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Mixed Tension Migraine

Reviewed by: HU Medical Review Board | Last reviewed: October 2020

Some people have headaches with some symptoms of migraine. There is disagreement among doctors about whether these attacks are tension headaches or mild migraines. That is why some people call this type of headache a mixed tension migraine.

Differences between headache and migraine

The International Headache Society does not recognize mixed tension migraine as an official type of migraine. Instead, it talks about tension-type headache and migraine without aura as 2 separate types. There are some key differences between tension headache and migraine, though a severe headache can feel more like a mild migraine.1

Tension headache

Tension-type headaches generally cause a dull, aching pain across a large part of the head and face, and usually are not severe enough to prevent daily activities. The headache may last from a few minutes to days. Unlike migraine, the pain does not get worse during normal activity such as walking or climbing stairs, and there is no nausea, vomiting, or sensitivity to light or sound. When a tension headache reappears often, or the pain becomes severe and throbbing, or there is sensitivity to light, some doctors may consider it a mixed tension migraine.2,3

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Migraine without aura

Migraine without aura is different because the pain is throbbing, usually on 1 side of the head, and severe enough to get in the way of daily activities. Other common symptoms of migraine include nausea, vomiting, numbness or tingling in the face, and sensitivity to light and sound. Attacks usually last 1 day or longer.2

Diagnosing mixed tension migraine

Keeping a migraine diary will help your doctor diagnose whether you are having headaches or migraines. Your diary should include details of each attack, a list of all the symptoms you have, their severity, and how long each lasted. Since headaches and migraines can be triggered by the same things, a diary can help you better understand your triggers too. Common triggers of both headaches and migraines include:1,2

  • Bright light
  • Not getting enough sleep
  • Skipping meals
  • Menstrual cycle
  • Drinking alcohol

Treatment for mixed tension migraine

Treatments for tension headache usually focus on pain relief. The most common drugs taken for headache pain relief are acetaminophen or ibuprofen. Relaxation techniques such as massage, yoga, or stretching can also help. Some people find that caffeine can help relieve their headache, but this can also cause rebound headaches if used too much.4

Migraine is treated with a combination of pain relievers, preventive drugs, acute drugs, and stress management.

The number and severity of headache and migraine can be reduced by avoiding triggers.