Headaches in children and teenagers

Headaches are a common and frustrating problem in children and adolescents. They are generally not serious.  In fact, between 5 and 8 of every 10 teenagers say they get at least one headache each month. However, headaches that occur more often than this can be upsetting and begin to worry you and your family. The most common headaches for teenagers are tension headaches and migraines.

Types of headaches

There are many different types of headaches and reasons as to why they occur. Also, they can range from mild to very severe, and affect people in different ways.

Some types of headache include:

  • Tension - which often feel like a tight band around your head. This is due to muscles around the head or neck stiffening or tensing up (contracting). The pain is dull and aching and usually felt on both sides of the head, but may be in front and back as well. Pressure at school or at home, arguments with parents or friends, having too much to do and feeling anxious or depressed can all cause this type of headache.
  • Psychogenic - are less common. They are similar to tension headaches, but the cause is due to an emotional problem, such as depression. Signs of depression include loss of energy, poor appetite or overeating, loss of interest in usual activities, change in sleeping patterns (trouble falling asleep, waking in the middle of the night or too early in the morning), and difficulty thinking or concentrating.
  • Migraine - are often described as 'throbbing' feeling in your head and are usually felt on only one side of your head, but may be felt on both. A migraine may make you feel light-headed or dizzy, and/or make your stomach upset (sometimes causing nausea and/or vomiting). You may see spots or be sensitive to light, sounds and smells. If you get migraines, chances are so does one of your parents or other family members.

Signs and symptoms

Tension headaches are common and are not associated with vomiting or visual changes. They are usually described as dull and steady, do not get better with sleep and are generally triggered by stress.

Migraine headaches are usually on one side, with pulsing or throbbing pain. Migraines may get better or go away altogether with sleep.  During a migraine you may also have:

  • an aura (visual or sensory changes that happen just before the headache starts).
  • visual changes
  • nausea
  • vomiting

Avoiding headaches

It is not known what causes headaches in most teenagers, but some things that can trigger headaches include artificial sweeteners, chocolate, caffeine, flashing lights, loud noises, not enough sleep, too much stress and missed meals. Try to find what starts your headaches by keeping a headache 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. Also note the time you went to bed, what time the headache stopped and if you missed any school because of it. This information will help the doctor to find the best way of managing and treating your headaches in the future.

To prevent your headaches you should avoid any specific triggers that you have found. It is a good idea to make sure that you are getting enough sleep, proper nutrition (limiting high sugar and high fat foods, eating fruits, vegetables, lean meats and low fat dairy products) and regular exercise.  Also make sure you have not taken on too many school and extracurricular activities.

Management

For the management of the occasional headache, you can take an over-the-counter pain medicine, such as paracetamol (Panadol, Dymadon etc) or ibuprofen (Nurofen etc). Do not use pain medication too often (i.e. don't take pain relief every day), as this can cause rebound headaches. Rebound headaches from overusing pain-medication can be very painful and are a common cause of chronic daily headaches. If you are having rebound headaches, it is important to stop all pain medications to break the cycle.

For more severe, recurrent headaches, you may be prescribed a stronger, combination medicine. If the headaches are very frequent, you might be advised to try a daily 'prophylactic' medicine to help prevent you from getting these headaches. It is important to discuss and plan this with your doctor.

There is no cure for migraine headaches. Anything that has triggered a migraine in the past should be avoided if possible.

If you are worried about your headaches, or they begin to disrupt your school, home, or social life, see your doctor. Other signs that mean you should visit your doctor include:

  • Head injury - headaches from a recent head injury should be checked right away, especially if you were knocked out (lost consciousness) by the injury.
  • Seizures/convulsions - any headaches associated with seizures or fainting need immediate attention.
  • Frequency - you get more than one headache each week.
  • Degree of pain - headache pain is severe and prevents you from doing activities you want to do or going to school.
  • Time of attack - headaches that wake you from sleep or occur in the early morning or when you wake up.
  • Visual difficulties - headaches that cause blurred vision, eye spots, or other visual changes.
  • Other associated symptoms - if fever, vomiting, stiff neck, toothache, or jaw pain accompany your headache, you may need an examination and some tests (such as an x-ray).

Key points to remember

  • Headaches are not a disease and are generally not serious.
  • Headaches are common.
  • Keep a journal to help you identify the sorts of things that may trigger your headaches.

See your doctor if:

  • the headaches are getting worse
  • they are waking you up from sleep
  • they are worse in the morning
  • you have persistent vomiting
  • you notice changes in your behaviour or personality.

For more information

Individual information

 

 

Developed by Quality & Improvement Dept & Dept of Neurology at the Royal Children's Hospital.  First published July 2008.
 

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