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| Main > School Age > Common Problems
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Headaches
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| Headaches are a common and frustrating problem in children and adolescents. Almost twenty percent of schoolage children have frequent, recurrent headaches and about ten percent of children complain of them weekly.
The different kinds of headaches that children can get include classic migraine headaches, which can be associated with nausea, vomiting, visual changes, relief with sleep, an aura (visual or sensory changes that occur just before the headache starts), and are usually one-sided, with pulsatile or throbbing pain. Younger children can get common migraine headaches, which are not associated with vomiting or visual changes, but do get better with sleep. Both types of migraine headaches are usually found in children who have other family members that also have migraines. Tension type headaches are also common in children, and are not associated with vomiting or visual changes. These headaches are usually describe as dull and steady, do not get better with sleep, can occur almost daily and are usually triggered by stress.
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Avoiding Headaches
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| It is not known what causes headaches in most children, but some things that can trigger headaches include artificial sweeteners, chocolate, caffeine, flashing lights, too little sleep, too much stress, and missed meals. Try to find what triggers your child's headaches by keeping a diary or daily headache journal, that includes when the headache started, how long it lasted, where it hurt, if there were any other symptoms, how bad it was on a scale of 1 (mild) to 10 (very bad), what seemed to trigger it, and what, if anything, helped it to go away.
To prevent your child's headaches you should avoid any specific triggers that you have found. It is a good idea to make sure that your child is getting adequate sleep, proper nutrition (eating three meals a day and two nutritious snacks, limiting high sugar and high fat foods, eating fruits, vegetables, lean meats and low fat dairy products), and regular exercise. Also, make sure that your child is not overwhelmed by school and extracurricular activities.
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Treating Headaches
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| For the occasional headache, treatment consists of giving your child an over-the-counter pain medicine, such as acetaminophen or ibuprofen. Do not use these pain medications too frequently, because they can cause rebound headaches, which is a prolonged extension of a headache in certain children that take pain medicines every day, or on most days. If your child is having rebound headaches, it is important to stop all pain medications to break this cycle.
For more severe, recurrent headaches, we may prescribe a stronger, combination medicine, such as Midrin or Fioricet. If the headaches are very frequent we may try a prophylactic daily medicine to help prevent your child from getting these headaches. These medicines include Periactin (an antihistamine that is taken twice a day; reduce the dosage if it is making your child drowsy), and Elavil (an antidepressant that helps reduce the frequency of headaches in some children).
Older children can try the newer antimigraine medications, such as Imitrex.
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Pain Behavior Management
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| For children with daily headaches, it is important to help your child to learn to deal with the headaches to minimize the disruption they can cause to their lives.
You can help by insisting on school attendance (if headaches occur in school, make arrangements so that he can lie down for a short period of time, take any necessary medications, and then return to class when the headache improves); restricting activities to schoolwork (no TV or videogames) or bed if he can't go to school; minimizing the attention that is paid to the headache pain behavior; rewarding him when he does his normal activities even though he has a headache; and helping your child to relax and minimize stress in their lives.
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Important Reminders
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- Call your pediatrician if the headaches are getting worse, wake your child up from sleep, are worse in the morning, or if your child has persistent vomiting or changes in his behavior or personality.
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