Headaches in children and teenagers

Headache is common in both children and teenagers. The cause is often colds and infections, but headaches can also be due to other illnesses, mental illness or lack of sleep. Often it is not possible to find an explanation for the headaches. For the most part, the pain goes away by itself, but sometimes it can sit for longer and come more often. Although it is very uncommon, headaches can in some cases be due to a serious illness.

More than half of all children from the age of seven and up have headaches at least once a year and among teens, it is even more common.

Different types of headaches

Headaches in children and teens can be divided into the following categories

  • tension headache
  • migraine
  • headache in case of illness
  • another headache.

tension headaches

The most common type of headache in children and teenagers is so-called tension headaches.

What causes the pain itself is still unclear, but researchers believe it may be due to increased tension in the muscles of the head and neck.

Tension headaches are often depressing and grinding

Tension headaches often begin with weak aches that become stronger during the day. It sits above the temples, forehead or head or as a band around the head. Sometimes the aches can also sit in the neck or shoulders. The pain, which often feels depressing and grinding, is usually mild to moderately intense.

The pain usually goes away within a day but can be prolonged

Most commonly, tension headaches come temporarily over a certain period of time. It often lasts from 30 minutes up to a few hours during the day, but can in some cases last until the evening.

About 1-2 percent of all teens have daily or almost daily tension headaches that have lasted for at least three months, so-called chronic tension headaches. Chronic tension headaches can cause the child to avoid leisure activities and contact with friends.  

Concerns, sleep deprivation and stress can cause tension headaches

Often it is not possible to find an explanation for the headaches, but sometimes tension headaches can be caused by anxiety, lack of sleep, fatigue and stress in the environment. For example, it can be about conflicts and stress at school or at home. The headaches can also be due to mental disorders such as anxiety and depression.

Stress headaches are not aggravated by physical activity

Stress headaches are rarely affected by physical activity. The child or teen can move freely in the usual way at home and at school without restrictions. Sound and light do not usually affect the headaches either.

Migraine

Migraines come quite suddenly, in recurring attacks. The attacks can come more rarely or often. In children, migraine attacks tend to occur more often than in adults. In contrast, seizures are often shorter and last shorter than in adults, from one hour up to several hours. Sometimes the attacks can last up to 24 hours. It is very rare for children to have migraine attacks that last for several days.

Sometimes a migraine attack with tension headaches begins and ends. It is also quite common for children and teenagers to alternately get both tension headaches and migraines.

Unlike tension headaches, migraines are often hereditary.

Some children feel that the migraine attack is on the way

Sometimes the child or teen knows in advance that “something is going on”, for example, the day before the attack. Such misconceptions may be unease, restlessness, decreased appetite or fatigue. 

Some also get so-called aura, a precursor to the migraine attack, just before the headache begins. Then parts of the field of vision can disappear and then go into blurred vision, flickering or flashes and zigzag lines appear in front of the eyes. Some also get ant creeps around the mongipan. Some people also feel tingling in one arm or that it fades or becomes paralyzed. These symptoms often last for 5-10 minutes but can last up to an hour before the attack. Often these symptoms disappear when the headaches come.

Migraines can often be linked to stress, fatigue, poor sleep, and some food

Migraine attacks are often associated with stress. It can be exciting for a school assignment, test, trip, competition or noise and mess in the surroundings. Physical activity, late-night fatigue, and poor night’s sleep also contribute. The seizures can also come at the end of the week as the child or teen goes down laps and relaxes.

Sometimes, certain foods containing the substance tyramine cause migraine attacks, such as chocolate and strong cheese. Strong smells, such as perfume and strong, flickering light can also trigger migraines.

Common to vomiting in migraine

The symptoms of migraines vary with age and they are not always as typical as described above. A toddler who has migraines may look pale and pain-affected, say hurt and point his head. In migraine attacks, it is common to feel sick and vomit, and in young children, sudden vomiting can be a clear symptom of migraine as the child has difficulty describing how the headache feels.

After the child or teen has vomited, the headaches usually ease and disappear afterward.

Physical activity can aggravate headaches

In migraine, the pain often gets worse by physical activity. The child or teenager prefers to keep his head completely still. Many also become sensitive to sound and light and prefer to lie in a quiet room with subdued lighting.

Headache in sickness

Headaches in infections

It is common for various respiratory tract infections to cause headaches, such as colds, flu or sinusitis. The headaches then usually sit in the forehead, face or entire head. Most often it is not so powerful. In young children, headaches can also be a symptom of ear inflammation.

Headache due to serious illness

Meningitis or inflammation of the brain can cause headaches. In these diseases, the child or teen quickly becomes very ill, gets a fever, nausea and sometimes vomiting. Neck stiffness can also be a symptom.

In rare cases, headaches can be caused by fluid under the meninges or a growing tumor. Then the headaches usually increase in strength over days or weeks. It can then be particularly severe in the morning which can cause nausea and vomiting. When the child or teen coughs or poop, the headaches often get worse.

Other headaches

Headache after a blow to the head

Headaches after a lighter stroke usually go away after a few hours of rest. However, if the child or teenager has battled properly, fainted or vomited in connection with an accident or head violence, they need to be examined at an emergency room as soon as possible. The same applies if the headaches do not go over.

Headache and jaw pain

It is common for children to grit teeth at night. In some cases, it can lead to pain in the jaw and thigh muscles. Also, some bite errors can contribute to such pain, for example, if teenagers only bite their back teeth.

At these ages, common symptoms are jaw sounds, such as snapping. It is also common to feel hard to gape, sore and stiff in the jaws, jaw joints or temples. The reason may be that the teen is squeezing or gnashing teeth during sleep or chewing gum a lot. The headaches for these problems are almost always tension headaches and can come frequently.

Headache due to refractive error in the eye

Some children and teens get tired of their eyes or get headaches when they read or have to have a book or screen close to their eyes. Then it is important for them to visit an optician who checks the vision.

But it is still unclear if there is a connection between headaches and various refractive errors in the eye, for example during myopia, myopia or other visual impairment in children and teenagers. During adolescence, the development of myopia is most common. There is a weak relationship between headache and myopia, but no relationship between myopia and headache.

Headaches for mental disorders

Many children and teenagers with anxiety and depression also have headaches. But headaches can also come in conjunction with other pains, such as recurring abdominal pain.

Headaches during heavy exertion, heat, cold, hunger and fluid deficiency

In conjunction with vigorous physical exertion, for example after hard work or football matches, children and teens can sometimes get headaches that feel pulsating or throbbing. The headache usually disappears when the child or teenager has rested after the exertion.

Children and teenagers can also get a headache from a cold that can sit for about a quarter when they have eaten ice cream. Some also get headaches if they have not eaten for a long time or if they have been out a lot during sunny and warm days and drank too little.

What can I do if I or my child have a headache?

For recurring headaches, it is good if you as a teenager learn to recognize situations that may contribute to your headaches. Then you can eventually learn how to prevent headaches.

An adult can help the child or teenager learn how to recognize various stress-relieving factors and what can be done to reduce their negative impact on headaches.

A regular life with regular meals, plenty of activities and fresh air can help prevent headaches in children and teens. It is also important that they get enough sleep because sleep deprivation and fatigue can trigger both tension headaches and migraines.  

Write down when the trouble comes in a headache diary

A good and easy way to get important information about when and how often the headaches come and how it feels is to write down in a diary when the headaches come. Such a headache diary makes it easier to see the patterns and probable causes behind the headaches. Younger children need help and support from an adult, while you as a teenager may be able to keep a headache diary on their own.

There are two types of diaries. One seizure diary for migraines, and one for headaches that come more frequently, such as tension headaches. Both diaries state which medications you took for the headaches, dose, and a number of tablets and the degree to which you were affected in the daily life of the pain.

The diary for migraine contains information on symptoms such as numbness, nausea, and vomiting. In the headache diary that comes often, you record what degree of headache you have on a scale for each day of the week for a certain amount of time.

After a while, you will hopefully get a good idea of ​​what is related to the pain. Then you can help prevent it by recognizing and avoiding situations that contribute to or trigger headaches.

The patient association  Huvudvärksförbundet has examples of headache diaries that you can download for free. 

When should I seek care?

Book an appointment at a health center or pediatrician’s office for the child or teen

  • have headaches in combination with prolonged sniffing, coughing, sore throat or cheeks
  • have migraine-like headaches or prolonged and often recurring headaches that do not last for several months.

Seek care directly at an emergency or pediatrician’s office about the child or teen

  • has severe headaches, fever, is tired, wants to lie still and seems stiff in the neck
  • suddenly gets an intense headache and seems tired and does not make the same contact as usual
  • have increasing headaches that have lasted for a while, wake up from it or have headaches with vomiting in the morning
  • has hit the head and then gets headaches that do not go over
  • has headaches and at the same time a fever with swelling and redness in the eye.

Contact a dentist if you suspect that the headache may be due to the child or teen pressing teeth.

Treatment of headaches

Treatment with drugs

You can relieve headaches in infections, tension headaches, and migraines and with the help of prescription-free and pain-relieving medicines. Such medications can either contain paracetamol, for example, Alvedon or Panodil, or ibuprofen, for example, Ipren or Ibumetin.

For children over seven years also medicines containing acetylsalicylic acid, such as All, help. However, it should not be given to children under seven years and never to children who have a fever. For older children, there are prescription drugs that are especially effective against migraine attacks, so-called triptans. These are in tablet or nasal spray and can be tested when the non-prescription medication does not help. It is important that you follow the instructions on the number and dosage on the package.

Note that these medications only provide temporary help. Therefore, they should not be used for an extended period or too often, at most 2-3 times a week, as they can also aggravate headaches.

Important to take the medicine early

It is important that the child or teen takes the medicine early, even when the headaches are on the way. This applies to both migraine and tension headaches. It is common to wait too long, until the headaches become too strong, as the effect of the medication diminishes.

Preventive medicine is available for migraines that come frequently

Some children and teens who have had migraines for an extended period of time may receive preventative prescription medication. This is especially true for children and teenagers who have migraine cases that come frequently, at least once a week.  

Treatment with physiotherapy and psychological methods

Sometimes neither the temporary nor the preventative medicine provides adequate help. Then the child or teenager may need to try another treatment, such as treatment with physiotherapy, ie physical therapy, or with psychological methods. Such treatment can be especially good for children and teenagers who have had a long-term headache that often comes, ie several times a week. 

Treatment with physical therapy can be good, for example, if the headaches are caused by the muscles of the head and neck being tense, for example, because of how the child or teenager sits or holds his head. The treatment is then aimed at an improved body consciousness often combined with physical exercise.

Relaxation training often has a good effect

Relaxation training often provides good help to relieve the pain in both migraine and tension headaches. It aims to teach children and teens to reduce the experience of stress and headaches. This is done by practicing a method that provides quick relaxation when the headaches begin to feel. The method that should be given by a psychologist has been shown to reduce the strength of the pain and how often the headaches come. It has also been shown that the improvement continues after completion of treatment.

Treatment with KBT

Cognitive-behavioral therapy (KBT) in headaches can help children and teens to reduce negative thought patterns in headaches. This can, for example, apply to so-called disaster thoughts in the style of “now the headaches will come again and nothing I can do about it”.

Another purpose of KBT is to support the child in being able to keep his usual activities in everyday life as much as possible.

For treatment with KBT, the child needs to be at least seven years. If the child is younger than this, it can be difficult to understand how different body signals should be linked with certain methods to reduce headaches.

There are also self-help programs on the Internet for young people and adults with troublesome headaches. These programs are usually based on psychological methods that have proven to be of good help in traditional therapy by a therapist, such as relaxation training and KBT. The result is often best if the teenager also has contact with a knowledgeable psychologist who can support and help when problems arise during treatment.

Important with medical examination before treatment

Before the child or teen begins treatment with a physiotherapist, psychologist or via the Internet, it is important that a doctor first performs a study to rule out that a physical illness is behind the headaches.

This is how a medical examination goes

When visiting a doctor, it is important that the doctor receives as detailed information as possible about the headaches. If the pain has been recurring, it is good if you as a teenager or adult with the child have brought or keep a diary of the headaches, so that the following questions can be answered:

  • Does the child or teen have two types of headaches, ie both migraine, and tension headaches?
  • Did the pain start in a short period of time as a seizure or did it come slowly and sneakily?
  • How long did the pain last and how intensely did it feel?
  • Where in the head did it sit?
  • Have the headache episodes or attacks changed?
  • When (time of day and weekday) did the child have a headache in recent times?
  • If painkillers were taken, did it help? How often is it used?
  • Are there other things that relieve or aggravate the pain, for example, certain activities, situations or intake of a certain food, drink, fatigue, stress, worry?

During the examination, the doctor decides which samples to take and whether the physical examination needs to be supplemented or whether a referral needs to be written for assessment or treatment by another specialist.

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