Headaches

What Are Headaches?

A headache is pain felt somewhere in the head or neck. They're very common in kids, and have a wide range of causes and many levels of severity.

It's important to understand how to recognize when a headache is a passing pain and when it's something more and needs medical care.

What Are the Signs & Symptoms of a Headache?

Two common kinds of headaches that kids get are tension headaches and migraines.

Tension headaches happen when stressed-out head or neck muscles squeeze too hard. This causes pain often described as:

• feeling as though someone is pressing or squeezing on the front, back, or both sides of the head
• dull
• aching
• constant

Migraine headaches are less common. They can cause:

• pounding, throbbing pain on one or both sides of the head
• dizziness
• stomachaches
• nausea and/or vomiting
• seeing spots or halos (called an aura)

Most migraines last from 30 minutes to several hours. Some can last as long as a couple of days. They can feel worse when someone is doing physical activity or is around light, smells, or loud sounds. Sometimes, just before a migraine happens, the person sees wavy lines or bright spots of light. This is called an aura.

Young kids with headaches may not be able to say what hurts. Parents may notice that they are cranky and less active. They may throw up, or look pale or flushed.

What Causes Headaches?

Headaches are thought to be caused by changes in chemicals, nerves, or blood vessels in the area. These changes send pain messages to the brain and bring on a headache.

Most headaches are related to:

• infections (such as ear infections, viruses like the flu or a cold, strep throat, meningitis, or sinus infections)
• having a head injury
• some medicines (headaches can be a side effect)
• too little sleep or sudden changes in sleep patterns
• getting dehydrated
• being under a lot of stress
• allergies (hay fever)
• menstruation or changes in hormone levels
• skipping meals
• using the computer or watching TV for a long time
• vision problems
• taking a long trip in a car or bus
• listening to really loud music
• smoking
• smelling strong odors such as perfume, smoke, fumes, or a new car or carpet
• too much caffeine (in energy drinks, soda, coffee, tea, and chocolate)
• some foods (such as alcohol, cheese, nuts, pizza, chocolate, ice cream, fatty or fried food, lunchmeats and hot dogs, yogurt, aspartame, and MSG)

Who Gets Headaches?

Headaches are common in kids and teens. Headaches (especially migraines) often run in families. So if a parent, grandparent, or other family member gets them, there's a chance that a child may get them too. Some kids are more sensitive to headache triggers than other kids.

How Are Headaches Diagnosed?

Your doctor will do an exam and get your child's medical history to help see what might be causing the headaches. The doctor will ask about:

• how severe the headaches are and how often they happen
• when the headaches first started
• what the headaches feel like, and where they hurt
• whether the headaches have a pattern or change over time
• any other symptoms
• any recent injuries
• anything that triggers the headaches
• your child's diet, habits, sleeping patterns, and what seems to help the headaches or make them worse
• any stress your child has
• any past medical problems
• any medicines your child takes
• any allergies
• any family history of headaches

To help pin down the problem, doctors often ask parents — and older kids and teens — to keep a headache diary. In the diary, list:

• all headaches
• when they happen
• how long they last
• a few notes about what might have brought them on

The doctor will do a complete neurological exam. This can involve looking in the eyes, testing nerves, and having your child do things like walk or touch his or her nose. To look for medical problems that might be causing headaches, the doctor may order:

• blood tests
• imaging tests, such as a CAT scan or MRI of the brain

How Are Headaches Treated?

Treatment for headaches depends on what the doctor thinks is the likely cause. But you can care for most everyday headaches at home.

To help ease the pain, have your child:

• Lie down in a cool, dark, quiet room.
• Put a cool, moist cloth across the forehead or eyes.
• Relax.
• Breathe easily and deeply.

Make sure your child has had something to eat and drink and is well hydrated. Kids with migraines often just want to sleep and may feel better when they wake up. A big part of treating migraines is avoiding the triggers that can cause them. That's where a headache diary can be helpful.

You also can give your child an over-the-counter pain reliever such as acetaminophen or ibuprofen. Read the label to make sure that you give the right dose at the right time. If you have any questions about how much to give, check with the doctor. And if your child is under age 2 or has other medical problems, call your doctor before giving any pain reliever. Your doctor can tell you whether you should give it and, if so, how much (based on weight and age).

Never give aspirin to kids or teens unless the doctor advises you to. Aspirin can cause Reye syndrome, a potentially life-threatening condition.

If your child gets migraine headaches often, the doctor may prescribe a medicine to take when they start or daily to try to prevent them.

Discuss pain management with your doctor. This might include trying things that don't involve medicine, such as:

• relaxation exercises
• stress-reduction techniques
• avoiding triggers

What Else Should I Know?

When your child has a splitting headache, it's easy to worry. But headaches rarely are a symptom of something serious.

Call the doctor if your child's headaches:

• are happening a lot more than usual
• don't go away easily
• are very painful
• happen mostly in the morning (when your child wakes up, especially if the headache wakes up your child)

Also note whether other symptoms happen with the headaches. This can help the doctor find what might be causing them. Call the doctor if your child has a headache and:

• seems less alert than usual
• is vomiting
• got the headache after a head injury or loss of consciousness
• seizures
• visual changes
• tingling sensations
• weakness
• clumsiness
• skin rash
• trouble walking or standing
• trouble speaking
• neck pain or stiffness
• fever or other signs of infection
• a change in personality
• is drinking or peeing a lot
• can't go to school or do everyday routines and activities