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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.

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