Headaches in Children

A headache is one of the most common complaints of children and teenagers. Fussiness, crankiness and not being able to sleep may be the only signs of head pain in children who are too young to tell you where they hurt.

There are many different types of headaches. Each type may be treated differently. A detailed history and physical exam help figure out what kind of headache your child has. All members of the family (mother, father and child, if possible) should help give the medical history.

Types of Headaches

Tension Headache - This is a less common and least serious type of headache. It happens when the muscles in the head and neck tighten and ache. Your child may say the pain feels like a tight band around the head. Emotional stress and getting too tired are the two most common causes. Family conflicts, school problems and peer pressures may add to everyday stress. Tension headaches can be a result of these pressures.

Congestion Headache - These headaches occur with viral infections (such as colds and flu) and usually stop when the illness is over. Sinus congestion and infections can cause head pain around the eyes and nose.

Medication Overuse or Analgesic Rebound Headache - This type of headache is becoming more common. When a child or teen-ager with headaches takes pain medicine too often, the headaches may become more frequent and more painful. Taking pain medicine for headaches more than twice a week for several weeks may cause this type of headache.

Headaches After a Head Injury - Headaches are common after a head injury. They are usually mild and go away within a week. Sometimes, though, the pain may occur for several weeks or months after an injury. Refer to the Helping Hand: Head Injury (HH-I-41 or HH-I-42) if the injury occurred in the last 24 to 48 hours.

Headaches with Dental Problems (such as jawbone joint problems) - This is an unusual cause of headache in children. The child may have jaw pain or discomfort, pain in the temples and a clicking sound when opening the jaw. Grinding of the teeth may cause this type of headache. A dental exam should be done.

Migraine Headache - This is a severe type of headache and is not discussed in this Helping Hand. If your child has migraine headaches, your doctor will give you more information after a thorough physical exam and medical history are done.

Home Treatments

The best treatment for a mild, occasional headache is rest and relaxation. Giving ibuprofen (such as Motrin® or Advil®) may give your child relief. Ask your pharmacist, doctor or nurse for the right dosage. Do not give aspirin or other medicines unless directed by your child's doctor. Use heat or cold, whichever helps your child the most.

• Do not give medicine too often. Giving medicine for headache pain too often may cause the headache to occur more often and be more severe. Don’t give pain medicine for headache more than 2 times per week. If it is given more often for several weeks, the headache may get worse.
• Apply a cold compress. Place a cold, wet washcloth or ice wrapped in a washcloth on the head or neck (Picture 1). Don't place ice directly on the skin because it can damage the skin.
• Apply heat. Place a warm - not hot - wet washcloth on the head or neck, or have your child take a warm shower.

Picture 1 - Rest and apply cold or warm compress to ease the headache.

Keep a Record

Keep a record of the headaches over a period of time. This will help the doctor decide on a plan of treatment for your child. (Use the Headache Records on pages 4 and 5.)

When to Get Emergency Care

Take your child to an emergency room immediately if your child has:

• Sudden, severe head pain happening for the first time - especially if the child has double vision (sees 2 of things), seems confused, sleepy (hard to wake up), has numbness or projectile vomiting (vomit shoots out of the mouth).
• Headache with a stiff neck, or complaints of neck pain, especially with a fever.

When to Call the Doctor

Call your child’s doctor if any of these things occur:

• Daily headaches, especially if they interfere with school or play.
• Headaches caused by straining from coughing, sneezing, running or having a bowel movement.
• Headaches that occur along with pain in the eye or ear, confusion, nausea or vomiting, sensitivity to light and sound, or numbness.
• Headaches that keep coming back and get worse.
• Headaches similar to those suffered by other family members.
• Headaches following a head injury that don't go away after a week.
• Headaches severe enough to wake the child from sleep.

Prevention

• Make sure your child gets plenty of rest.
• Serve meals at regular times (don't let your child skip meals).
• Your child should drink plenty of liquids, especially water. Sports drinks may also be given.
• Make sure your child gets regular exercise.
• Try to keep your child from feeling too much stress. Encourage your child to talk openly with you so you're aware of what's troubling him or her.
• Some children are sensitive to certain foods. It may help to avoid these foods for a while to see if the headaches go away: Chocolate, cured meats such as hot dogs and bacon, aged cheeses, fried foods, caffeine (found in coffee, tea, and colas).

Follow-Up Appointment

• The doctor will want to see your child for follow-up. It is important to keep these appointments.
• Please bring the Headache Record (PDF) with you when you see the doctor.

Headaches in Children (PDF)

HH-I-158 6/92, Revised 3/12 Copyright 1992-2012, Nationwide Children’s Hospital