Most of us are familiar with the feeling: a pulsing across the forehead from spending too much time on the computer, an ache behind the eyes from lack of sleep, or pounding temples from dehydration. Diagnosis: It’s a headache.
But for kids who are still learning their bodies’ signals and cues, and how to articulate these sensations, a headache may not seem so straightforward.
“It can be hard to evaluate if your kid has a headache because they don't know how to describe it,” said Dr. Sonia Varghese, a pediatric neurologist at Novant Health’s Wilmington Pediatric Specialty Division. “Some kids, they will act out, have temper tantrums or they're just not sleeping, and not acting like themselves. It could be a headache, because that actually is pretty common.”
During back-to-school season, when children are transitioning to a different schedule and routine, Varghese said she sees an increase in headaches. Here are three common types of headaches in children and what you can do to help prevent them.
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1. Tension headache
Just as adults are susceptible to headaches caused by stress, kids are, too. Tension headaches, those caused by physical, mental or emotional stress, are the most common type of headache in kids. Tension headaches usually create pain on both sides of the head, and they may include discomfort in a band around back of the head or the neck.
While it’s typically safe to use an over-the-counter children’s pain reliever, like Tylenol, for a tension headache, it’s important not to rely on these too much. Using over-the-counter pain medicines more than two days a week can cause a medication overuse headache, also known as an analgesic rebound headache.
The best medicine for a tension headache is a dose of prevention. Ensuring your child eats regular meals, drinks enough water, participates in daily exercise and receives emotional support are all effective ways to help prevent tension headaches.
Also very important, Varghese said, is making sure your child gets enough sleep. Low sleep quality is one of the most common causes of tension headaches in kids.
“That really is important, starting that sleep routine as early as possible,” Varghese said. “Start with a good daytime routine and bedtime routine.”
This, she continued, is key for your child’s developing brain to establish healthy circadian rhythms. Her other tips for establishing good sleep habits are:
- During the day, keep the bedroom a space for relaxing and quiet activities only, such as reading.
- Don’t use the bedroom as a timeout space, to avoid associating this space with punishment.
- Wind down for one hour before bed with soothing activities like bathing and/or reading.
- Keep that one hour before bedtime free of phones and TVs.
When getting your child to put down the tablet an hour before bedtime is a real challenge, Varghese emphasizes to approach positive changes one day at a time and to not get frustrated.
“Just try to make every day fun,” she said. “You know schedules do make it easier, but you don't need to be too strict with things. Just be consistent and be there for your kid.”
One in 10 children suffers from migraine headaches, the American Migraine Foundation reports. Migraines are a neurological pain disorder that are defined as either episodic (less than 15 pain days a month) or chronic (more than 15 pain days a month) and often cause pain on only one side of the head. In addition to severe pain, migraines can cause a variety of other symptoms. Some kids may experience nausea, sensitivity to light, blurred vision and/or difficulty focusing.
“They might say that the only thing that makes them feel better is going to sleep,” Varghese said.
While researchers have not identified one specific cause of migraines, they are known to be hereditary, so a child is more likely to suffer from them if one or both parents do as well. Knowing your family’s medical history can help a pediatrician determine if your child’s headache is, in fact, a migraine. Typically, migraines are diagnosed based on their symptoms and don’t require testing.
A large part of preventing migraines is helping your child avoid the things that cause a migraine attack, known as triggers. Common triggers include stress, certain foods, skipping meals and sleeping too much or too little.
Varghese recommends what she calls “headache hygiene,” daily routine adjustments to help avoid common migraine triggers. Her top three headache hygiene recommendations are:
- Ensure your child doesn’t skip meals.
- Stick to a regular bedtime and wake schedule.
- Have your child drink at least 40 to 60 ounces of water a day, more if they are active.
If lifestyle changes aren’t fully effective, prescription medication options exist to help reduce the frequency and severity of migraines.
3. Injury-related headache
Headaches can occur in kids as the result of an injury to the head. Accidental injuries are common when kids are at play. One type of head injury that may cause a headache is a concussion.
A concussion is a mild type of traumatic brain injury that results from a jolt or blow to the head, causing the brain to bounce or twist inside the skull. Concussions in children are common, with youth athletes experiencing a greater risk of the injury.
“Boys that are in American football, lacrosse or hockey, that's where you encounter more concussions,” Varghese said. “For females, it’s field hockey, soccer and lacrosse as well. Those are the contact sports that we get concerned about.”
A widespread misconception of concussion is that it always causes unconsciousness, Varghese said. It’s important to recognize that this is not always the case. A headache is commonly the first symptom of a concussion.
“Some things to look out for are headache, confusion and memory loss,” Varghese said. Any child who suffers a fall or hit to the head then displays these symptoms, even if they don’t lose consciousness, should get checked out by a doctor right away.
The standard treatment for a concussion is to cut back on physical and mental activity for a few days, and your child’s pediatrician will make personalized recommendations for their recovery. Varghese emphasized that it’s important to give the brain time to rest and heal following a concussion.
“I know it’s hard to get your kid to take it easy, but they’ll need to for a day or two,” she said. “You want brain rest. No going back to the field for at least two days.”
For sports and activities that might cause a fall, like bike riding and skateboarding, kids should always wear a well-fitting helmet. And for high-contact sports like tackle football, Varghese suggests a modification for kids.
“I typically recommend for my patients to do flag football until they get older,” she said. “We want to be able to prevent as many concussions as possible when they’re young.”
Pediatric specialty care in your neighborhood
Novant Health is committed to increasing access to pediatric specialty care in Wilmington, and welcomed several new children’s specialists to their team in 2022 to serve the coastal community. This commitment is part of Novant Health’s expanded partnership with University of North Carolina Health, and it allows parents to seek care for their children closer to home, with less travel and shorter wait times.
You'll find new and expanded children's services in Wilmington at Novant Health Nunnelee Pediatric Multispecialty Care - Autumn Hall and Novant Health Betty H. Cameron Women’s & Children’s Hospital.