What is the main difference between a migraine and a tension headache?

A migraine is typically a severe, throbbing pain on one side of the head often accompanied by nausea and light sensitivity. A tension headache is a dull, squeezing pain felt on both sides of the head, often linked to neck tension and posture.

How can an Osteopath help with headaches?

Osteopaths use soft tissue techniques and spinal articulations to reduce tension in the neck, shoulders, and scalp muscles, which are common triggers for tension-type headaches.

Headaches vs Migraine – The Ultimate Guide

Written by: James Gill BOst GOsC 6039. Registered Osteopath, Founder & Clinic Director

Medically Reviewed Shibin Vinod BPT, HCPC PH124277, CSP 111177, MSc Sport and Exercise Medicine | MSK Physiotherapist

Headaches

Headache

Headaches are generally classified by their cause and can be categorized into two main groups: primary headaches and secondary headaches.

Primary headaches are headaches that have not been caused by any other medical condition. Whereas, secondary headaches are headaches that are caused by an underlying medical condition. This blog will explain the main types of primary headaches and their causes.

Primary headaches can occur at any age and are one of the most prevalent neurological conditions. There are two main types of primary headaches: migraines and tension type headache.

Migraine

What is a migraine?

A migraine headache is described as a moderate to severe one-sided headache. It is normally pulsating in nature. How long do migraines last, anywhere from 4-72 hours.

There are several different types of migraine:

Migraine with aura – A migraine aura is when an individual has sensory warning signs prior to the headache. These warning signs may include visual disturbances, dizziness, blind spots, flashing lights, tingling in the face or hands.
Migraine without aura – this is the most common type of migraine and as the name suggests, it is a migraine that occurs without any of the sensory warning signs.
Chronic migraine – This is when an individual experiences a migraine headache on 15 or more days a month over a period of three months.
Menstrual migraine – This is a condition in which an individual is likely to experience a migraine shortly before or during menstruation. This is due to the sudden natural drop in oestrogen whilst menstruating.
Hemiplegic migraine – This is a rare condition in which there is temporary weakness on one side of the body.
Abdominal Migraine – Also known as stomach migraines. This type of migraine is more common to see this type of migraine in children. Symptoms include abdominal pain with loss of appetite, nausea and vomiting and headache.
Vestibular migraine – This is a condition in which there is a problem within the nervous system that causes repeated dizziness in people who have a history of migraine symptoms.
Visual migraine – Also known as optical migraine, ocular migraine or retinal migraines is a rare condition in which an individual may suffer from visual disturbances such as; temporary visual loss, blind spots, zig zag lines or seeing stars.

What are the symptoms of a migraine?

As well as having a headache, individuals may also experience other migraine symptoms, including:

What are the causes of migraine?

The exact causes of migraines still remain to be unknown, however researchers believe that migraines occur as a result of abnormal brain activity. This can affect the brain’s chemicals, blood vessels and communication between the nerves.

Research has also demonstrated genetics to play a role in migraines. It has been shown to make individuals more sensitive to certain triggers that are likely to set off a migraine. There are many possible migraine triggers, including;

How is a migraine diagnosed?

It is recommended to seek advice from your GP if you think you are suffering from migraines. Your GP may perform a range of tests to exclude any other cause of headache, this may include but is not limited to:

What are the treatment options for migraine?

Currently, there is not one single cure for migraine. Therefore, the main aim of treatment is to reduce the frequency of migraines and to control the symptoms of the migraine. There are many different types of treatment for migraine, these include:

Over the counter pain relief medication such as paracetamol, anti inflammatory drugs such as ibuprofen or aspirin can help to reduce migraine symptoms.
A newer class of drugs known as Triptans can be prescribed by your GP. Triptans work by increasing serotonin levels and reducing inflammation in your brain.
Anti-nausea medication can help with reducing nausea and vomiting. These drugs are usually taken along with painkillers.

Tension Type Headache

What is a tension type headache?

A tension headache is described as a mild to moderate bilateral (both sides) headache.
It is the most common type of primary headache and it is usually dull or squeezing in nature, lasting anywhere from 30 minutes to several days.

There are two main types of tension headache:

What are the symptoms of a tension type headache?

As well as having a bilateral headache individuals may also experience pressure behind the eyes and tension in the neck and shoulders. The headache is not usually affected by normal daily routines and there is no nausea or visual disturbances associated. Photophobia and phonophobia may be experienced.

How is a tension type headache diagnosed?

Tension type headaches are diagnosed mainly through the patients reported symptoms. Sometimes physical examinations and tests may be taken to exclude any other cause of headache.

On physical examination of the neck there may be tenderness on palpation of the neck and scalp muscles which may elicit or increase headache symptoms.

What are the causes of tension type headache?

There is not one single cause of tension type headache. It is multifactorial in nature, meaning there are many different causes. Certain factors have been shown to trigger tension type headaches and are mainly linked to increased strain of the muscles of the head and neck. Triggers include:

Poor posture
Stress
Anxiety
Jaw or dental problems.

Addressing underlying jaw dysfunction through specialised TMJ jaw pain treatment is often the key to resolving chronic tension headaches.

What are the treatment options for a tension type headache?

There are various different treatment options for Tension type headaches. These include:

Chiropractic, Physiotherapy, Osteopathy and other types of manual therapies including Deep Tissue Massage can help with treating the symptoms of tension type headache. Therapists will use a variety of soft tissue techniques and spinal articulations to help reduce the tension in the neck and shoulder muscles.
Postural improvement – poor posture can increase the amount of strain on certain muscles and joints around the head and neck. Improving your posture when sitting and standing is a great way to relieve pressure on the neck and shoulders. Pilates is a great way of using exercises to help improve your posture and increase the strength of the muscles surrounding your upper back and neck.
Hot compress- using a heat pack on your shoulder muscles is another great way to help relax the muscles around your shoulders.
Relaxation techniques – Stress and anxiety is one trigger for tension type headaches. Meditation or taking time out of your day to concentrate on deep breathing are great ways to help reduce stress.
Acupuncture is classed as an alternative therapy and may reduce stress and tension in the body. Fine needles are placed in certain areas of the body, including the neck and shoulders.