They differ. The distinction decides the direction of treatment.

Tension headache feels like the head being gripped or pressed, and comes on both sides. It worsens towards the afternoon and is often accompanied by neck and shoulder stiffness. Moving does not make it much worse.

Migraine throbs on one side, with sensitivity to light and sound and accompanying nausea. Moving makes it worse, so you want to lie down. Some experience an aura of zigzag patterns in the visual field before the headache.

The approaches differ. For tension headache we address neck and shoulder muscle tension and posture; for migraine we go towards finding the triggers (lack of sleep, particular foods, the menstrual cycle, stress) and reducing the frequency.

Having both mixed together is also common.