cancer or reduced immunity, or while taking anticoagulant medicine.³⁵

A GP can consider the complete pattern, carry out a neurological and general examination, review medicines and decide whether tests, preventive treatment or specialist referral are appropriate. Not everyone with recurring headache needs a scan; the decision depends on the history, examination and warning signs.

Ask about medicine safety

A pharmacist or GP can advise whether an acute headache medicine is suitable alongside your conditions and other medicines. Follow the label or prescription. Using acute medicines too often can contribute to medication-overuse headache, so record every treatment day and seek advice if use is becoming frequent.⁵

Consider musculoskeletal assessment only when appropriate

After urgent and other medical causes have been considered, an assessment may be relevant if a familiar headache pattern occurs with neck or shoulder discomfort, restricted movement or sustained work demands. The aim is to assess those musculoskeletal factors and decide whether care or referral is appropriate—not to claim that spinal treatment cures migraine.

Body Therapy Chiropractic’s migraine and headache pages explain the concerns assessed at the Chatswood clinic. These pages do not replace diagnosis or medical migraine management.

How Body Therapy Chiropractic can help

Migraine is a neurological disorder and is managed medically. Where an assessment can help is a different question: whether coexisting neck or shoulder problems are adding to your overall headache burden, and whether chiropractic care is a reasonable option alongside your medical care.

At our Chatswood clinic, an appointment with James Zheng (Chiropractor) follows the same structure for everyone:

• A thorough history - your headache pattern, what you have already tried, your work and activity levels, and any past injuries or health conditions. Bring any scans, reports or referrals, plus a list of your current medicines and how many days a month you use acute headache medicine.
• A physical and movement assessment - your posture, neck and upper-back movement, and how the joints and muscles involved are working, so care is based on findings rather than guesswork.
• An explanation before anything is done - we talk you through what we have found and what we recommend, in plain language, in English, Mandarin or Cantonese. Nothing proceeds without your agreement.
• Care where it is appropriate - chiropractic adjustments combined with soft-tissue therapy, with around ten minutes of massage-based muscle work part of every session.
• A personalised care plan - with practical advice such as exercises, desk and screen adjustments or activity changes, so progress continues between visits.

We will also say when chiropractic care is not the right answer. Migraine diagnosis, preventive treatment and acute medicine are matters for your GP or a specialist; a new, changing or aura-like symptom needs medical assessment first; and any of the emergency signs above needs urgent care, not an appointment with us. We will tell you so rather than starting a care plan.

Book an appointment, or read more about what to expect at a first visit.

Questions a clinician may ask

• Is this the first episode, or does it match a previously assessed pattern?
• Did the pain start suddenly or build gradually?
• Is the pain pressing, throbbing, one-sided or on both sides?
• Does normal activity make it worse?
• Are nausea, vomiting, light or sound sensitivity, aura or neck symptoms present?
• Has the pattern, frequency or severity changed?
• Which medicines are used, and on how many days each month?
• Are there neurological, infectious, injury-related or other warning signs?
• How much does the episode affect work, driving, sleep and normal activity?

Clear answers help distinguish patterns and identify when investigation or referral is more important than symptom management alone.

Common questions about migraines and headaches

Is every severe headache a migraine?

No. Migraine can cause severe pain, but other primary and secondary headaches can also be severe. A sudden “worst-ever” headache or severe pain with neurological or systemic symptoms needs emergency assessment, not a migraine label.

Can migraine occur without aura?

Yes. Many people with migraine do not experience aura. Aura is one possible feature, not a requirement for every migraine diagnosis.¹

Can migraine occur without a headache?

Yes. Some people experience migraine aura without subsequent head pain. Because new aura-like symptoms can resemble stroke or other conditions, they should be medically assessed rather than self-diagnosed.

Is neck stiffness proof that a headache comes from the neck?

No. Neck pain or stiffness can occur during migraine and tension-type headache as well as in other presentations. Timing, associated symptoms, examination findings and warning signs all matter.

Should I remove every possible migraine trigger?

Usually not. Generic lists include many normal activities and foods, while triggers vary between people. Track repeated personal patterns and discuss significant restrictions with your GP or an accredited practising dietitian.

Can chiropractic care cure migraine?

No healthcare practitioner should promise a cure for migraine. Migraine is a neurological disorder that may require medical diagnosis, acute treatment and preventive management. A chiropractor may assess coexisting musculoskeletal concerns when appropriate, but that does not replace medical care or establish that the neck caused the migraine.

What this article cannot determine

This article cannot diagnose migraine, identify the cause of a headache, distinguish aura from stroke, decide whether imaging is needed, prescribe medicine or determine whether chiropractic care is suitable. Online comparisons cannot account for every serious presentation. Seek urgent help for sudden, severe, changing or concerning symptoms.

The key difference is the whole pattern—not pain alone

Migraine is a neurological disorder with a broader attack pattern; headache is a symptom shared by many conditions. Compare the pain quality, associated symptoms, effect of activity, duration and recovery, but do not rely on a checklist for diagnosis. Track familiar episodes, arrange medical review when the pattern is new or changing, and act immediately when warning signs appear.

References

Footnotes

1. Healthdirect Australia. Migraine. Accessed 12 August 2026. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

2. Healthdirect Australia. Tension headache. Accessed 12 August 2026. ↩ ↩²

3. Healthdirect Australia. Headaches. Accessed 12 August 2026. ↩ ↩² ↩³ ↩⁴

4. Stroke Foundation Australia. Signs of stroke. Accessed 12 August 2026. ↩ ↩² ↩³

5. NSW Agency for Clinical Innovation, Emergency Care Institute. Migraine patient fact sheet. Published July 2022; accessed 12 August 2026. ↩ ↩² ↩³