Headaches are among the most common health complaints in the general population. Although they are often associated with stress, fatigue, or lack of sleep, not all headaches are the same, nor do they require the same treatment. In fact, there are more than 200 types of headaches, including tension-type headaches and migraines, two conditions with very different characteristics and impacts.

Dr. Elena Riva Amarante, Director of the Headache and Facial Pain Unit within the Neurology Department at Hospital Ruber Internacional, part of the Quirónsalud group, explains that tension-type headaches are the most common in the general population, while migraines cause the greatest disability and account for a higher number of neurological consultations.

"Migraine is a neurological disease, not just a headache. It can significantly affect family, social, and professional life, especially when attacks are frequent or disabling," the specialist points out.

Migraine is estimated to affect approximately 12% of the population and is particularly common among people aged 20 to 50. It is also more prevalent in women, who account for around 80% of those affected.

How Can You Tell the Difference Between a Migraine and a Tension-Type Headache?

One of the main challenges is correctly identifying the type of headache. Tension-type headaches usually cause a sensation of pressure around the head, similar to wearing a tight helmet or band. The pain is generally mild to moderate and usually allows people to continue with their daily activities.

Migraine, on the other hand, causes attacks of moderate to severe pain that can last between 4 and 72 hours if left untreated. The pain is often throbbing, affects one side of the head, and worsens with physical movement. It may also be accompanied by nausea, vomiting, and increased sensitivity to light and sound.

"Diagnosis is primarily based on the symptoms described by the patient. That is why it is important to understand how the pain begins, how long it lasts, which symptoms accompany it, and how much it interferes with daily activities," explains Dr. Riva.

The neurologist also notes that approximately one in four people with migraine experience temporary neurological symptoms known as aura during some attacks. These may include flashes of light or other visual disturbances before the headache begins.

When Should You Be Concerned About a Headache?

Although most headaches are not associated with serious medical conditions, certain warning signs require urgent medical assessment.

These include an extremely severe and sudden headache, difficulty speaking, loss of strength, confusion, seizures, or headaches accompanied by fever and neck stiffness.

Attention should also be paid to headaches that differ from a person's usual pattern, progressively increase in intensity or frequency, occur after a head injury, or appear for the first time after the age of 50.

According to Dr. Elena Riva, when headaches occur several times a month, no longer respond to usual treatments, or interfere with everyday life, it is important to consult a specialist. "We should not wait until the problem becomes disabling," she advises.

The specialist also warns that migraine remains an underdiagnosed condition, with many people waiting years before receiving an appropriate neurological assessment.

New Treatments to Control Migraine

Migraine management has evolved considerably in recent years. Today, treatment combines healthy lifestyle habits, medications to relieve acute attacks, and preventive therapies designed to reduce their frequency and severity.

"One of the key aspects is treating an attack as early as possible. Delaying medication out of fear of taking too many painkillers can make the pain harder to control and may ultimately lead patients to require additional doses," explains the neurologist.

For patients experiencing frequent or particularly disabling attacks, preventive treatments can significantly improve disease control. Among the most important advances are medications targeting molecules involved in migraine mechanisms, as well as other preventive therapies involving periodic injections, which are indicated for certain patients with chronic migraine.

"Today, we have specific treatments that have transformed our ability to control migraine. The key is to individualize treatment and identify the most appropriate option for each patient," Dr. Riva emphasizes.

The specialist also points out that frequent use of painkillers may indicate that the condition is not adequately controlled and that treatment needs to be reassessed, rather than simply increasing medication.

Sleeping Well, Exercising, and Maintaining Regular Routines

In addition to medical treatments, everyday habits play a fundamental role in managing headaches.

Changes in sleep schedules, skipping meals, stress, alcohol consumption, and hormonal fluctuations can trigger migraine attacks in susceptible individuals. For this reason, the neurologist at Hospital Ruber Internacional recommends maintaining regular sleep and meal schedules, engaging in physical exercise, moderating caffeine intake, and learning to identify individual triggers.

She also advises keeping a headache diary to record the frequency and intensity of episodes, as well as the circumstances in which they occur. This can be a useful tool for monitoring the condition and assessing treatment effectiveness.

"Lifestyle habits are just as important as medical treatments. Sleeping well, maintaining regular routines, and exercising consistently can help reduce migraine attacks and improve quality of life," she explains.

Finally, Dr. Elena Riva Amarante stresses the importance of moving away from the belief that living with frequent headaches is normal.

"We should not normalize pain or simply resign ourselves to living with it. Migraine is a neurological disease, and today we have effective treatments. With proper management, the vast majority of patients can achieve good control of their condition and lead practically normal lives," she concludes.