What’s the Difference Between a Tension Headache and a Migraine?
The clearest way to separate them: tension headaches are muscular in origin and typically bilateral, pressing like a band around both sides of the head. Migraines are neurological, usually unilateral, and come with accompanying symptoms like nausea and light sensitivity that tension headaches rarely produce.
A tension headache develops when the muscles of the neck, scalp, and jaw stay contracted over time. The pain is dull and non-pulsating. It doesn’t usually get worse with movement, and it doesn’t cause nausea.
A migraine involves different mechanics. The pain is one-sided and throbbing, worsens with routine activity, and often brings nausea and sensitivity to light and sound with it. Some people experience an aura beforehand: visual disturbances, tingling, or briefly altered speech.
|
Tension Headache |
Migraine |
| Location |
Both sides of head |
Usually one side |
| Quality |
Pressing, tightening |
Throbbing, pulsating |
| Nausea |
Rare |
Common |
| Light/sound sensitivity |
Rare |
Common |
| Aura |
No |
Sometimes |
| Primary cause |
Muscular |
Neurological |
| Duration |
30 min to several hours |
4 to 72 hours |
The International Headache Society’s third edition classification, published in
Cephalalgia in 2018, formally defines the two conditions on exactly these characteristics and remains the diagnostic standard used by neurologists worldwide.
How Zone Technique Approaches Each Type
At Vita Nova Chiropractic, Dr. Korrin uses
Zone Technique. For headaches, the distinction between tension and migraine isn’t just diagnostic. It determines which zones need attention.
Tension headaches involve two zones. Zone 5 (muscular) addresses the chronically contracted muscles of the neck, upper back, and scalp that generate the bilateral pressing quality. When these muscles stay tight, they compress the cervical spine and sustain the headache cycle. Zone 3 (nervous) addresses the cervicogenic component: the nerve interference that builds when the cervical spine is under sustained mechanical load from that muscle tension.
Migraines involve three zones. Zone 1 (glandular) addresses the hormonal and neurochemical dimension. Estrogen and serotonin fluctuations are documented migraine triggers, and Zone 1 work addresses the glandular system’s role in those cycles. Zone 3 (nervous) addresses the cervicogenic and neurological component shared by both headache types, including the disrupted nerve signaling in the upper cervical spine that feeds into the migraine’s pain amplification cycle. Zone 6 (circulatory) targets the vascular dimension: the vasodilation and changes in cerebral blood flow that characterize the active migraine phase.
The broader zone involvement reflects how much more systemically complex migraines are. Care for a migraine pattern typically takes longer to work through than a tension headache pattern.
What to Expect at Your First Visit
Your first visit starts with a detailed headache history. Dr. Korrin asks which side, how often, what tends to trigger it, whether light or sound bothers you, and whether you’ve noticed a hormonal or stress pattern. Those details help him identify whether he’s looking at a tension presentation, a migraine presentation, or both.
From there, he runs a Zone Technique assessment to identify which zones are disrupted and where the nervous system interference is concentrated. For headache patients, the upper cervical spine and the zones specific to your presentation get particular attention.
Most patients with chronic headaches who come to see us in Plano can begin care at the first visit. He’ll be direct with you about what a realistic care timeline looks like for your pattern.
Where to Go Next
For more on how we approach each condition, our
migraine chiropractic care page and our
headaches page cover the full picture for each. The
headache and migraine service page covers how Dr. Korrin works with both.
When you’re ready to talk through your headache history and figure out what’s driving it, Dr. Korrin sees patients at our Plano, TX office.
Schedule a visit here.
We’re Here in Plano
Dr. Korrin grew up in
Plano, TX and sees headache patients at Vita Nova Chiropractic every week: people who’ve been managing migraines for years, and people who’ve written off their tension headaches as just stress and never pressed further. There’s more to know about both.
