How to Know If Your Headache Is a Migraine

 In Chronic Migraine, Functional Medicine, Neurology

If you are bothered by headaches it may be helpful to know that all headaches are not the same. A narrow definition of headache would include pain in any part of the head, often parts of the face, especially around or behind the eyes, and frequently the upper part of the neck. If you’ve had a headache at least once in the past year you are not alone! The World Health Organization estimates that headaches affect at least 50% of all adults just like you. Not only that, but headache on 15 or more days every month affects 1.7 to 4% of the world’s population.[1] What you may not know is that headache is a broad, descriptive term, not a diagnosis. Read on to learn about the difference between a headache and a migraine, and how we can help with migraine treatment options.

What Is a Headache? 

Let’s get down to basics. There are many different kinds of headaches. Two big distinctions are whether the headache is the disorder or whether the headache is part of a bigger problem, in other words caused by another disorder. When the headache is the defining disorder it is called a Primary Headache. When the headache is caused by another disorder, like infection, or trauma, stroke, or tumor, it is called a Secondary Headache. We are going to focus on Primary Headaches in this blog.


If you go to the doctor to get help with headache you may be surprised to find out there are no tests to confirm the diagnosis of a Primary Headache. Magnetic Resonance Imaging (MRI) might be helpful to rule out other medical disorders where headache is a symptom, but it won’t help your doctor make the diagnosis of migraine. Blood tests are not helpful, either. When it comes to Primary Headache Disorders the symptoms (what you tell your doctor about how you feel or how you are affected) are what defines the headache. To make sure that all doctors make the diagnosis of a Primary Headache Disorder – like migraine – the same way there is a classification system called ICHD-3. This stands for International Classification of Headache Disorders Version 3, and it was created by the International Headache Society. Any time research in the area of headache is performed all the investigators have to agree on the definition of headache, and they rely on the ICHD-3 to level the playing field. The first two headache disorders listed in the ICHD-3 under Primary Headaches are Migraine and Tension-type Headaches, but the focus here will be on migraine.

What Is a Migraine? 

How do you know that the headache you are having is a migraine? While anyone who suffers from migraine may recall the first time they experienced this disabling type of headache the formal diagnosis actually requires more than one attack. In fact, the ICHD-3 says, “at least 5 attacks fulfilling the criteria.”[2] This is where it can get confusing. Even within the category of migraine there are many different subtypes, and in some cases, a migraine can occur in the absence of headache. But for our purposes I am going to focus on the situations where headache does occur.


The basic definition of migraine is that these headaches last 4 to 72 hours if untreated or unsuccessfully treated. The good news is that the standard measure of successful migraine treatment is pain relief in two hours or less, so don’t worry. The next part of the migraine definition is that two of the following four characteristics should be fulfilled: The headache affects one side of the head only, it is pulsating in quality, it is moderate or severe, it is aggravated by routine physical activity like walking or climbing stairs. Many migraine sufferers report that they lay down and try not to move when they have a migraine. Next, the definition of migraine requires at least one of the following two problems: nausea and/or vomiting, sensitivity to light and sensitivity to sound.


That’s it. If you meet the criteria I have just discussed, then you have a migraine.


Sometimes migraines are associated with more symptoms. In fact, in some cases these symptoms can come on before the onset of headache itself, and they are sort of a warning to the migraine sufferer that the headache is about to come on. These warning symptoms are referred to as an “aura,” and there are several common forms of migraine aura. Visual aura is the most common and may consist of zigzag lines that gradually spreads into your vision or a shimmering, expanding blind spot. Sometimes the aura consists of pins and needles sensations in the face, tongue, and hand, often on one side of the body only. Less frequently the aura consists of some form of speech disturbance, such as difficulty getting one’s words out. While an aura might seem scary the definition of an aura is that it is fully reversible, and that it lasts between 5 and 60 minutes. The aura is followed within 60 minutes by a headache and other common migraine symptoms but can in some instances occur during the headache phase.

Migraine Treatment at Sharlin Health and Neurology

Migraine affects three times as many women as men, and tends to run in families. The good news is that migraine is not only related to your genes from your mother and father, but to shared patterns of lifestyle and environment that you have the power to change. There are also excellent treatments for migraines that can both prevent the occurrence of a migraine and treat an individual attack quickly and effectively. At Sharlin Health and Neurology we specialize in identifying the root causes of migraines while helping our patients through natural migraine treatment options and medication choices that match their busy lifestyle in order to minimize side effects, risks, and cost. Read more about our functional approach to chronic migraine, or sign up for a 30-minute initial consultation with Dr. Sharlin.


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In these difficult times we want to share with you some brief bullet-points about Sharlin Health and Neurology and COVID-19:
  • First and foremost, we want you to know that the safety and well-being of each and every one of you is number one importance to us. If you have a chronic lung condition or another health reason that would make you susceptible to the more severe effects of the coronavirus, we want you to stay at home.
  • Sharlin Health and Neurology is considered an “essential” business because we provide critically needed care to those with neurological disease in our community. Despite the threat of the coronavirus conditions like Alzheimer’s, Parkinson’s disease, seizures, migraine, MS, and other neurological diseases do not go away. We are a privately-owned neurology practice here to serve our community.
  • We follow all CDC guidelines for protection against the dissemination of coronavirus. There have not been any known cases of coronavirus in our office, among staff and those customers who have entered our door. 
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  • If you are sequestered at home, it may be possible to visit with you by telemedicine. We have the capability of using a telemedicine portal though the smart phone or computer that is HIPAA compliant and allows us to see you and speak with you. Alternatively, we can speak by telephone. Please ask our receptionist.
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  • If you have had contact with a person with known or suspected COVID-19, have had contact with a person coughing or with fever in the past 14 days, or you yourself have a fever, cough, or runny nose in the past 14 days, please let us know and we will either reschedule you or schedule you a telemedicine visit. 

If you think you may have been exposed to COVID-19 please reach out to your nearest medical center. We will not be testing patients at Sharlin Health and Neurology. 

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