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Headache

Definition

  • Pain or discomfort of the head
  • This includes the forehead to the back of the head
  • Not caused by a head injury

Causes

  • Viral illnesses. Most headaches are part of a viral illness, especially with colds. Most often, these last a few days.
  • Muscle tension headaches. Most common type of frequent headaches. Muscle tension headaches give a feeling of tightness around the head. The neck muscles also become sore and tight. Tension headaches can be caused by staying in one position for a long time. This can happen when reading or using a computer. Other children get tension headaches as a reaction to stress or worry. Examples of stress in children are pressure for better grades or family arguments.
  • Migraine headaches. Severe, very painful headaches that keep your child from doing normal activities. They are throbbing and often occur on one side. Vomiting or nausea are present in 80%. Lights and sound make them worse. Most children want to lie down in a dark, quiet room. Will recur.
  • Other common causes. Hunger, hard work or sports, sunlight, coughing.
  • Frontal sinusitis. Can cause a frontal headache just above the eyebrow.  Rare before 10 years old because frontal sinus not formed yet.  Other sinuses cause face pain, not headache.
  • Serious causes. Meningitis or encephalitis. Symptoms include a headache, stiff neck, vomiting, fever and confusion.

Pain Scale

  • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
  • Moderate: The pain keeps your child from doing some normal activities.  It may wake him or her up from sleep.
  • Severe: The pain is very bad. It keeps your child from doing all normal activities.

When to Call Us for Headache

Call 911 Now (your child may need an ambulance) If

  • Hard to wake up or passed out
  • Acts or talks confused
  • Weakness of arm or leg
  • Walking not steady
  • You think your child has a life-threatening emergency

Call Us Now (night or day) If

  • Your child looks or acts very sick
  • Stiff neck and can't touch chin to chest
  • Severe headache
  • Vomiting
  • Blurred vision OR seeing double
  • You think your child needs to be seen urgently

Call Us During Weekday Office Hours If

  • You have other questions or concerns
  • Headache without other symptoms lasts more than 24 hours
  • Sore throat lasts more than 48 hours
  • Any headache lasts more than 3 days
  • Headaches are a frequent problem

Parent Care at Home If

  • Mild headache
  • Migraine headache, just like past ones

CARE ADVICE FOR HEADACHES

Treatment for Mild Headache

What You Should Know:
  • Headaches are very common with some viral illnesses. Most often, these will go away in 2 or 3 days.
  • Unexplained headaches can occur in children, just as they do in adults. They usually pass in a few hours or last up to a day.
  • Most headaches (including muscle tension headaches) are helped by the following measures.
Pain Medicine:
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
  • Headaches due to fever are also helped by bringing the fever down.
Food:
  • Give fruit juice or food if your child is hungry.
  • If your child hasn't eaten in more than 4 hours, offer some food.
  • Reason: Skipping a meal can cause a headache in many children.
Rest:
  • Lie down in a quiet place and relax until feeling better.
Cold Pack:  
  • Put a cold pack or a cold wet washcloth on the forehead.
  • Do this for 20 minutes.
Stretching:
  • Stretch and rub any tight neck muscles.
Call Your Doctor If:
  • Headache becomes severe
  • Vomiting occurs
  • Headache without other symptoms lasts more than 24 hours
  • Headache lasts more than 3 days
  • Your child becomes worse
Extra Advice - Muscle Tension Headache Prevention:
  • If something bothers your child, help him talk about it. Help him get it off his mind.
  • Teach your child to take breaks when he is doing school work. Help your child to relax during these breaks.
  • Teach your child the importance of getting enough sleep.
  • Some children may feel pressure to achieve more. This may cause headaches. If this is the case with your child, help him find a better balance.
  • Caution: Frequent headaches are often caused by too much stress or worry. To be sure, get your child a medical checkup first.

Treatment for Migraine Headache

What You Should Know:
  • This headache is like the migraine headaches that your child has had before.
  • Here is some care advice that should help.
Migraine Medicine:
  • If your child's doctor has prescribed a medicine for migraines, use it as directed. Give it as soon as the migraine starts.
  • If not, ibuprofen is the best over-the-counter drug for migraines. Give ibuprofen now. Repeat in 6 hours if needed. See Dose Table.
Sleep:
  • Have your child lie down in a dark, quiet place.
  • Try to fall asleep.
  • People with a migraine often wake up from sleep with their migraine gone.
Prevention of Migraine Attacks:
  • Drink lots of fluids.
  • Don't skip meals.
  • Get enough sleep each night.
Call Your Doctor If:
  • Headache becomes much worse than past migraines
  • Headache lasts longer than past migraines

And remember, contact us if your child develops any of the "Call Us" symptoms.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Copyright 1994-2013 Barton D. Schmitt, M.D.

Message to Our Patients

Due to increased illnesses in the area, unfortunately, call hold times may be longer than usual. Our staff are working to get to everyone, and we apologize for any inconvenience.