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CENTROMED

Tension headache or migraine: how to tell them apart

CENTROMED medical team
Author
21 Jul 2026 · 6 min

Two different pains — two different treatments. A neurologist on simple self-check signs and when it is time to see a doctor.

A neurologist during a consultation

Tension headache

The most common type: the head feels squeezed by a “band” or “helmet”, the pain is on both sides, moderate, without nausea. It usually appears towards the end of the working day, after stress, long hours at a computer or lack of sleep, and goes away after a walk or rest.

Migraine

The pain is one-sided, throbbing and severe; it gets worse with movement and lasts from 4 hours to 3 days. It often comes with nausea and sensitivity to light and sound; sometimes an “aura” — shimmering zigzags in front of the eyes — appears before an attack.

  • One-sided throbbing plus nausea — more likely migraine
  • Two-sided pressure without nausea — more likely a tension headache
  • Pain more than 4 times a month — a reason to see a neurologist

Why it matters

With tension headaches, working on the neck and shoulder muscles, sleep and daily routine helps; with migraine — specific medication and attack prevention. A separate problem is taking painkillers more than 10 days a month: it leads to medication-overuse headache.

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