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Migraine vs tension headache vs cluster headache

"Headache" covers three very different animals. Knowing which one your attacks resemble won't diagnose you — that's a clinician's job — but it will help you describe them well, and describing them well is half the diagnosis.

Updated August 2026 · 7 min read

Three conditions, one word

Migraine, tension-type headache and cluster headache are the three most common primary headaches — meaning the headache itself is the condition, not a symptom of something else. They differ in mechanism, in how they feel, and crucially in how they're treated, which is why lumping them together as "bad headaches" can leave people on the wrong strategy for years. The formal definitions live in the International Classification of Headache Disorders (ICHD-3), the criteria clinicians actually diagnose against; what follows is the honest plain-language version.

Migraine: the whole-system event

Migraine is not just pain — it's a neurological episode with pain in the middle of it. The classic picture: pain on one side of the head (though it can be both), pulsating or throbbing in character, moderate to severe, lasting from 4 hours up to 3 days untreated, and made worse by ordinary movement like climbing stairs. What really distinguishes it is the company the pain keeps: nausea or vomiting, and marked sensitivity to light and sound that sends you to a dark, quiet room. Around a quarter to a third of people with migraine also experience aura — visual or sensory disturbances that typically precede the pain. Attacks often have a prodrome (yawning, cravings, irritability the day before) and a hangover-like postdrome after.

Tension-type: the tight band

Tension-type headache is the most common headache of all, and the least dramatic. The pain is typically on both sides, pressing or tightening — people reach for the phrase "like a band around my head" — mild to moderate, and it doesn't usually get worse when you move around. The tell is what's absent: no vomiting, at most mild queasiness, and not the combined light-and-sound aversion of migraine. Life continues, unpleasantly, in a way it usually doesn't during a full migraine attack. Episodes can last from half an hour to several days. Because it's milder, it's also the diagnosis migraine most often hides behind — a "tension headache" that forces you to lie down in the dark deserves a second look with a doctor.

Cluster: the alarm-clock attack

Cluster headache is rarer and in a different league of intensity — patients and clinicians alike describe it as one of the most painful conditions known. Attacks are strictly one-sided, boring into or around one eye or temple, and comparatively short: 15 minutes to 3 hours. They arrive in clusters — often daily or several times daily for weeks, frequently at the same time of day or night — then can vanish for months. The eye on the painful side goes red and waters, the nostril runs or blocks, the eyelid may droop. And where a person with migraine seeks stillness, a person in a cluster attack paces, rocks, cannot sit down. That restlessness is one of the sharpest distinguishing features. The NHS is blunt that cluster headache needs specialist assessment — over-the-counter painkillers are typically too slow for attacks this short and severe.

Where tracking fits in

Formal criteria are pattern criteria. ICHD-3 doesn't classify a single attack; it asks about your history — how many attacks, how long they last, which side, which companion symptoms, how often per month. That's precisely the information memory serves up worst and a diary serves up best. A record showing, say, twelve attacks over three months, each 6–24 hours, mostly left-sided, with nausea and light sensitivity, reads directly onto the migraine criteria. Fifteen-minute nocturnal attacks with a watering eye read onto something very different, and faster referral.

This is where a low-friction tracker earns its keep: Dim logs an attack in three taps — time, intensity, side — and its dark, glare-free screen was built for exactly the light-sensitive moments when logging normally gets skipped. Over a few months, those small entries become the pattern history a clinician can classify from; the doctor report lays it out in one page. You track, honestly and lightly; your doctor diagnoses.

Give your doctor a pattern, not a guess

Dim records time, side and intensity in three taps and turns months of attacks into a one-page report your clinician can classify from.

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