Types of Headaches and How to Tell Them Apart

Types of Headaches Compared

The three types of headaches most people deal with are migraine, tension headache and sinus headache, and they are easier to tell apart than most people assume. Location, pain quality and what comes with the pain separate them. The most common mistake is calling a migraine a sinus headache, because both cause facial pressure and a blocked nose.

AHC treats migraine with prescription medication after a provider review. AHC does not treat sinus infections, and this post says plainly where the line sits. Nothing below is a way to diagnose yourself. It is a way to describe the types of headaches you get accurately enough for a clinician to work with.

How the three most common types of headaches differ

This table covers the three types of headaches people most often try to tell apart. They overlap on individual symptoms and separate on patterns, so match the whole row rather than one line.

Headache classification is more detailed than three categories. The International Classification of Headache Disorders lists well over a hundred. The NIH headache guide sets out how primary and secondary headache are grouped.

What a migraine is

Of the three types of headaches in that table, migraine is the only one that is a neurological condition rather than a symptom or a muscular problem. That distinction matters, because it explains why the symptoms go well beyond pain.

An attack usually brings throbbing pain, often on one side, that gets worse when you move. Nausea is common. So is sensitivity to light, sound and sometimes smell. Attacks run from four hours to three days.

Some people get aura before the pain starts. That means visual changes such as flashing lights, zigzag patterns or blind spots, or tingling and numbness, usually lasting under an hour. Aura is not required for a migraine diagnosis and most people with migraine do not get it.

Migraine also runs in families, which is why a parent or sibling with the same pattern is a useful clue. None of the other types of headaches here carry that signal as strongly.

What a tension headache is

Tension headache is the most common of all the types of headaches. It feels like steady pressure rather than throbbing, usually on both sides, often described as a tight band.

Tenderness in the scalp, neck or shoulders is common. Nausea and light sensitivity are not, which is the cleanest line between this and migraine. Unlike other types of headaches, the pain tends to stay level rather than building, and it usually does not stop you functioning.

Stress is the best known trigger, but poor sleep, dehydration, eye strain and long stretches in one posture all contribute. Frequency is what turns it into a medical problem. NIH defines chronic headache as more than fifteen headache days a month, which is a threshold worth knowing if you are tracking yours.

Why most sinus headaches are not sinus headaches

This is the most useful distinction among the three types of headaches. True sinus headache is uncommon, and most people who self-diagnose one are having migraine attacks.

A genuine sinus headache comes from inflamed or infected sinuses. It brings facial pressure that worsens when you bend forward, thick discolored mucus, a stuffy nose, a reduced sense of smell and often a fever. The headache is a symptom of the infection, so it tends to resolve when the infection does.

Migraine can produce congestion, facial pressure and a runny nose too. What it does not produce is thick colored mucus or fever. If your nasal discharge is clear and you have no temperature, you are more likely looking at migraine than sinusitis, whatever the pressure in your cheeks suggests.

Worth checking. Clear discharge and no fever points away from a sinus infection. Thick colored mucus plus a fever points toward one. That single check sorts out a large share of the confusion between these two types of headaches.

Where the types of headaches overlap

Three overlaps cause most of the misreading between these types of headaches.

• Neck pain. It is common in migraine, not only in tension headache. Neck pain on its own does not settle the question.
• Facial pressure. Shared by migraine and sinus headache, which is the single biggest source of confusion.
• Stress. A trigger for migraine and tension headache both, so it does not separate them.

There is a fourth overlap that catches people out. Several of the types of headaches below can look like migraine or tension headache without being either, which is why a pattern over weeks tells a clinician more than any single attack does.

Other types of headaches worth recognizing

Three categories cover most headaches, but not all of them. These four come up often enough to be worth knowing by name, so you can describe what you get rather than guess at a label.

• Cluster headache. Severe pain around or behind one eye, often with a watering eye, a drooping lid or a blocked nostril on the same side. Attacks are short but come in bouts over weeks. It is frequently mistaken for sinus or dental pain.
• Cervicogenic headache. Pain that starts in the neck and refers into the head, usually on one side. It can follow a neck injury or arthritis in the upper spine, and it is easy to confuse with both migraine and tension headache.
• Medication overuse headache. A headache that develops from frequent use of pain relief, then gets treated with more pain relief. If you are taking something for headache most days of the week, this is worth raising with a clinician.
• Menstrual migraine. Migraine attacks clustered around the days before or during a period, or at mid-cycle. The pattern is the clue, which is another reason tracking dates is useful.

Naming these types of headaches is for recognition, not diagnosis. Take the pattern to a clinician rather than deciding which one fits.

Types of headaches that need urgent care, not a self-diagnosis

Some headaches are not a matter of working out which of the types of headaches you have. These need medical attention straight away, not an online form.

• A sudden, severe headache that peaks within a few minutes, especially the worst you have had
• Headache with fever and a stiff neck
• Headache with weakness, numbness, confusion, difficulty speaking or a change in vision
• A new headache after a head injury
• Headache with scalp tenderness or jaw pain when chewing, particularly over the age of fifty
• A headache that is steadily getting worse, wakes you, or worsens when you cough or bend
• Your first severe headache if you do not normally get headaches

Seek emergency care or contact a clinician. None of these belong in a discussion about types of headaches at home. Do not wait to see whether it passes, and do not use an intake form as the first step.

How AHC treats migraine

AHC prescribes sumatriptan and rizatriptan for migraine. Both are FDA-approved migraine medications, dispensed after a provider review. You can see the current options on the AHC migraine treatment page.

Migraine is the only one of these types of headaches AHC treats directly. It has its own medical intake form, as every medication at AHC does, so a migraine request stays separate from anything else you are treated for.

A licensed provider reviews the intake and decides whether treatment is appropriate. This review matters more than usual with this class of medication, because these medications are not suitable for everyone and cardiovascular history is part of what gets assessed. The provider retains full discretion to approve or decline.

Nausea is part of the attack for many people. Ondansetron ODT is an FDA-approved nausea medication AHC also offers, and it dissolves on the tongue rather than needing water. It is an option a provider may consider, not something required alongside migraine treatment.

What AHC does not treat is sinus infection, which is one of the types of headaches covered above. If your symptoms point that way, you need a clinician who can assess and treat the infection itself.

One practical point. Migraine medication is taken during an attack, so it needs to already be in your cupboard. Orders are typically processed within 1 to 2 business days, with an average delivery window of 4 to 12 business days. Order before you are out, not during an attack.

How to track your headaches before asking for treatment

A provider can only work with what you give them, and the types of headaches you get are far easier to separate over two weeks of notes than in one appointment. It costs nothing to keep them.

1. Record when each headache starts and stops. Duration separates the types of headaches faster than anything else.
2. Note where the pain sits and whether it is throbbing or steady pressure.
3. Write down what came with it. Nausea, light sensitivity, fever, nasal discharge and its color. These are what separate the types of headaches most reliably.
4. Note what you did about it and whether it helped.
5. Log sleep, stress and any missed meals on those days.
6. Count your headache days per month and how often you took pain relief.

Ready to get migraine treatment reviewed?  A licensed provider reviews every order and decides whether treatment is appropriate. Start with AHC’s migraine intake.

The short version. Across these types of headaches the pattern does the work. Throbbing, one-sided, with nausea and light sensitivity points to migraine. Steady band-like pressure with no nausea points to tension headache. Facial pressure with thick colored mucus and a fever points to a sinus infection. Anything sudden and severe goes to emergency care.

Frequently asked questions

Can AHC treat my migraines?

AHC offers prescription migraine treatment after a provider review. Sumatriptan and rizatriptan are both FDA-approved migraine medications. A licensed provider decides whether either is appropriate for you.

Can AHC tell me which type of headache I have?

No. An intake form cannot separate the types of headaches and it is not a diagnosis. A provider reviews your history and decides whether the treatment you requested is appropriate, which is a different question from classifying your headache.

Do I need a separate intake form for migraine treatment?

Yes. Every medication at AHC has its own medical intake form, so a migraine request is separate from any other treatment you receive.

What does the provider review look at before prescribing migraine medication?

Your medical history and your intake answers. Cardiovascular history is part of the assessment with this class of medication, because it is not suitable for everyone. The provider can decline.

Can I get migraine treatment and weight loss treatment from AHC?

Yes, but they are separate intakes and separate provider reviews. They are not bundled and one does not affect the other.

Does AHC treat sinus infections?

No. If your symptoms suggest a sinus infection, thick colored mucus and fever alongside facial pressure, you need a clinician who can assess and treat the infection.

Can AHC help with the nausea that comes with a migraine?

Ondansetron ODT is an FDA-approved nausea medication AHC offers. It is an option a provider may consider. It is not required alongside migraine treatment.

How long does a migraine order take to arrive?

Orders are typically processed within 1 to 2 business days, with an average delivery window of 4 to 12 business days. AHC ships within the United States only.

Should I order when a migraine starts?

Order before you need it. Migraine medication is taken during an attack, so delivery timing means it has to already be in your cupboard.

My headaches are getting more frequent. What should I do?

Track them and speak to a clinician. More than fifteen headache days a month meets the definition of chronic headache, and frequent pain relief use can cause headaches of its own.

What do I do if a headache comes on suddenly and severely?

Seek emergency care. A sudden, severe headache that peaks within minutes needs immediate assessment, not an online intake form.

Can I have more than one of these types of headaches?

Yes, and it is common. Many people get both migraine and tension headaches, which is one reason a single attack tells a clinician less than a pattern over several weeks does.

Does a headache on one side always mean migraine?

No. Cluster headache and cervicogenic headache are also one-sided, and migraine is not always one-sided. Location alone does not separate the types of headaches.

Is a headache with facial pressure always sinus related?

No. Facial pressure is common in migraine, and migraine is the more likely answer when nasal discharge is clear and there is no fever.

How do I reach AHC with a question about my treatment?

Live chat on the website, or [email protected]. Support routes clinical questions to AHC’s medical officer.

Want to ask a provider directly?  A provider consultation costs $29.99 if you would rather talk through which of these types of headaches you get before requesting treatment. See the AHC patient FAQs or contact support through live chat.

Medical Disclaimer

Sumatriptan, rizatriptan and ondansetron ODT are FDA-approved medications, dispensed following a review by a licensed provider.  Individual results vary.  This content is for informational purposes only and is not medical advice, and it is not a tool for diagnosing your own headaches. Clinical services are provided by independently contracted, U.S.-licensed clinicians. Speak with a licensed provider about your individual situation.  If you experience severe or sudden symptoms, seek emergency medical care. For questions about your treatment, contact AHC support through live chat on the website or at [email protected]