Primary or secondary headaches?
To fully understand the difference between a tension headache and a migraine , it is necessary to consult the international classification of headaches . This distinguishes between two types of headaches: primary headaches and secondary headaches . The latter are the consequence of an additional problem, it can be an infection, a cranial trauma, an abuse of drugs or substances, etc. Typically, Arnold's neuralgia is one of the secondary headaches, it is the consequence of a compression of one of the occipital nerves. Migraine and tension headache are primary headaches that share many commonalities, but also have several differences.
Distinguishing tension headache from migraine
We will discuss here under the term migraine, migraine without aura . Migraine aura extends a migraine subtype. The diagnosis between migraine and tension headache can be difficult, because on the one hand the phenotype of the disease can be very similar and that very often the patient who has frequent headaches can suffer from both migraines combined with tension headaches . These two pathologies progress through headache attacks , can associate sensitivity to noise and light and associate sensitivity disorders in the skin and muscles. Both are subdivided into two subtypes " episodic " and " chronic ". Tension headache further subdivides the episodic type into “infrequent” and “frequent”.
A different pain
To distinguish between these two headaches, one must first consider the quality of the pain . In a tension headache, the pain is mild to moderate, while in a migraine it can be much more severe and can be described as severe . The duration of the attack is also markedly different, the tension headache can last from a few minutes to several days while the migraine attack will be limited to 72 hours at most. The localization of the pain also varies, it is mainly bilateral in the tension headache whereas in the migraine it will most often be localized on one side of the head. A patient with tension headaches will feel a pinch sensation between the front and back of the head, while a migraine patient will feel a throbbing pain .
In conclusion, if these headaches are very often confused with each other, there are nonetheless important differences that should guide the diagnosis. We have listed the characteristics of headaches in the table below. This will make it easy for you to navigate between tension headache and migraine.