What is a headache?
Headache is one of the most common pain complaints in children and adolescents. A headache often feels like a ‘tight band’ or ‘squeezing’, ‘sharp’, ‘throbbing’, or a general ‘ache’ around the head or neck.
Tension-type headaches and migraines are the most common types of headaches in children and adolescents. (Please see separate fact sheet for ‘Migraines’).
Most headaches come from the nerves, blood vessels, and muscles that cover a person’s head and neck. Commonly the muscles or blood vessels can swell or tighten, which can put pressure on the surrounding nerves. The nerves then communicate this sensation to the brain, and the brain then produces the feeling of pain - in this case, a pain in the head or ‘headache’.
What causes headaches?
Headaches can be caused by many things, including:
- Illness such as colds, eye or sinus problems, muscle tension, dental problems, infections or injury
- Daily life issues such as stress, worry, dehydration, lack of sleep, too much sitting or screen time
- A reaction or side-effect to some medicines
Most headaches are not serious and can be treated easily and effectively.
Headaches can often be prevented by ensuring your child is getting enough sleep, rest, regular exercise; eating a balanced diet, drinking enough water, and is managing any stress.
When to take your child to the doctor
Medical attention should be sought if your child’s headache:
- is increasing in severity and/ or frequency
- wakes them from sleep or stops them from getting to sleep
- causes them to miss school or other activities
- occurs early in the morning with or without vomiting
- is constant and daily
- is not relieved by over-the-counter medicine
Medical attention should be sought sooner if your child is less than 5 years of age, or if you notice that your child is:
- walking differently or falling over often
- complaining of dizziness or numbness
- has changes in their behaviour
- losing daily skills such as starting to drop things
A medical practitioner will take a detailed history and do a physical examination to make a specific diagnosis, and will decide if any scans are needed or if you need to be referred to a specialist doctor. A headache diary may be recommended by your doctor to keep track of headache patterns as well as effectiveness of treatments.
How to treat a headache
If your child is having occasional headache, they can manage them at home by:
- having something to eat or drink
- taking time to rest and relax
- placing a cool, wet cloth on the forehead
- having a gentle massage or stretch of the head and neck muscles if they are tight or tender
- using distraction to move attention from pain to an enjoyable activity such as art or music
If these strategies do not work, some non-prescription pain medicine such as paracetamol or ibuprofen may help. Follow the instructions on the packet and do not use for more than two days in a week, without seeing your doctor.
Note: Aspirin should NOT be used for pain management in children.
Life can be disrupted for children with recurrent persisting headaches. It can impact their school attendance and performance, social activities, sleep, mood, appetite and family interactions.
Once you have visited your doctor, and a diagnosis of persistent headaches has been made, the management approach will consider a combination of: Medicine, Movement and Mind-based strategies.
How to manage persistent headaches
Along with the strategies mentioned above under ‘How to treat a headache’, below are some additional suggestions to manage persistent headaches. Your doctor will give you more specific, individualised recommendations.
- Simple over-the-counter medicines are most commonly used to manage persistent headaches.
- Instructions on the pack must be followed. Avoid using these medicines regularly i.e. multiple times a day every day. This is especially important if they do not seem to be helping.
- Occasionally, some other medicines may be needed which can be discussed with your doctor.
- Some children may benefit from acupuncture, which can be done with needles or laser. It is recommended that this be done by a registered health care provider.
It is understandable that you or your child may think it is best to rest and reduce activities, such as school and sport, when having ongoing headaches. However, moving less over time can make pain worse. The key to managing ongoing headaches is to find ways in which to continue with typical activities.
- When we exercise, the body’s own pain relievers called ‘endorphins’ are released, which can help reduce headache pain.
- Gradually grading up activities (by time or effort) may be recommended if your child has been inactive for some time. Regular breaks may be needed when initially participating in activities.
- Rest periods should be brief.
- Seeing a physiotherapist may be recommended if the headaches are due to tight neck muscles, a painful jaw, or poor posture.
- Movement is very important for general well-being. Regular physical activity helps improve strength, fitness, energy, mood, sleep and stress management and reduces sensitivity to pain. Children and adolescents should aim for an hour of physical activity per day.
- Attending school is an important part of managing headaches. School is a good distraction and assists your child to keep in touch with friends and teachers. You may wish to talk with the school so they can assist with rest breaks and any stressors associated with friends or grades.
- Living with pain can be stressful for your child and for the whole family. However, pain can also feel worse if your child or others around them are stressed or anxious.
- Using relaxation strategies everyday can be helpful to calm the mind and body, and turn down pain. This may include guided imagery, meditation, chilled music, distraction or deep breathing. There are many websites and apps that are available to assist in these strategies, such as Smiling Mind.
- Getting enough sleep at night is an important part of managing headaches. A good sleep routine may include going to bed at the same time each night and waking at the same time each day, not having daytime naps, using the bed only for sleeping and not using screens an hour before bed.
- A psychologist is often recommended when people have ongoing pain, stress or anxiety, or troubles sleeping. They can help with pain management strategies that will best suit your child, help them develop skills to manage feelings such as worry or sadness, as well as support effective sleep routines. Psychologists can also provide advice on how you can support your child.
Overall, successful pain management is measured by participating more in everyday activities. Pain will usually reduce once your child has returned to everyday activities. Once treatment has started, it is recommended that focus is taken off the pain and on towards recovery strategies and daily activities.
- Many headaches can be managed well at home with brief rest, drinking water, and taking simple over-the-counter medicines
- Treatment combining medicine, movement and the mind are the most safe, effective, and lasting ones
- It is recommended that you see your doctor for headaches if your child is under 5 years, if the headaches persist, or there are changes in your child’s movement or ability to do everyday activities
- Reduction in pain is often seen once a return to everyday activities is restored
- Headache Australia
- Royal Children's Hospital. Melbourne