Headache Types (Sar Dard): Tension, Migraine or Sinus?
Most headaches (sar dard) fall into three everyday types, and you can usually tell them apart in a minute by asking where it hurts, how it feels and what set it off. A tight band on both sides is tension-type. A throbbing one-sided pain that hates light and movement is migraine. And the “sinus headache” you’ve been blaming on your nose is, more often than not, a migraine wearing a disguise. Here’s the comparison, a self-check, and the short list that needs a doctor today.
In brief
- Tension-type: both sides, pressing or tight, mild to moderate, you can still work
- Migraine: often one side, throbbing, moderate to severe, worse with movement, light and noise bother you, nausea common
- True sinus headache: rare, needs a real sinus infection (thick coloured discharge, fever, blocked nose over 10 days)
- Cluster: agonising, one eye, tearing on that side, attacks in cycles, needs a doctor fast
- Emergency: sudden worst-ever headache, fever with stiff neck, after a head injury, with weakness, confusion, vision loss or speech change
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How do I tell which headache I have?
Doctors sort headaches with four questions: where, what does it feel like, what came before, how long. Put your answers next to the table and one column will usually fit.
| Question | Tension-type | Migraine | Sinus (real) |
|---|---|---|---|
| Where | Both sides, forehead, temples, back of head, like a band | Usually one side, can switch sides between attacks | Over the cheeks, between the eyes, upper teeth |
| Feel | Pressing, tight, dull | Throbbing, pulsing with your heartbeat | Deep pressure, worse bending forward |
| Strength | Mild to moderate, you can carry on | Moderate to severe, you want to lie down | Moderate, with a heavy face |
| Comes with | Tight neck and shoulders, stress, screens | Nausea, dislike of light and sound, sometimes aura | Thick yellow or green discharge, fever, blocked nose for over 10 days |
| Lasts | 30 minutes to a few days | 4 to 72 hours untreated | As long as the infection |
| Movement | Doesn’t change much | Climbing stairs makes it worse | Worse leaning forward |
One thing trips people up. Migraine needn’t be one-sided or have an aura; many are plain two-sided throbbing headaches with nausea that people call “bad tension headaches” for years. A diary sorts it out.
Why is my “sinus headache” probably a migraine?
Migraine pain often sits over the cheeks and forehead, right where your sinuses are, and it can make the nose run and the face feel full, because the nerve that carries the pain also switches on those glands. So you get a face-ache with a drippy nose and reach for a sinus tablet. It eases a little (most contain a painkiller and caffeine), comes back next week, and the label sticks.
When doctors examine people who are sure they have sinus headaches, most turn out to have migraine. A real sinus headache needs a real sinus infection, and that has signs you can’t miss: thick, coloured discharge from the nose, a blocked nose that has lasted more than 10 days, sometimes fever, and pain that’s worse when you bend forward or press on the cheekbones. No discharge, no fever, headache that comes and goes for months? Think migraine, and read our sinusitis vs cold vs allergy guide for the nose side of the story.
Did you know? The brain itself can’t feel pain. Headache comes from the blood vessels, the covering of the brain, the muscles and the nerves around it.
Tension-type and migraine, up close
Tension-type: the cap that is too small
Like a cap that’s one size too small. It presses on both sides, sits around the forehead and temples, and often creeps up from a stiff neck. It’s dull rather than throbbing. You can still cook, drive and answer messages, just with less patience. It builds through a long day at a screen or after a bad night, and it’s the headache home measures help most.
Migraine: the pulse in the head
Like something inside the head is beating with your pulse, and the world has turned up its brightness. You want a dark, quiet room. Stairs are a punishment. Many people feel sick, and about a quarter get an aura first: zig-zag lights, a blind patch, or tingling that travels up one arm over 20 minutes and fades. Attacks last from four hours to three days, run in families, and are around three times more common in women. Our migraine triggers in desi life post covers skipped meals, chai timing and wedding season, and shows how to keep the diary.
What about cluster and the other rare ones?
Cluster headache is nothing like the others. Severe, drilling pain around one eye, and on that side the eye waters and reddens, the lid droops, the nostril runs or blocks. Attacks last 15 minutes to 3 hours, often at the same time each night, for weeks, then vanish for months. People pace instead of lying still. Nobody should manage this at home; a doctor has specific treatment that works when ordinary painkillers don’t.
Three others are worth a line. Medication-overuse headache is a daily dull ache in someone taking painkillers on more than 2 or 3 days a week; the tablets have become the cause. Caffeine-withdrawal headache turns up within a day of missing your usual chai. Eye-strain headache sits across the forehead after hours of close work and clears after rest.
Myth: a headache means my blood pressure is high
Almost never. High blood pressure has no symptoms for most people, which is exactly why it’s dangerous. Ordinary headaches don’t come from BP, and taking your BP during a headache usually shows a number that’s up a little because you’re in pain, not the other way round. The one exception is a reading of 180/120 or higher together with a headache, chest pain, breathlessness, confusion or vision change. That is an emergency. Everything else is a headache that happens to occur in someone who may or may not have BP.
A 60-second home self-check
- Place it. Point to the pain. Both sides in a band means tension-type. One side, or one eye, means migraine or cluster. Cheeks and upper teeth with a discharging nose means sinus.
- Time it. Note when it started and, later, when it ended. Under 3 hours with an eye watering points to cluster. Between 4 and 72 hours with nausea points to migraine.
- Test movement. Walk up 10 stairs at normal speed. If the pain gets clearly worse with each step, that’s a migraine feature.
- Test light. Glance at a window or your phone at full brightness for 5 seconds. Wincing and looking away is a migraine feature.
- Check the neck. Press with two fingers where the skull meets the neck, 2 cm either side of the midline. Tender knots that reproduce the headache point to a neck and posture cause.
- Count the tablets. A painkiller on 10 or more days this month may be the cause, not the treatment. Write it down.
- Run the red-flag list. Before anything else, check the “when to see a doctor” box below. If any line fits, stop here and go.
What helps at home, and what it won’t do
For tension-type: a warm cloth on the neck for 15 minutes, a 10-minute walk, water and food if you’ve skipped a meal, neck stretches. For migraine: a dark, quiet room, a cold cloth on the forehead, and sleep. Both: steady sleep and meal times. Our headache home remedies post ranks the balms, ginger, ice and pressure points honestly.
What home measures won’t do is fix a headache that comes more than once a week for a month, stop a migraine at full strength, or end a painkiller-overuse headache. Those need a doctor, and the diary makes the visit twice as useful. The rest of Desi Remedies takes the same line.
Go to emergency (1122 in Pakistan, 112 in India) for a headache that hits full force within a minute (the worst of your life), a headache with fever and a stiff neck or a rash, a headache after a blow to the head, or one with weakness on one side, confusion, slurred speech, double vision or vision loss. See a doctor the same day for a new type of headache after age 50, any headache in pregnancy with swelling or high BP, a headache that wakes you from sleep or is worst on waking with vomiting, a child with headache and vomiting, or a headache that gets steadily worse over days. See a doctor soon if you’re taking painkillers on more than 2 or 3 days a week, or if headaches come more than once a week for a month. Never guess at tablet amounts; the pack or a pharmacist sets them, and pregnant women should ask before taking anything.
Headache types: your questions answered
How do I know if my headache is a migraine or a tension headache?
Migraine throbs, is often one-sided, gets worse when you climb stairs, and comes with nausea or a dislike of light. Tension-type presses on both sides like a band, stays mild to moderate, and doesn’t change much with movement. If you had to lie down in the dark, it was probably migraine.
What are the main types of headache?
Tension-type, migraine and cluster are the three main “primary” headaches, meaning the headache is the illness itself. Then there are “secondary” ones caused by something else: sinus infection, caffeine withdrawal, dehydration, eye strain, painkiller overuse, a head injury, high fever, or rarely something serious. The red-flag list exists to catch that last group.
Sar dard ki kitni iqsam hoti hain?
Rozmarra ki zindagi mein teen aam iqsam hain: tension headache (dono taraf dabao), migraine (aadha sar dard, dharakta hua, roshni se takleef) aur cluster headache (ek aankh ke peeche shadeed dard). Sinus ka sar dard sirf asli sinus infection ke saath hota hai.
Is a sinus headache real?
Yes, but only with a real sinus infection: thick coloured discharge, blocked nose for more than 10 days, sometimes fever, pain worse bending forward. A recurring “sinus headache” with a clear or absent discharge is nearly always migraine.
What headache is dangerous?
The sudden thunderclap headache that peaks within a minute; headache with fever and a stiff neck; headache after a head injury; headache with weakness, confusion, speech or vision change; a new headache after 50; and headache in pregnancy with swelling or high BP. These need a doctor today, not a home remedy.
Does high blood pressure cause headaches?
Rarely. Most people with high BP feel nothing, and everyday headaches are not a BP sign. The exception is 180/120 or above with headache and other symptoms such as chest pain, breathlessness or confusion, which is an emergency.
Why do I get a headache every day?
The common causes are painkiller overuse (tablets on more than 2 or 3 days a week), poor sleep, caffeine swings, neck strain from phones and laptops, and untreated migraine. A daily headache for more than two weeks needs a doctor visit with your diary.
Should I keep a headache diary?
Yes, for a month. Note the date, start and end time, where it hurt, how strong (0 to 10), what you’d eaten and slept, any painkiller taken, and what you think triggered it. Doctors can read a month of this faster than a year of memory.