If you’ve had a throbbing headache on one side of your head for hours, felt sick, and had to dim the lights because they hurt your eyes, you may be wondering whether this is a migraine—and whether you need to see a doctor or can manage it yourself.

The truth is that migraine is far more than a bad headache. It’s a condition that can disable you for hours or days, and it shows itself differently from person to person. Some people get a warning phase hours before the pain starts.

Some see flashing lights or feel tingling in their hands. Some never get those warnings at all. The key is learning to recognise your own pattern so you know what’s happening and when you need help.

Quick answer: A migraine typically causes throbbing, one-sided head pain lasting 4–72 hours, often with nausea, vomiting, and sensitivity to light or sound. You can manage mild migraines at home with rest and over-the-counter pain relief. For urgent warning signs, see the red flags section below.

What a migraine actually feels like

A migraine is not simply a stronger version of a tension headache. The pain is typically throbbing or pulsing—as if your heart is beating inside your head—and it usually affects one side of your head, though it can move or affect both sides. The pain is often moderate to severe, and movement, light, sound or even smell can make it worse.

Beyond the headache itself, you may feel nausea or actually vomit. Your eyes may water. You might feel a sense of pressure in your face, or pain in your neck. You may feel exhausted, irritable or foggy.

Some people describe a migraine as leaving them unable to do anything but lie down in a dark, quiet room—and that’s not an exaggeration. The condition can genuinely disable you for hours or even a full day or more.

What makes migraine confusing is that it often mimics other conditions. Migraine pain in the face can feel like a sinus headache, and the watering eyes and nasal congestion that sometimes come with migraine can reinforce that impression.

Pain in the neck can feel like arthritis or muscle strain. This is why many people who think they have sinus headaches actually have migraines—and why it matters to recognise the pattern correctly, so you get the right help.

The four phases of a migraine: what happens and when

Not every migraine has all four phases, and not everyone experiences them the same way. But understanding these phases helps you recognise what’s happening to your body and predict what comes next.

Phase 1: Prodrome (the warning phase)

This phase can start up to 24 hours before the headache itself. You might feel unusually tired, irritable, or restless. Some people crave certain foods or lose their appetite.

You might notice mood changes, difficulty concentrating, or stiffness in your neck. These are subtle signs that a migraine is on its way, though not everyone gets them, and you may not recognise them as a warning until you’ve had migraines for a while.

Phase 2: Aura (the sensory warning)

Only some people with migraine experience an aura. If you do, it typically starts 10 minutes to an hour before the headache pain begins, and it usually lasts between 5 and 60 minutes. An aura is a group of sensory or motor symptoms that act as a clear warning that the headache is coming.

The most common aura symptom is a vision change: you might see flashing or bright lights, zigzag patterns, dots, or sparks. Your vision might become blurred or you might develop a blind spot. Some people experience tingling or pins-and-needles sensations in their hands, arms, face or lips.

Less commonly, aura can affect your ability to speak, cause temporary weakness in your limbs, or make you feel confused. These symptoms can be frightening if you don’t know what they are, but they pass—usually within an hour—and they are not a stroke, even though some of them can look similar.

Phase 3: The attack (the headache itself)

This is the migraine headache proper. It typically lasts between 4 and 72 hours, though most last 24 to 48 hours. The pain is throbbing or pulsing, usually on one side of the head, and it can range from moderate to severe.

During this phase, you may feel nausea or vomit, become extremely sensitive to light (photophobia), sound (phonophobia), or even smell. Movement often makes the pain worse. Many people find that they cannot work, concentrate, or do anything but rest in a dark, quiet room.

Phase 4: Postdrome (the hangover phase)

After the headache pain fades, you may feel exhausted, foggy, or emotionally drained for hours or even a day. Some people describe this as a “migraine hangover.” You might feel weak, have difficulty concentrating, or feel emotionally sensitive. This phase is real recovery time, and pushing yourself too hard during it can sometimes trigger another migraine.

How to tell migraine apart from other headaches

The headaches you’re experiencing could be migraine, tension headache, sinus headache, cluster headache, or medication-overuse headache. The difference matters because the treatment and when you need to see a doctor are different for each.

Migraine vs. tension headache

Tension headaches are the most common type of headache. They usually cause a pressing or tightening sensation—like a band around your head—rather than throbbing. The pain is usually mild to moderate, affects both sides of your head equally, and lasts 30 minutes to several hours. Tension headaches don’t usually cause nausea, vomiting or sensitivity to light.

They may be triggered by stress, poor posture, or muscle tension in the neck and shoulders, and they often improve with rest or over-the-counter pain relief. A migraine, by contrast, is throbbing, often one-sided, moderate to severe, can last much longer, and is frequently accompanied by nausea and light sensitivity.

Migraine vs. sinus headache

Sinus headaches cause pain and pressure in the face—around the eyes, cheeks, forehead or nose—and are usually caused by sinus infection or inflammation. They may come with nasal congestion, discharge, or a sense of facial fullness. However, migraine pain can also be felt in the face, and migraine can come with watering eyes and nasal congestion, which makes it easy to confuse the two.

The key difference is that migraine pain is typically throbbing and one-sided, and it comes with sensitivity to light and nausea, whereas true sinus headache does not. If you think you have chronic sinus headaches but they come with light sensitivity and nausea, they are probably migraines.

Migraine vs. cluster headache

Cluster headaches are rare and cause intense, burning pain, usually around one eye. They come in clusters—multiple headaches over weeks or months, then long periods of remission. They are much less common than migraine and typically affect men more than women.

Cluster attacks last about 15 to 180 minutes, whereas migraine attacks last 4 to 72 hours. If your headaches are throbbing rather than burning and last hours rather than minutes, they are more likely to be migraine.

Red flags: when a headache needs urgent care

Most migraines, while painful and disabling, are not dangerous. However, some headaches are warnings of something more serious. If you experience any of the following, seek medical attention urgently—either at your nearest hospital emergency department or by calling emergency services:

• Sudden, severe headache: A headache that comes on suddenly and is the worst you’ve ever felt, even if it feels like your usual migraine but much worse, needs urgent evaluation.
• Headache with weakness, numbness or difficulty moving: If the headache comes with weakness on one side of your body, numbness in your face or limbs, or difficulty moving, seek emergency care immediately.
• Headache with difficulty speaking or confusion: If you struggle to find words, speak unclearly, or feel confused, this needs urgent assessment.
• Headache with vision loss: If you lose vision or have vision changes that don’t match your usual aura, seek urgent care.
• Headache with fever and neck stiffness: This combination can signal meningitis and needs emergency evaluation.
• Headache after a head injury: If you’ve had a fall, blow to the head or accident, and now have a headache, get it checked.
• A change in your usual migraine pattern: If your migraines suddenly feel different, happen more often, last longer, or come with new symptoms, see a doctor.
• A first headache after age 50: A headache that is new for someone over 50 needs prompt medical assessment.
• Headache that wakes you or is worse lying down: Pain that disturbs sleep or worsens when you lie flat needs urgent evaluation.
• Headache brought on by cough, exertion or sexual activity: A headache triggered by straining, coughing or physical exertion needs a medical check, particularly if it is new.
• Seizures: Any fit or seizure alongside a headache needs emergency care.
• Headache in pregnancy: Any severe or unusual headache during pregnancy or after childbirth needs prompt assessment, as it can signal a pregnancy-related condition.

These red flags do not mean you have a serious condition—but they do mean you need a professional assessment to rule one out.

When to see a doctor: the decision tree

Not every migraine needs a doctor’s visit. But certain patterns and warning signs mean you should book an appointment. Here’s how to decide what to do now.

You can manage at home if:

Your headaches happen occasionally (four or fewer times a month), the pain is mild to moderate, and you can relieve it with rest, fluids, and over-the-counter pain relief such as paracetamol or ibuprofen.

If you recognise the pattern, know what triggers it, and the migraine passes within 24–48 hours without new symptoms, home management is reasonable. Keep a simple note of when the headaches happen, what triggered them, and how long they lasted—this information will help a doctor later if you need one.

See your general physician if:

Your migraines are new (you’ve never had them before), or your usual pattern has changed—they’re happening more often, lasting longer, or coming with new symptoms. A GP can also prescribe stronger pain relief or refer you to a neurologist. If you’re unsure whether your headaches are migraines or something else, a GP is a safe first step.

Book a neurologist if:

Your migraines happen more than four times a month, are severe enough to stop you working or studying, or are not responding well to over-the-counter pain relief. A neurologist specialises in headache disorders and can diagnose migraine accurately, identify your triggers, prescribe preventive medications if needed, and manage your condition long-term.

Seek urgent care if:

You have any of the red-flag symptoms listed above. Do not wait for a routine appointment.

What happens when you see a neurologist

Preparation makes the appointment far more useful: bring your headache diary, a list of all the medicines you take, and any previous scan reports, such as CT or MRI results. Here’s what to expect at a neurologist’s appointment for migraine assessment.

The neurologist will ask detailed questions about your headaches: when they started, how often they happen, how long they last, where the pain is, what it feels like, and what makes it better or worse. They’ll ask about other symptoms—nausea, vomiting, light sensitivity, aura symptoms, mood changes—and about your family history, because migraine often runs in families.

They’ll ask about your triggers: stress, certain foods, hormonal changes, sleep, caffeine, or other patterns you’ve noticed. They may ask about your work, sleep, stress levels and other health conditions, because these all affect migraine.

The neurologist will examine you: checking your blood pressure, testing your reflexes, assessing your strength and sensation, and checking your eyes and balance. In most cases of migraine without red flags, imaging (CT or MRI scan) is not needed.

The diagnosis is usually made from your history and examination alone. However, if your headaches are new, severe, or have changed, or if you have any red-flag symptoms, the neurologist may recommend a scan to rule out other causes.

Once diagnosed, the neurologist will discuss treatment options. For occasional migraines, this may be acute medication—pain relief to take during an attack.

For frequent migraines (more than four a month), preventive medication may help reduce how often and how severe they are. Preventive medications are taken daily and work over weeks to months. The neurologist will explain the options, their side effects, and what to expect, and will work with you to find what suits you best.

When a neurosurgeon’s assessment becomes necessary

Most migraines are managed by neurologists and do not need a neurosurgeon. However, if your migraine is accompanied by red-flag symptoms, or if imaging shows an abnormality, a neurosurgeon’s assessment may be needed.

A neurosurgeon is the right specialist if your headache is caused by a structural problem—such as a brain tumour, aneurysm, Chiari malformation, or other condition that may need surgery or specialist imaging review. If your neurologist suspects this, they will refer you.

If you already have a scan that shows an abnormality and want a specialist opinion on what it means, ask your neurologist or a neurosurgeon to review the images themselves, not just the written report. You can find information about Dr. Shyam D’s neurosurgery practice at drshyam.com.

For straightforward migraine without structural causes, a neurosurgeon is not needed. A neurologist is the right specialist to manage your condition long-term.

Tracking your migraines: what to record

Before you see a doctor, and especially before a neurologist’s appointment, keeping a simple migraine diary helps enormously. You don’t need anything complicated—a notebook or a note on your phone is enough.

For each headache, record: the date it started, the time of day, how long it lasted, where the pain was (one side or both, front or back), what it felt like (throbbing, pressing, sharp), and how severe it was on a scale of 1 to 10. Note any other symptoms: nausea, vomiting, light sensitivity, sound sensitivity, vision changes, tingling, weakness, or mood changes.

Write down what you think triggered it: stress, lack of sleep, certain foods, hormonal changes, weather, or anything else you noticed. Note what you took for it and whether it helped. Over a few weeks, patterns will emerge—you’ll see which days of the week, times of month, or situations tend to bring on a migraine. This information is invaluable to a doctor and helps them recommend the right treatment.

Common migraine triggers and what you can do about them

Migraine triggers are highly individual—what sets off one person’s migraine may not affect another. However, some triggers are common enough that recognising them in your own pattern can help you reduce how often migraines happen.

Stress and emotional changes

Stress is one of the most common migraine triggers. Interestingly, it’s often not the stress itself but the relaxation after stress that brings on a migraine—the “let-down” migraine on a weekend or after a busy work period. If stress is a pattern for you, managing it through regular exercise, sleep, or relaxation techniques may help. You cannot eliminate all stress, but you can reduce its impact.

Sleep changes

Too little sleep, too much sleep, or irregular sleep patterns can trigger migraine. Aim for consistent sleep and wake times, even on weekends. If you travel across time zones, be aware that jet lag often triggers migraines in people who are prone to them.

Skipped meals and dehydration

Fasting or going too long without food can trigger migraine. So can dehydration. Eating regular meals and drinking enough water throughout the day is a simple preventive step. Some people find that caffeine withdrawal also triggers migraine, so if you drink coffee or tea regularly, avoid sudden changes.

Hormonal changes

For women, migraines often follow hormonal patterns. Some women’s migraines worsen around their menstrual cycle, during ovulation, or when taking hormonal contraceptives. If you notice a pattern linked to your cycle, mention it to your doctor—there are strategies to help, including timing of medication or adjusting contraception.

Certain foods

Some people find that specific foods trigger migraine: aged cheeses, cured meats, chocolate, citrus fruits, or foods containing MSG or artificial sweeteners. The evidence for food triggers is mixed, and they vary widely between individuals.

If you suspect a food trigger, keep a note in your migraine diary and see if a pattern emerges. Avoid eliminating foods unnecessarily—work with your doctor or a dietitian if you think diet is a factor.

Weather and environmental changes

Changes in barometric pressure, humidity, or temperature can trigger migraine in some people. Bright or flickering lights, loud noise, or strong smells can also be triggers. If you notice these patterns, you may not be able to prevent them, but you can prepare—resting in a quiet, dark space when you sense a migraine coming can sometimes reduce its severity.

Managing a migraine when it starts: what actually helps

Once a migraine has begun, the goal is to stop it or reduce its severity as quickly as possible. The earlier you act, the better the outcome.

Pain relief medication

Over-the-counter options include paracetamol (500–1000 mg) or ibuprofen (400–600 mg). These work best if taken early in the migraine, before the pain becomes severe. Some people find that combining paracetamol with ibuprofen works better than either alone.

Triptans are prescribed, not self-started, and they are not suitable for everyone; they must be avoided in people with heart or blood vessel disease, uncontrolled high blood pressure, or pregnancy, so check with a doctor before using one for the first time.

If over-the-counter medication doesn’t work, or if your migraines are frequent or severe, a doctor can prescribe stronger options such as triptans (sumatriptan, rizatriptan) or other migraine-specific medications. Triptans work by narrowing blood vessels and blocking pain pathways in the brain, and they are often more effective than simple pain relief for moderate to severe migraine.

Because they narrow blood vessels, they should only be used under medical advice and avoided in heart or blood vessel disease, uncontrolled high blood pressure, or pregnancy. Taking pain relief on more than 10–15 days a month can cause medication-overuse headache, so keep track of how often you use it.

Anti-nausea medication

If nausea is severe, an anti-nausea medication (such as metoclopramide) taken alongside pain relief can help. This also helps the pain relief work better, because nausea can prevent you from absorbing medication.

Rest and environment

Lie down in a dark, quiet room. Reduce sensory input—dim the lights, close the curtains, turn off notifications on your phone. Apply a cold compress to your forehead or neck, or a warm compress if that feels better. Some people find that heat or cold helps; experiment to see what works for you. Stay hydrated—sip water slowly if you can.

What doesn’t help

Pushing through a migraine rarely works. Trying to work, exercise, or carry on as normal usually makes it worse. Rest is not laziness; it’s part of treatment. Caffeine can help some people if taken early, but it can also trigger rebound headaches if used too often, so use it sparingly.

Preventing migraines: when medication makes sense

If you have more than four migraines a month, or if they are severe enough to stop you working or studying, preventive medication may help. Preventive medications are taken daily, whether or not you have a headache, and they work over weeks to months to reduce how often migraines happen and how severe they are.

Common preventive medications include beta-blockers (propranolol), tricyclic antidepressants (amitriptyline), anticonvulsants (topiramate, valproate), and newer monoclonal antibody medications (erenumab, fremanezumab). Each has different side effects and benefits.

A neurologist will discuss which option suits you best based on your other health conditions, other medications you take, and your preferences. Preventive medication is not a cure—migraines may still happen, but they should be less frequent and less severe. It takes time to work, so patience is needed.

Frequently asked questions

What’s the difference between migraine with aura and migraine without aura?

Migraine with aura includes sensory warning symptoms (vision changes, tingling, weakness, or speech difficulty) that come before or during the headache. Migraine without aura is just the headache and its associated symptoms (nausea, light sensitivity) without the sensory warnings. Both are migraines; the difference is whether you get the aura phase. About one-third of people with migraine experience aura.

Can migraine cause permanent damage to my brain?

Migraine itself does not cause brain damage or permanent harm. However, very frequent or severe migraines can affect your quality of life, work, and relationships. This is why getting proper treatment and management is important—not because migraine is dangerous, but because it can be disabling and you deserve relief.

Can I prevent migraines completely?

There is no cure for migraine, and you cannot prevent all of them. However, identifying and avoiding your triggers, managing stress and sleep, staying hydrated, and taking preventive medication if needed can reduce how often they happen and how severe they are. Most people with migraine can achieve significant improvement with the right approach.

Related guides

• Migraine vs Brain Tumor: How to Tell the Difference: how migraine symptoms compare with those of a brain tumour, and when imaging is considered.
• Which Doctor to Consult for Headache in India: which specialist to see first for different types of headache.
• Neurologist vs. Neurosurgeon: Understanding the Difference for Madurai Patients: the role of each specialist and how referrals work.
• Chronic Headaches: 7 Warning Signs to Know: persistent headache patterns that warrant a professional review.

Sources

• Migraine: What It Is, Types, Causes, Symptoms & Treatments — Cleveland Clinic
• Migraine — NHS
• Migraine | National Institute of Neurological Disorders and … — U.S. National Institutes of Health

This article explains general medical information. It is not a diagnosis — please see a qualified doctor about your own symptoms.

Sources and further reading

• Cleveland Clinic: Migraine: What It Is, Types, Causes, Symptoms & Treatments
• Cleveland Clinic: Silent Migraine (Typical Aura Without Headache)
• U.S. National Institutes of Health: Migraine | National Institute of Neurological Disorders and …
• MedlinePlus (U.S. National Library of Medicine): Migraine