If you have ever wondered whether you should say migraine or migraines, you are not alone. The distinction might seem like a minor grammatical issue, but it has become an interesting point of discussion among headache specialists, patients, researchers, and migraine advocates.

Both terms are widely used, and both are technically correct. However, there is a growing preference among many healthcare professionals and patient advocates for using the singular term migraine when referring to the neurological disease, rather than the plural term migraines, which can imply that the condition is simply a collection of individual headaches.

So, is there a meaningful difference between migraine and migraines? Why does terminology matter, and which term should you use?

Let's explore the debate.

Is It Migraine or Migraines? Understanding the Difference

The distinction comes down to whether we are referring to the underlying neurological disorder or individual episodes of headache.

Migraine (singular) refers to a neurological disease characterized by recurrent attacks involving a range of symptoms. These may include:

• Moderate to severe head pain, often throbbing or pulsating.

• Sensitivity to light (photophobia) and sound (phonophobia).

• Nausea and vomiting.

• Visual disturbances or other neurological symptoms known as aura.

• Difficulty concentrating, fatigue, dizziness, and other symptoms.

Importantly, migraine is much more than a headache. It is a complex neurological disorder involving changes in brain function and sensory processing.

Migraines (plural) is commonly used to describe multiple migraine attacks or episodes. For example, someone might say, "I had three migraines last month."

Both expressions are understandable. However, using the plural term to describe the disease itself can unintentionally reinforce the misconception that migraine is simply a series of unrelated headaches.

Why Some Experts Prefer the Term "Migraine"

The preference for saying "migraine" rather than "migraines" reflects a broader effort to recognize migraine as a chronic neurological disease.

Consider the difference between these statements:

• "I suffer from migraines."

• "I have migraine."

The first statement can suggest that the person experiences occasional episodes of headache. The second emphasizes that the person has an underlying neurological condition that can produce recurrent attacks.

This distinction is similar to how we discuss other chronic medical conditions. We generally say that someone has asthma rather than describing them as having multiple "asthmas," or that someone has epilepsy rather than referring to individual "epilepsies" when discussing their underlying condition.

Migraine is a disease, not simply a collection of headaches.

People living with migraine may experience attacks intermittently, but the underlying neurological susceptibility remains even when they are feeling well.

This is particularly important when discussing people with frequent attacks or chronic migraine.

Migraine Is More Than Just a Headache

One of the biggest reasons terminology matters is that migraine is frequently misunderstood.

Many people still think of migraine as an especially severe headache. In reality, migraine is a neurological disorder that can affect multiple aspects of brain function.

A migraine attack can involve several phases:

1. Prodrome

Hours or even days before the headache begins, some people experience changes such as fatigue, food cravings, irritability, neck stiffness, or difficulty concentrating.

2. Aura

Some people experience temporary neurological symptoms, most commonly visual disturbances such as flashing lights, zigzag lines, or blind spots. Sensory disturbances and speech difficulties can also occur.

3. Headache phase

The headache may be accompanied by nausea, vomiting, light sensitivity, sound sensitivity, and significant functional impairment. Not every migraine attack includes headache, however.

4. Postdrome

After the headache resolves, some people experience fatigue, difficulty concentrating, dizziness, or a general feeling of being unwell.

Not everyone experiences all four phases, and symptoms can vary considerably between individuals and even between attacks in the same person.

Furthermore, migraine can occur without headache altogether. This is another reason why equating migraine with headaches is an oversimplification.

Episodic Migraine vs. Chronic Migraine

The distinction between migraine as a disease and individual migraine attacks becomes particularly relevant when discussing episodic and chronic migraine.

Episodic migraine generally refers to people experiencing fewer than 15 headache days per month, with migraine features on at least some of those days.

Chronic migraine is defined by the International Classification of Headache Disorders (ICHD-3) as:

• Headache occurring on 15 or more days per month for more than three months.

• At least eight days per month with migraine features

These classifications describe different patterns of the same underlying neurological disorder.

Someone with episodic migraine does not necessarily have a less legitimate or less significant disease than someone with chronic migraine. Even a few attacks per month can substantially affect quality of life, work productivity, relationships, and family life.

Does the Terminology Affect How Migraine Is Treated?

The words themselves do not change the biology of the disease or determine which treatment someone should receive.

However, the way we talk about migraine can influence how patients, healthcare professionals, employers, and society understand it.

When migraine is described as simply having occasional headaches, its broader neurological and functional consequences can be overlooked.

This can contribute to:

• Delayed diagnosis and inadequate treatment.

• Underestimation of the impact of migraine on work and daily activities.

• Failure to recognize symptoms beyond head pain.

• Less attention to preventive treatment.

• Stigma surrounding people who frequently need to miss work or cancel activities because of migraine.

Recognizing migraine as a neurological disease encourages a more comprehensive approach to management.

Treatment should not simply focus on relieving individual headaches. It should also consider reducing attack frequency, improving function, identifying triggers where appropriate, and preventing progression to chronic migraine.

Modern migraine treatment includes acute medications such as triptans and gepants, as well as preventive treatments such as CGRP-targeting medications, Botox (onabotulinumtoxinA) for chronic migraine, and traditional preventive medications.

Lifestyle strategies, behavioral therapies, and selected supplements may also play a role in a comprehensive migraine management plan.

Should We Stop Saying "Migraines"?

Not necessarily.

There is no need to correct someone who says they have migraines. The plural term is firmly established in everyday English, and it is perfectly reasonable when referring to multiple migraine attacks.

For example:

• "I had three migraines this month."

• "My migraines have become more frequent."

• "I have been experiencing migraines since childhood."

All of these are understandable and commonly used expressions.

However, when discussing the neurological disease itself, using the singular term migraine can help reinforce an important message: migraine is a medical condition, not simply a series of bad headaches.

Healthcare professionals, researchers, journalists, and patient advocacy organizations can help improve public understanding by being intentional about terminology.

Ultimately, the goal should not be to police language, but to improve awareness and recognition of the disease.

The Bottom Line: Migraine or Migraines?

Both terms are correct, but they are not always used to communicate exactly the same thing.

• Migraine refers to the underlying neurological disorder.

• Migraine attack refers to an individual episode of migraine symptoms.

• Migraines is commonly used in everyday language to describe multiple attacks or the experience of living with the disease.

There is value in emphasizing migraine as a neurological disease rather than simply a type of headache. Better terminology can help improve awareness, reduce stigma, and encourage people to seek appropriate medical care.

Whether you say migraine or migraines, the most important thing is recognizing that migraine is a real, complex, and often disabling neurological condition that deserves appropriate attention and treatment.

-Neurologist and Co-Founder of NeuroNaturals

Frequently Asked Questions

Is migraine a disease or a symptom?

Migraine is a neurological disease, not simply a headache symptom. It causes recurrent attacks that may involve headache, nausea, sensory sensitivity, visual disturbances, and other neurological symptoms.

Is it grammatically correct to say "I have migraine"?

Yes. "I have migraine" is a medically appropriate way to describe having the neurological disorder. "I have migraines" is also common and grammatically correct English.

What is the difference between a migraine and a migraine attack?

Migraine refers to the underlying neurological disorder. A migraine attack is an individual episode of symptoms associated with that disorder.

Can you have migraine without having a headache?

Yes. Migraine can occur without headache. Some people experience aura without headache, while others experience other neurological and sensory symptoms during attacks.

Is chronic migraine the same as having frequent migraines?

Not exactly. Chronic migraine has a specific clinical definition involving at least 15 headache days per month for more than three months, including at least eight days with migraine features or migraine-specific treatment response.

Why is migraine often misunderstood?

Migraine is frequently misunderstood because it is commonly equated with headache. In reality, it is a complex neurological disorder that can affect sensory processing, cognition, mood, and daily functioning, sometimes even in the absence of head pain.

Medical disclaimer: This article is for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment.