Headache symptoms always include pain in the head. Tension headaches include muscle tension, while migraines may include nausea and sensory changes.
The main symptom of a headache is pain in the head; all headaches have this in common. However, there are many different potential causes of headache, and each type will have slightly different symptoms associated with it.
The two most common types of headaches are tension headaches and migraine headaches. Symptoms associated with tension headaches include:
• Dull, aching pain on both sides of the head, which begins gradually and may vary in intensity throughout the day
• A feeling of pressure or tightness in the head, often described as feeling like a tight band around the head
• Tight or tender muscles in the neck and/or scalp
Tension headaches are caused by tightness or tension in the muscles of the neck, shoulders, scalp, and face. They are often exacerbated by stress. The pain is often present throughout the day (though it may vary in intensity) and is usually a dull, aching pain (rather than the throbbing pain more associated with migraines). It’s diffuse and usually present all over the head, rather than on one side or in one spot. Tension or tenderness in the muscles of the neck and scalp is associated with tension headaches.
Symptoms associated with migraine headaches include:
• Throbbing or pulsating pain in the head, on one or both sides
• An “aura” preceding the headache, which often consists of seeing spots or patches of light
• Nausea and vomiting
• Sensitivity to light and sound
• Fatigue or dizziness
Unlike the pain of a tension headache, migraine headaches may cause pain on one side only; sometimes, the pain moves between different regions. A sure sign of a migraine is the presence of an “aura” beforehand, during which the person experiences sensations that aren’t really present, such as seeing patches or spots of light. While most migraine patients do not have an aura, the presence of an aura signifies that the headache is a migraine.
A migraine often causes nausea and vomiting during the headache. This makes it difficult to take medication to control the pain; some migraine medications are available as suppositories for this reason. Patients may be very sensitive to light and sound during a migraine, and may wish to lie down in a dark, quiet room. Additionally, a migraine may make the patient feel very tired, and they may also feel dizzy. As a result, functioning at work or school during a migraine is very difficult.
There are other causes of headache than these two most common ones. Some are very serious, such as a brain tumor, stroke, or infection. If you have the worst headache of your life (different from previous headaches you have had), or if your headache is associated with other symptoms such as fever, changes in sensation or motor function, trouble speaking or understanding speech, loss of balance, a very stiff neck, or anything else unusual, you should visit an emergency room to rule out these serious causes of headache.
National Institute of Neurological Disorders and Stroke (NINDS). “NINDS Headache Information Page.” NINDS website (2015). http://www.ninds.nih.gov/disorders/headache/headache.htm
Mayo Clinic Staff. “Migraine: Symptoms.” Mayo Clinic website (2013). http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/symptoms/con-20026358
Mayo Clinic Staff. “Tension headache: Symptoms.” Mayo Clinic website (2013). http://www.mayoclinic.org/diseases-conditions/tension-headache/basics/symptoms/con-20014295