How do common types of headaches differ?

There are various types of headaches that have no specific cause. The most common of these are tension headaches, migraines and cluster headaches.

Headaches that have no specific cause (like an illness or injury) are called primary headaches. If headaches are caused by an illness or injury, they are known as secondary headaches. The three most common types of primary headaches are tension headaches, migraines and cluster headaches.

Tension headaches

Most people have a tension headache at some point in their life. The pain

  • is dull (but not throbbing), accompanied by a feeling of pressure or tightness, and is felt on both sides of the head,
  • is mild to moderate,
  • can last anywhere from 30 minutes to several days,
  • doesn't cause nausea,
  • doesn't get worse during physical activity, and
  • usually doesn't stop you from going about your daily activities.
Illustration: Common types of headaches: Where they typically occur – as described in the article


Migraine headaches are not as common as tension headaches. Even so, a lot of adults and children have them. Women have more migraines than men do, often before or during their monthly period. Migraine headaches are far more painful than tension headaches are, so migraines also affect your daily life more.

Headaches are considered to be migraines if you have had five or more attacks with typical symptoms, such as

  • moderate to severe pulsating, throbbing or pounding pain, usually mainly at the front of your head,
  • often pain on one side of your head only, although it may switch sides,
  • headache attacks lasting from at least four hours up to three days (at least two hours in children),
  • sensitivity to light, sounds and/or smells,
  • often nausea too, sometimes with vomiting and
  • symptoms that get worse during physical activity.

Migraines are sometimes accompanied by vision problems, seeing flashes of light, unusual skin sensations (like tingling) or dizziness. This is known as an aura. Auras may occur before or during migraine attacks. They come on within a few minutes and usually go away again within one hour.

People who have a migraine often need to lie down in a dark and quiet room because their symptoms are made worse by light, sound and movement.

Cluster headaches

Cluster headaches occur in bouts that last a few weeks. During that time, people usually have the headaches every day. Cluster headaches affect only one side of your head, near the temple and around the eye. They generally always occur on the same side of the head. The name of these headaches comes from the fact that they tend to happen in a grouped "cluster" over a certain time period. Cluster headaches

  • are very intense, making them the most severe kind of primary headache,
  • are described as a burning, stabbing or piercing pain,
  • last between 15 minutes and three hours,
  • can happen regularly over a time period of days or weeks (in bouts) – several times a day in some people – and at the same times each day, usually in the early hours of the morning, and
  • are accompanied by symptoms like a stuffy nose, eye redness, a sweaty forehead or watery eye.

Physical movement sometimes relieves the pain somewhat. Because of this, people tend to be restless during cluster headache attacks (unlike during migraine attacks) and may pace back and forth, for example. Cluster headaches are far less common than tension headaches and migraines. They are the only type of primary headache that are more common in men than in women.

Illustration: Types of headaches: Differences in severity and duration of pain

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Hacke W. Neurologie. Berlin: Springer; 2016.

Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol 2018; 17(1): 75-83.

International Headache Society (IHS). Die Internationalen Klassifikation von Kopfschmerzerkrankungen, 3. Auflage – ICHD-3. 2018.

May A, Evers S, Brössner G et al. Leitlinie zur Diagnostik, Therapie und Prophylaxe von Cluster-Kopfschmerz, anderen trigeminoautonomen Kopfschmerzen, schlafgebundenem Kopfschmerz und idiopathisch stechenden Kopfschmerzen. Nervenheilkunde 2016; 35: 137-151.

Straube A. Therapie des episodischen und chronischen Kopfschmerzes vom Spannungstyp und anderer chronischer täglicher Kopfschmerzen (S1-Leitlinie, in Überarbeitung). AWMF-Registernr.: 030-077. 2022.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on April 5, 2023

Next planned update: 2026


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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