Migraine and Tension-Type Headache: Diagnosis and Treatment

Med Clin North Am. 2019 Mar;103(2):215-233. doi: 10.1016/j.mcna.2018.10.003. Epub 2018 Dec 3.


Migraine and tension-type headache are highly prevalent. Migraine is associated with significant work- and family-related disability. Migraine is underdiagnosed; it reasonable to err on the side of migraine when choosing between primary headaches. Barriers to appropriate treatment of migraine include lack of access to providers, misdiagnosis, and acute and preventive therapies not being prescribed. Acute, rescue, and preventive treatment options are extensive, and new classes of treatments are either available or in development. This review addresses diagnostic challenges including recognizing migraine with aura. It also summarizes nonpharmacologic, acute, rescue, and preventive treatment options for migraine and treatment of tension-type headache.

Keywords: Headache; Migraine; Migraine with aura; Nonpharmacologic treatment; Prevention; Rescue treatment; Tension-type headache; Treatment.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Migraine Disorders* / diagnosis
  • Migraine Disorders* / drug therapy
  • Migraine Disorders* / prevention & control
  • Migraine Disorders* / therapy
  • Tension-Type Headache* / diagnosis
  • Tension-Type Headache* / drug therapy
  • Tryptamines / therapeutic use*


  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Tryptamines