When a Migraine Isn’t “Just a Migraine”: Understanding Migraine-Like Headaches
- Julian Simpson
- 20 hours ago
- 4 min read
When a Migraine Isn’t “Just a Migraine”: Understanding Migraine-Like Headaches
Migraines are common, disabling, and often recurrent. But not every headache that looks like a migraine actually is a primary migraine.
Current research is shining a spotlight on an important — and often overlooked — group of headaches known as migraine-like headaches (sometimes called migraine mimics or symptomatic migraines).
At Health Wise Chiropractic, understanding these distinctions matters — because identifying the right type of headache leads to the right care.
What Is a Migraine-Like Headache?
A migraine-like headache is a headache that:
Looks and feels like a migraine
May include throbbing pain, nausea, light sensitivity, or aura
But is caused by an underlying medical condition, not a primary migraine disorder
These headaches are often initially treated as migraine, until further investigation reveals a secondary cause.
That’s why careful clinical assessment is essential.
How Common Are Secondary (Non-Migraine) Headaches?
The prevalence varies depending on setting:
Emergency departments report 2–7% of headache patients have secondary causes
The World Health Organization estimates up to 18% of headaches may be secondary
This means nearly 1 in 5 headaches may not be primary migraine.
What Causes Migraine-Like Headaches?
The study found a wide range of underlying causes, most commonly:
🧠 Vascular causes (29%)
Stroke
Cerebral aneurysms
Other blood vessel disorders
⚡ Neurological causes
Epilepsy
Post-traumatic brain injury (TBI)
🧬 Other important causes
Autoimmune conditions
Infections (including post-viral and COVID-related cases)
Tumours
Idiopathic intracranial hypertension (IIH)
Rare metabolic or genetic conditions (e.g. MELAS syndrome)
👉 Importantly, many of these conditions are treatable once identified.
What Do Migraine-Like Headaches Feel Like?
The review found common features that closely resemble migraine:
✔ Severe pain✔ One-sided (unilateral) headaches✔ Frontal, temporal, or occipital location✔ Episodic attacks rather than daily headaches
However, some features occurred more often than in primary migraine:
🚩 Key Differences to Watch For
Aura occurred in ~50% of cases (higher than typical migraine)
Sudden or unusual onset
New or changing headache patterns
Headache after head injury
Headaches associated with systemic symptoms (fever, neurological changes, unexplained fatigue)
These features are often referred to as “red flags.”
Why Red Flags Matter
Identifying migraine-like headaches early can be life-changing — and sometimes life-saving.
Unlike primary migraine:
Secondary headaches often require treating the underlying cause
Some patients in this review required surgery or targeted medical treatment
About 16% of patients underwent cranial surgery once the cause was identified
Early recognition leads to:✔ Faster diagnosis✔ More appropriate imaging (especially MRI)✔ Better long-term outcomes
The Role of Imaging
MRI was the most commonly used imaging tool, especially when:
Red flags were present
Autoimmune or vascular causes were suspected
Headaches were severe or unusual
Interestingly, patients who received early and thorough imaging tended to report fewer migraine days, highlighting the value of timely investigation.
What Does This Mean for You?
If you experience migraines, this research does not mean you should panic — most migraines are still primary.
But it does reinforce the importance of reassessment if headaches:
🚩 Change suddenly🚩 Become more severe or frequent🚩 Include new neurological symptoms🚩 Appear after trauma🚩 Don’t respond as expected to treatment
How Health Wise Chiropractic Approaches Headaches
At Health Wise Chiropractic, we believe effective headache care starts with listening and thorough assessment.
Our approach includes:
Detailed history and symptom analysis
Screening for headache red flags
Understanding posture, movement, and nervous system load
Referring for imaging or medical review when appropriate
Collaborative, evidence-informed care
Chiropractic care does not replace medical evaluation — it complements it, especially when headaches involve musculoskeletal, postural, or nervous system stress.
The Take-Home Message
✔ Not all migraines are primary migraines✔ Some migraine-like headaches have identifiable, treatable causes✔ Red flags matter — and should never be ignored✔ Early assessment and imaging can improve outcomes✔ A whole-person, evidence-based approach leads to safer care
If headaches are impacting your life — or something about them doesn’t feel “quite right” — our team is here to help guide you through the next steps.
📍 Book an appointment with Health Wise Chiropractic📞 Or speak with our team about a headache assessment today
Headache Chiropractor
Q: Can a chiropractor help with headaches?Yes, chiropractic care can help relieve tension headaches and cervicogenic headaches by improving spinal alignment and reducing muscle tension.
Q: How does chiropractic treat headaches?We use gentle spinal adjustments, posture correction, and muscle therapy to relieve the stress and pressure that often trigger headaches.
Q: Is chiropractic care safe for frequent headaches?Yes, chiropractic is a safe and drug-free option for many types of headaches when provided by qualified practitioners.
Q: How soon will I feel headache relief?Some patients notice improvement after their first few visits, while others may need a tailored care plan depending on the cause of their headaches.
For more information about how we can help YOU with your headaches and improve your underlying dysfunction so the problem doesn’t come back. Please call Health Wise Chiropractic 03 9467 7889 or book online to see one of our Chiropractors in Sunbury or Melton/Strathtulloh Today!
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Gama-Reyes EG, de Caceres-García AN, Castillo-Vaca MF, Hernandez-Ramirez J, Jimenez-Romo AE, Fuentes-Mendoza JM, Rodríguez-Lizarraga E, Díaz-Garza CA, Galnares-Olalde JA. Migraine-like headaches: a systematic review of secondary etiologies, clinical features and therapeutic patterns (1977-2024). J Headache Pain. 2025 Oct 28;26(1):232. doi: 10.1186/s10194-025-02151-8. PMID: 41152703; PMCID: PMC12570850.
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