Migraine and tension-type headache compared: features, treatment and warning signs

What does a tension headache feel like?

Tension-type headache typically causes a dull, pressing or tight-band pain felt on both sides of the head. An NHS-linked self-care leaflet describes tension-type headache as mild to moderate and not made worse by ordinary daily activity.

The NHS says tension headaches last at least 30 minutes and can last for several days. MedlinePlus says tension headaches usually do not cause nausea or vomiting.

The NHS says tension headaches can be eased with painkillers and activities that help with relaxing.

What does a migraine feel like?

An NHS-linked self-care leaflet describes migraine as usually moderate to severe, on one or both sides of the head, and it can be made worse by ordinary daily activity. Nausea, vomiting, and sensitivity to light and sound are common.

Attacks typically last for hours, and some people have an aura, a set of temporary symptoms such as visual disturbance, before the headache starts.

Early warning symptoms, such as feeling very tired, can start hours or even a day or two before the head pain.

Aura can include seeing zigzag lines or flashing lights, numbness, dizziness or difficulty speaking.

How are they treated?

For tension-type headache, NICE advises considering aspirin, paracetamol or an NSAID for the acute treatment, and the NHS mentions activities that help with relaxing. NICE says treatment to help prevent the underlying headache may be offered alongside stopping the medicines that are causing medication-overuse headache.

The NHS migraine page advises taking painkillers as soon as the headache starts. For the acute treatment of migraine, NICE advises offering an oral triptan together with an NSAID, or an oral triptan together with paracetamol.

Taking painkillers or triptans too often can cause medication-overuse headache, which NICE says is treated by stopping the medicines, with advice from a healthcare professional.

When is a headache an emergency?

The NHS says to call 999 or go to A&E for a sudden and extremely painful headache, a headache after a head injury, loss of vision, confusion or drowsiness, a seizure, new numbness or weakness, or a rash that does not fade under a glass.

These signs can mean a serious condition, and getting help promptly matters.

Headaches with vomiting, or vision or eye problems, can need an urgent GP appointment or a call to NHS 111.

Migraine that is new in pregnancy or soon after having a baby is something to speak to a healthcare professional about promptly.

When should someone see a GP?

The NHS advises seeing a GP if headaches happen several times a week or are severe, or if painkillers and relaxing activities do not help.

The site's page on headache sets out causes and warning signs in more detail.

What else do the sources say?

NHS migraine treatments include painkillers, medicines called triptans, and medicines that help with feeling or being sick. NICE says medication-overuse headache is treated by stopping the painkillers or triptans causing it, with support from a healthcare professional, and headaches may get worse before they improve. A throbbing pain at the front or on one side of the head, or feeling sick or finding light or noise painful, can point to migraine rather than a tension headache.