Migraine symptoms: What to watch out for

People might say they're having a migraine when they get an especially bad headache, but there's much more to a migraine than just head pain. Migraines come with a host of other unique symptoms, and they progress through distinctive phases. Knowing what to watch out for, such as what symptoms suggest a migraine rather than another type of headache, can help you and your healthcare provider figure out what's wrong and what treatments may be best.

Headache is one of the most common forms of pain. It's a major reason why people miss work, skip school or decide to see a healthcare professional. Although there are many different types of headaches, the most frequent are:

• Tension headaches
• Cluster headaches
• Migraine headaches

A typical migraine is on one side of your head or behind your eye. It usually begins gradually and gets worse over several hours. Without treatment, a migraine typically goes away within four to 72 hours of onset.

Many people with migraines also become sensitive to bright lights or loud noises, causing them to retreat during a migraine attack. Nausea and vomiting are common as well. Some people find it painful to have their head touched, like when they're brushing their hair.

Some, but not all, people with migraines get warning symptoms, called an aura, before their headaches begin. This generally lasts for 15 to 30 minutes before the headache starts. Vision changes are an important part of a migraine aura. These might include:

• Blurred vision
• Flashing lights
• Seeing zigzag lines
• Temporary, partial loss of vision

Other symptoms of a migraine aura include weakness on one side of the body, burning or prickly sensations, and trouble speaking.

In contrast, tension headaches usually affect both sides of the head, don't throb, don't have an aura and don’t usually worsen from activity. Cluster headaches, which are very uncommon, typically begin without warning and usually peak quickly. They may last only a few minutes, but it’s possible to experience multiple cluster headaches in a day.

People with migraines may still have other kinds of headaches, and some types of headaches can indicate a more serious medical problem, sometimes even an emergency. You should contact your healthcare provider right away or go to an emergency department if you have any of these headache symptoms:

• A severe headache that comes on quickly, like a thunderclap
• A headache along with seizures, seeing double, a high temperature (fever), confusion, a stiff neck, or new numbness or weakness anywhere in the body
• A headache that begins after a head injury
• A headache that is made worse by coughing, straining, quick movements or physical exertion
• New headache pain that begins after age 50

While there is some overlap between the symptoms of tension, cluster and migraine headaches, migraines typically stay on one side of your head, worsen from bright light, noise and movement, and often come with nausea and vomiting. Work with your healthcare provider to determine if your headaches are migraine headaches or something else.

Published January 2023.