Should I treat this as migraine, or get emergency help?
If this is a sudden, extremely painful headache unlike anything before, skip this page and call 999. Also call 999 for one-sided weakness, trouble speaking, a seizure, confusion, loss of vision, or a headache after a recent head injury. Use this page for recurrent migraine, NHS options, and what not to do.
Do not drive yourself to A&E. If you are in the middle of a typical, recognised migraine, rest in a dark room and use the treatment that has been agreed for you. If the attack has lasted longer than 72 hours, aura has lasted longer than 1 hour, or you are pregnant or have just had a baby, get urgent GP advice or call NHS 111 rather than waiting it out.
This article cannot diagnose a first severe headache. New neurological symptoms need a person, not a comparison chart.
How is a migraine different from an ordinary headache?
A migraine is a neurological condition, not just a bad headache. An attack usually means throbbing pain, often on one side and worse with movement, plus feeling sick and sensitivity to light or sound. The NHS says attacks usually last between 4 hours and 3 days.
A tension-type headache is typically a tight band of pressure without those extra features. If your attacks include nausea, light sensitivity or a need to lie still in a dark room, treat them as migraine until a GP says otherwise.
The NHS notes that migraines affect 10 million people in the UK. They can run in families and are more common in women than men. Frequency varies: some people have attacks several times a week, others far less often.
| Feature | Migraine | Tension-type headache | Cluster headache |
|---|---|---|---|
| Pain | Throbbing, often one-sided, worse on moving | Pressure or tight band, often both sides | Severe pain around one eye, in bouts |
| Extra symptoms | Nausea, light and sound sensitivity; sometimes aura | Not usually nausea or strong light sensitivity | Restlessness, a watering eye or blocked nose on that side |
| Typical length | 4 hours to 3 days | Minutes to hours, sometimes longer | Shorter attacks that repeat in clusters |
| First NHS step | Treat early; GP if frequent or disabling | Rest, fluids, simple painkillers; GP if frequent | See a GP; this pattern needs specific treatment |
Early symptoms can start hours or up to 2 days before the pain: tiredness and yawning, food cravings or thirst, mood change, a stiff neck, or peeing more. After the pain settles, people often feel washed out.
Menstrual migraines happen just before or during a period. The NHS says they are often longer and more severe than attacks at other times.
What is a migraine aura?
An aura is a warning phase some people get, most often visual — zigzag lines, flashing lights or patches of lost vision. It can also mean tingling, dizziness or difficulty speaking. The NHS says aura should not last longer than 1 hour. If it lasts longer, get urgent advice.
Not everyone with migraine has aura. Having aura does not make you “more official”; it does change when you should worry. New speech trouble, new weakness, or visual loss that does not match your usual pattern is a 999 situation until proven otherwise.
If you get aura without much headache, still tell a GP. They can check that the label is right and talk about treatment and, if relevant, hormonal contraception.
What can I do during an attack?
Treat the attack early. Rest in a darkened room, take suitable painkillers as soon as the headache starts, and use any anti-sickness or migraine medicine you have been prescribed. A pharmacist can advise on ibuprofen or paracetamol. Do not wait until the pain is at its worst.
Sip water if you can keep it down. If vomiting is a major part of your attacks, say so at the pharmacy or GP — tablets you cannot keep down will not help, and other forms of medicine exist.
Other practical steps:
- reduce light, noise and strong smells
- sleep if sleep helps you, but do not use extra sleep as your only plan every time
- have a way to get help without driving
- if vomiting stops you keeping tablets down, tell a GP — other forms of medicine exist
You may need to try a combination of treatments before something works. That is common, not a sign you are imagining it.
When should I see a GP about migraine?
See a GP if attacks are severe, getting worse, lasting longer than usual, happening more than once a week, hard to control, or regularly linked to your period. Get urgent GP advice or call NHS 111 if an attack lasts longer than 72 hours, aura lasts over 1 hour, or you are pregnant.
The same urgent GP or 111 route applies if you have just had a baby. Medicine choices and assessment are different in pregnancy and just after birth, even if the attack feels like your usual migraine.
Bring a simple diary if you can: dates, how long it lasted, what you took, and possible triggers. That helps a GP decide between better attack treatment and prevention.
Call 999 if you or your child have a headache that came on suddenly and is extremely painful, problems speaking or remembering, loss of vision or blurred or double vision, drowsiness or confusion, a seizure, a very high temperature with meningitis symptoms, weakness on one side of the body or face, or a recent head injury.
What treatments can the NHS offer?
There is no cure, but treatment can ease attacks and reduce how often they happen. Attack treatment includes painkillers, medicines called triptans and gepants, and anti-sickness medicines. Prevention can include certain tablets (including some beta blockers, antidepressants and epilepsy medicines), acupuncture, relaxation techniques, CBT, and vitamin B2. A GP may also suggest regular meals and less caffeine.
NICE guidance on headaches in over-12s supports matching treatment to how often and how severe attacks are, and reviewing it if it is not working. If standard treatment fails, you may be referred to a specialist.
Do not start a preventive medicine from a friend or an online list. Some of these drugs are used for other conditions, and they are not suitable for everyone, including some people who are pregnant.
What should I not do if I get migraines?
Do not take painkillers on more than 2 days a week as a habit. The NHS warns that this can cause more headaches and make migraine harder to treat. Do not skip meals, rely on extra caffeine, or drive during an attack. Do not ignore a headache that feels different from your usual migraine.
Other things that backfire:
- taking another dose “just in case” beyond the packet or prescription
- waiting all day to treat an attack you already recognise
- assuming pregnancy will automatically improve migraine and stopping useful treatment without advice
- using codeine-containing painkillers regularly — they are a common route into medication-overuse headache
If you need pain relief most days, that is a reason to see a GP about prevention, not a reason to keep escalating tablets.
How do I spot my triggers?
Triggers are personal. The NHS lists periods, anxiety and depression, stress and tiredness, skipping meals or not eating regularly, too much caffeine, and not getting enough regular exercise. A diary is more useful than cutting out an ever-growing list of foods on hearsay.
Record, for a few attacks:
- sleep (too little or a sudden lie-in)
- meals and hydration
- stress and come-down after stress
- hormones
- caffeine and alcohol
- screen glare or missed glasses prescription, if relevant
Then change one thing at a time. Regular sleep, regular meals, hydration, limiting caffeine and alcohol, a healthy weight, regular exercise and stress management are the NHS lifestyle basics. They will not abolish migraine, but they make attacks less easy to provoke.
Do hormones, pregnancy or menopause change migraine?
They can. Menstrual attacks are often longer and more severe. Migraine sometimes improves in pregnancy and often improves after the menopause, but not for everyone. If you are pregnant or have just had a baby and you have a migraine attack, the NHS says to get urgent GP advice or call NHS 111, because assessment and medicine choices are different.
Tell a GP or family planning clinic about migraine with aura before starting combined hormonal contraception. That conversation belongs with a clinician, not a forum thread.
Most people find attacks slowly ease with age. If yours are getting worse, more frequent, or changing shape, that is a reason to go back to a GP rather than assuming it is “just getting older”.
Common questions about migraine
- Is a migraine the same as a bad headache?
- No. A migraine is a neurological condition that usually causes throbbing pain alongside other symptoms such as nausea and sensitivity to light or sound. Tension headaches feel more like a constant band of pressure and do not usually cause these extra symptoms.
- What is a migraine aura?
- An aura is a set of warning symptoms some people get before a migraine, usually visual — flashing lights, blind spots or zig-zag patterns — and sometimes tingling or speech difficulty. The NHS says aura should not last longer than 1 hour. Not everyone with migraine gets an aura.
- What are common migraine triggers?
- Triggers differ between people but often include stress, tiredness, skipped meals, too much caffeine, hormonal changes around periods, anxiety and depression, and not enough regular exercise. Keeping a diary of attacks can help you spot your own patterns.
- Can migraines be cured?
- There is no cure, but migraines can usually be managed well. This may involve avoiding known triggers, treating attacks early with suitable painkillers, and, for frequent migraines, preventive treatments prescribed by a doctor.
- How long does a migraine last?
- The NHS says attacks usually last between 4 hours and 3 days. Early symptoms such as tiredness can start hours or up to 2 days before the head pain. If an attack lasts longer than 72 hours, get urgent GP advice or call NHS 111.
- When should I see a GP about migraine?
- See a GP if attacks are severe, getting worse, lasting longer than usual, happening more than once a week, hard to control, or regularly coming before or during your period. Ask for urgent GP care or NHS 111 if you are pregnant or have just had a baby and have a migraine attack.
- Can painkillers make migraine worse?
- Yes. The NHS advises trying not to take painkillers for more than 2 days a week, because that can cause more headaches and make migraine harder to treat. If you need painkillers that often, see a GP about prevention rather than taking more tablets.
- Do migraines improve with age or after menopause?
- The NHS says most people find attacks slowly get better as they get older. In women, migraine often improves after the menopause and sometimes improves in pregnancy, but that is not guaranteed. Do not stop useful treatment on the assumption it will vanish.
- What can I take during an attack?
- A pharmacist can advise on painkillers such as ibuprofen or paracetamol, taken as soon as the headache starts. A GP may prescribe triptans, gepants, or anti-sickness medicine. Do not take extra doses beyond the packet or prescription, and do not drive to A&E during a severe attack.