There are really, really bad headaches and then there are migraines. As a lifelong migraine sufferer, I know a migraine is in my future because my body gives me advance warning in the form of a dull headache the day before and bouts of blurred vision, which are known as “aura.”

According to Dr. Vernon Williams, a neurologist and director of the Kerlan-Jobe Center for Sports Neurology and Pain Medicine at Kerlan-Jobe Orthopaedic Clinic in Los Angeles, “Headaches and migraines are caused when the blood vessels, muscles, and nerves in the head are overstimulated. When these pain-sensitive structures become overactive, or when chemical activity in the brain is altered, we feel the uncomfortable sensations of a headache.”

So, what differentiates a common headache from a migraine? There are some very specific things that make migraines … migraines. Additionally, if you think you may suffer from migraines, you can take this migraine quiz and then seek the opinion and advice of a professional.

Regular headaches occur in multiple locations in the head

Let’s start by talking about regular headaches, which are painful, uncomfortable, and interfere with the general enjoyment of life. They happen in multiple locations.

“Most headaches are found in the back, front, or top of the head,” Dr. Mark Khorsandi of the Migraine Relief Center and a migraine surgeon based in Houston, told me. “It feels like a tightness and can limit your concentration.”

Headaches are relieved by non-Rx medications

Dr. Khorsandi also explained that “regular” headaches “can range anywhere from 30 minutes to a few days, but diminish with help from over the-counter-medication.” You can pop a few Tylenol and resume your day, going about your basic activities despite being in the throes of a headache, no matter the intensity.

Headaches are usually relegated to the head

Dr. Williams acknowledged that basic headaches are noxious, telling me, “A headache is an unpleasant sensation in any region of the head or upper neck. It may appear as a dull ache, a throbbing feeling or a sharp pain, and intensities of the pain vary with whatever is causing it,” he said. “Though most people associate a headache with pain in the brain, the actual pain felt is stemming from the tissues that surround the brain. A headache can be brief – lasting less than an hour – or linger for several days.”

But here’s the essential takeaway — regular headache pain is localized. There aren’t additional symptoms in other parts of the body, as is the case with migraines.

Migraines come with heightened sensitivities

Now that we’ve gone over the basics of regular headaches, let’s go over what migraines are and what sets them apart.

“A migraine is clinically defined as a specific type of headache that is felt more intensely, and usually has accompanying symptoms in addition to the pain felt in the head,” Dr. Williams explained. He lists common migraine symptoms as “pounding or throbbing pain that is moderate to severe and feels as if it is engulfing the entire head or shifting from one side of the head to the other,” as well as heightened sensitivities to sound, odors, or light.

That’s why migraines often have me lying in a dark, quiet room — it’s an effort to quell my super acute senses.

Migraines have triggers

Dr. Asher Goldstein, the CEO and founder of Genesis Pain Centers, told me that migraines almost always have triggers. “Generally, migraine headaches are differentiated by auras and triggers,” he said. “A trigger is something specific that sets off a migraine.”

Common triggers are stress, an adverse reaction to a food, hunger, and dehydration.

Migraines have more specific locations

The eyes have it! As Dr. Khorsandi explained, “Migraines are usually located behind the eye.” Indeed, my eyes almost always feel like ticking bombs during my worst migraines and I don’t want to use my peepers for anything, hence why I prefer to curl up in a fetal position in both darkness and silence.

Migraines are accompanied by visual disturbances

One of the key indicators of a migraine is the additional symptoms besides the debilitating pain, like visual disturbances also known as auras.

“Migraines can come with a variety of other symptoms including aura, vomiting, sensitivity to light and sound, and visual distortions,” said Dr. Khorsandi. Dr. Williams further detailed the auras as “troubles including blurriness, bright/flashing dots, wavy or jagged lines.” I am plagued by auras before the migraine arrives. It’s the disturbance in the force, the calm before the storm, and serves a warning so I can attempt to deal with what’s to come.

Sally Morgan, a holistic physical therapist and certified craniosacral therapist who also suffered from migraines, reminded me of another side effect of migraines that we don’t think of often — bumps and bruises. She said, “Visual acuity lessens during migraine attacks and people report walking into a wall or knocking things over accidentally during a headache.” Been there, done that.

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