How can tension-type headache be distinguished from migraine?
Tension-type headache often feels like pressure on both sides, while migraine may be throbbing, more disabling and associated with nausea or sensitivity to light or sound. Migraine is not always one-sided, and no single feature establishes the diagnosis. Attack patterns and assessment help distinguish them.
Details
Notice activity and associated symptoms
Normal activities may remain possible with tension-type headache, whereas movement can worsen migraine pain. Visual or sensory aura precedes some migraine attacks, but many people do not have aura.
Keep a headache diary
Record duration, frequency, symptoms, triggers, medicines and days of use. Excessive painkiller use can worsen headache. A clinician can discuss acute and preventive treatment rather than one prescription for every headache type.
Recognize urgent features
A sudden extremely severe headache, weakness, speech or consciousness changes, or fever with neck stiffness requires emergency assessment. A new severe headache during pregnancy or after birth needs prompt evaluation rather than being assumed to be usual migraine.
Related reading: What causes neck pain on waking, and what can help?.