How to Decide if It's Headache or Migraine: Try This Strange Method

Headache, migraine medication

If you are suffering from a headache, how can you tell if it is just a headache or if it is a migraine? The Charlotte Headache Center in North Carolina offers criteria for suffers as identified by the International Headache Society called the "5,4,3,2,1" method.

A migraine is a common type of headache that tends to first appear between the ages of 10 and 45. They do run in families and occur more often in women than men. Migraines are ranked by the World Health Organization as number 19 among all diseases world-wide causing disability.

Identifying whether a headache is a migraine or not is important because having the correct diagnosis will improve your healthcare provider’s ability to manage your symptoms.

One of the easiest ways to determine if your condition is migraine without aura is to use the “5, 4, 3, 2, 1 criteria” established by the International Headache Society. Here are the guidelines they’ve set:

5 or more attacks (for migraine with aura, two attacks are sufficient for diagnosis)

4 hours to 3 days in duration

2 or more of the following:
Unilateral (affecting one side of the head)
Moderate or severe pain intensity
Pain is aggravated by routine physical activity

1 or more of the following:
Nausea and/or vomiting;
Sensitivity to both light and sound


If you are experiencing four of these five symptoms: pulsating headache, duration of 4–72 hours, pain on one side of the head, nausea, or pain sufficient to interfere with daily life, the probability that you’re dealing with a migraine is 92 percent.

There is no specific cure for migraine headaches; the goal is treat symptoms right away and to reduce the number of attacks in those who suffer frequently. Medications include antidepressants such as amitriptyline or venlafaxine, blood pressure medicines such as beta blockers or calcium channel blockers and seizure medications such as valproic acid, gabapentin, and topiramate. Botulinum toxin (Botox) injections have also been shown to be helpful.

Over the counter pain medications such as acetaminophen, ibuprofen, or aspirin can help if the headache is mild but be aware that taking these drugs more often than 3 days a week may lead to rebound headaches.

Patients should also identify migraine triggers that can be avoided. Alcohol, stress and anxiety, certain odors or perfumes, loud noises or bright lights, and smoking may trigger a migraine.

Migraine attacks may also be triggered by:

• Caffeine withdrawal
• Changes in hormone levels during a woman's menstrual cycle or with the use of birth control pills
• Changes in sleep patterns
• Exercise or other physical stress
• Missed meals
• Smoking or exposure to smoke

Common Foods That Trigger Migraine Headaches
• Any processed, fermented, pickled, or marinated foods, as well as foods that contain monosodium glutamate (MSG)
• Baked goods, chocolate, nuts, peanut butter, and dairy products
• Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
• Fruits (avocado, banana, citrus fruit)
• Meats containing nitrates (bacon, hot dogs, salami, cured meats)
• Onions

If you are having frequent headaches, and particularly if you have identified your headaches as migraines, please visit your healthcare provider for the name of a specialist in your area.

Charlotte Headache Center
International Headache Society
National Headache Foundation
PubMed Health – ADAM Medical Encyclopedia


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