Often, migraines are confused with tension-type headaches. A tension headache can be due to nerve irritation or muscle tightness, particularly around the neck and shoulders. Tension headaches typically stem from psychological triggers, such as stress or anxiety, and a lack of sleep or other causes for increased fatigue. To understand the differences, we must first look at the two types of headaches that occur. Primary: Not caused by another underlying disease or condition. Their causes can be linked to pressure on the nerves, blood vessels or muscles in the head and neck. Secondary: Linked to another disease or condition, where headaches are a symptom or by-product of that condition. These could be caused by the flu, alcohol, sinusitis, tumours, blood clots, concussion, glaucoma or medications.