Headaches in children: what causes them and how to treat

Common causes of headache in children

It’s been a long day at school and your child comes home complaining of a headache.
As parents, we all worry when our children complain of pain. Thankfully, serious causes of headaches are rare1 and headaches happen to be one of the most common types of pain in children2. Most children and teenagers get at least one headache a year3 and up to three out of every four children complain of having a headache each month1. Headaches can have a big impact on your child’s life so it is important to understand them.

What causes them and what can you do if your child has a headache?

What causes a headache in children?

Most headaches in children are usually not serious. Some general factors which may trigger a headache include 4:
● cold or flu
● stress4 or anxiety3
● bad posture
● vision problems
● skipping meals or not eating regularly
● taking too many painkillers
● dehydration or blood sugar changes brought on by playing sports3

Types of headaches

There are several types of headaches that may affect children, including migraines, tension-type headaches, cluster headaches, and medication-overuse headaches.

Tension-type headaches

If your child has a tension headache, they may describe it as a feeling of tightness in the head or neck5. It’s usually mild to moderate in severity, does not pulsate, and is not usually worsened by physical activity. It usually isn’t accompanied by nausea or vomiting and parents may find that younger children may play less and want to sleep more. It can last anywhere from half an hour to several days.

Migraines

A migraine headache is usually a severe, throbbing headache that may be felt on one side of your child's head (sometimes the side may change or the pain is on both sides of the head)6. It can last for over 4 hours if not treated, gets worse with activity, is often accompanied by nausea, and feels like it’s pulsating (though some may complain of a dull or stabbing feeling). Some people may have visual warning signs before a migraine headache comes on. This is called an aura. If your child has an aura before a migraine, they may say that they can see sparkling lights or describe other visual symptoms. If your child has a migraine, they may also feel nauseous and have difficulty coping with light and loud noises. Doctors believe that migraines occur when blood vessels in the brain both open (dilate) and tighten (constrict), leading to a headache 6 . However, the exact cause of migraines is still not understood very well.

Cluster headaches

Cluster headaches are very rare in children7 but can happen. If your child has a cluster headache, they may complain of a very intense pain on only one side of the head that very often starts after they fall asleep7. They may describe it as being a sharp, stabbing pain5. A child with a cluster headache may also seem teary, have a blocked or a runny nose, or be restless and agitated. Cluster headaches get their name because they often occur in bouts, for 6-12 weeks,once every year or two years, and often at the same time each year7.

Medication overuse headache

Medication overuse headaches may occur in some children. These headaches may happen if someone overuses painkillers to treat their headaches (usually on 15 or more days a month)7 or frequent use of common migraine medications (on 10 or more days a month).

Chronic daily headaches

A “chronic daily headache” is the name given by doctors to a headache that occurs 15 or more days every month5. Chronic daily headaches can be caused by many things. They may be migraines or tension-type headaches, or they may be caused by an infection, minor head injury, or taking too many pain medications 5 . If your child has a chronic headache, it’s best to speak with your GP to rule out any serious problems.

When to see a doctor

Most headaches in children aren’t serious and can be treated at home3. But if you are at all worried about your child’s headache, be sure to speak with your doctor or pharmacist about it.

See your doctor if your child’s headache4:
● keeps coming back
● is accompanied by bad throbbing pain at the front or side of their head
● is accompanied by feeling sick, vomiting, or sensitivity to light or noise
● doesn’t respond to painkillers
● is accompanied by other symptoms, such as arms or legs feeling numb or weak
● is interfering with schoolwork3

See the GP urgently if your child has a severe headache and their jaw hurts when eating, has blurred or double vision or their scalp feels sore.
Take your child to the A&E or call 999 if your child4:

● has injured their head badly, such as after a fall or accident
● has a headache that comes on suddenly or is extremely painful

How to treat a headache in children

If your child has a headache, you can do the following to try and help them through it3:
● lie them down in a quiet, dark room
● put a cool, moist cloth across their forehead or eyes
● ask them to breathe easily and deeply
● encourage them to have plenty of rest and sleep
● encourage them to eat or drink something (without caffeine)

Some other natural ways to help children with headaches include relaxation techniques and even the use of a headache diary 8 , which will also be useful to keep track of your child’s headaches and identify possible triggers. These simple steps may be enough to help your child recover. However, if you think your child needs painkillers, start them as soon as possible after a headache begins. Pain-relief medications such as paracetamol or ibuprofen * may help to relieve your child’s headache 3 . Make sure that you give your child the medication and dose that is suitable for their age. If you believe your child may have a migraine, speak to your pharmacist about medication that treats migraines and is suitable for children.

*Nurofen for Children Orange/Strawberry: Singles / Cold, Pain and Fever 100g/5ml Oral suspension / Baby Oral suspension /3 months to 9 years 100mg/5ml Oral suspension / 3 months to 12 years Oral suspension. Contains ibuprofen, for children over 3 months (weighing more than 5kg) to 12 years. For pain relief. Nurofen for children 100 mg, chewable capsules, soft. For fever and
pain relief in children aged 7 to 12 years. Contains Ibuprofen. Always read the label. Use only as directed.If symptoms persist consult your healthcare  rofessional. All information presented on these web pages is not meant to  iagnose or prescribe. For further advice please speak to your doctor or pharmacist.

1. Moreno, M. A. Advice for patients. Treating headaches in children and adolescents. JAMA
Pediatr. 167, 308 (2013).
2. Perquin, C. W. et al. Pain in children and adolescents: a common experience. Pain 87, 51–58 (2000).
3. NHS-UK. Headaches in children. nhs.uk Available at:
https://www.nhs.uk/conditions/headaches-in-children/. (Accessed: 18th October 2018)
4. NHS-UK. Headaches. nhs.uk Available at: https://www.nhs.uk/conditions/headaches/.
(Accessed: 29th November 2018)
5. Headaches in children - Symptoms and causes. Mayo Clinic (2016). Available at: https://www.mayoclinic.org/diseases-conditions/headaches-in-children/symptoms-causes/syc-20352099.
(Accessed: 18th October 2018)
6. Kantor, D. The impact of migraine on school performance. Neurology 79, 168–169 (2012).
7. E A Macgregor T J Steiner. Guidelines for All Healthcare Professionals in the Diagnosis
and Management of Migraine, Tension-Type, Cluster and Medication-Overuse Headache.
British Association for the Study of Headache 3rd edition, (2010).
8. Genizi, J. & Srugo, I. Primary Headache in Children and Adolescents: From
Pathophysiology to Diagnosis and Treatment. J Headache Pain Manag 1, (2016).
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