What is a headache?
A headache is a pain, ache or throbbing sensation in any area of the head. Headaches are common in school-aged children and teenagers.
Signs and symptoms of headache
A headache can feel like a sharp pain, throbbing sensation, or a dull ache. The pain may occur on one or both sides of the head. Headache may be associated with many childhood conditions and may be associated with other symptoms. Identifying other associated symptoms will help you and your child’s health-care provider understand why your child is experiencing headache.
Observe your child and ask about any associated symptoms, such as:
- changes in concentration, memory, or speech
- weakness of an arm or leg
- any vision or hearing changes
- fever
- congestion, runny nose or muscle aches
- nausea or vomiting (throwing up)
- recent head injury or concussion
- pain at the back of the head
Make note of possible triggers relating to the headaches, such as:
- lack of sleep
- skipping meals
- dehydration
- stress
- using screens (phones, computers, video games or TV) for a prolonged time
- menstruation in girls
Causes of headache
Headaches can be primary or secondary. Primary headaches do not have a serious underlying medical cause. This category includes tension-type headaches and migraines.
Tension-type headaches
Tension-type headaches are the most common headache, occurring in 20% of children and adolescents. A tension-type headache feels like there is a tight band around the head. They are usually mild to moderate in intensity and last anywhere from 30 minutes to several days. They are not associated with nausea or vomiting. Treatment involves emotional support and over-the-counter pain medication.
Migraine
About 10% of children and adolescents have migraine, a condition that often includes specific, recurrent headache features with or without other symptoms. Children with migraine are likely to have one or more relatives with migraine and may also experience motion sickness. Migraine headaches can last from two to 72 hours and are often described as throbbing or pulsatile, are located on one side of the head, and are moderate to severe in intensity. Migraine can be associated with other symptoms such as nausea, vomiting, abdominal pain, and sensitivity to noise and light.
Some children and adolescents may experience an aura before the headache begins. Aura is a sensation that precedes or accompanies a migraine headache. Aura is often a visual symptom but may also be a change in speech, numbness, tingling or weakness. They are often aggravated by regular physical activity and can interfere with regular activities. Some children with migraine have specific triggers that can cause symptoms. Most children feel better after rest or sleep.
There are medications that can be used to prevent migraine headaches from recurring and medications to treat migraine once it starts. Preventative medications include prescription medications as well as supplements such as riboflavin, magnesium and Co-enzyme Q. Regular and sufficient sleep, regular meals, avoiding triggers and sometimes diet changes can help children reduce the frequency of migraine headache. Children with frequent migraine headaches may experience school absences and effects on school performance. Your child’s health-care provider can help you and your child create a treatment plan by identifying triggers, preventing migraine headache frequency and effectively treating symptoms when they occur.
Secondary causes of headache
A secondary headache is caused by another medical condition that your child already has. There are many possible causes which include:
- minor illness (such as a cold) or major infection (such as meningitis)
- allergies
- effects of medications
- head injury or trauma
- sinus infection
- elevated blood pressure
- dental or TMJ (temporomandibular joint) problems
- exposure to drugs or toxins
- brain tumour
- bleeding in the brain
Taking care of your child with a headache at home
Your child may have a headache because they feel hungry. Offer your child some food to eat. A nap or resting in a calm and peaceful setting may also help your child feel better.
You can offer your child pain medications such as acetaminophen or ibuprofen. If your child has been diagnosed with migraine or recurrent headaches, give pain relief as soon as your child feels the headache coming on. This will help stop the headache early.
Before going to a health-care provider
If your child complains of repeated or recurring headaches, take them to the their health-care provider. Before the appointment, take notes on the details of the headache, such as:
- the type of pain
- the location of the pain (where it is)
- how long the pain lasts (minutes or hours)
- the time of day when your child feels the pain (morning, afternoon or evening)
- triggers (Is there a bright light? Is it during a certain class at school?)
- any treatment that helps lessen the pain
If your child has recurrent headaches, record the timing of the headaches in a "headache diary". This can be a simple paper calendar or using a digital app. The key is to record each headache event, including the time of occurrence, severity, duration and treatment used. This helps your child’s health-care provider find a pattern and helps you and your child identify headache triggers and monitor improvement.
When to see a health-care provider
Make an appointment with your child’s health-care provider if:
- headaches last longer than two days
- headaches do not improve, or get worse, despite using acetaminophen or ibuprofen or other headache medicines
- headaches affect your child’s usual habits or routines such as play, school, eating, drinking or sleeping
- recurrent headaches happen more often or are worse than usual
- recurrent headaches are not improving with recommended treatments and medications
- the headaches are waking your child at night or are associated with vomiting
Go to your nearest Emergency Department or call 911 if your child has a headache with the following symptoms:
- sudden severe pain in the head
- a headache that gets worse or continues to come back following a head injury
- dizziness, fainting or loss of consciousness
- fever
- stiff neck
- repeated vomiting (throwing up)
- slurred or altered speech
- weakness of a part of the body
- changes in vision
Resources
Find more information about migraine using this Patient Education Resource Kit from Migraine Canada.