Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Managing chronic headaches in children

Roy Benaroch, MD
Conditions
October 9, 2013
Share
Tweet
Share

Jenny wrote in about her son, who has a lot of headaches: “My 12 year old son gets them pretty much every day, and this has been going on for six months. He missed a lot of school, and now is starting to get them again in the summer. The doctor ordered a CT scan which didn’t show anything. What can this be? Could it be sinuses?”

Headaches are common in children. They’re usually “primary” headaches — meaning they’re not caused by anything specific, and they’re not associated with any specific medical condition. They’re just headaches.

Kinds of “primary” headaches in children include:

Migraine.  Maybe the most common of the more-severe headaches. In children they’re often bilateral and fairly brief. Sometimes they’re accompanied by vomiting, or are worsened by lights or sound; often the best “cure” is to go to sleep. Migraines often run in families.

Tension. These create a band-like, or squeezy feeling in the head, and aren’t usually severe. Yes, kids of all ages get tense.

Chronic daily headache. This sounds like Jenny’s son. They often occur on top of occasional more-severe headaches, like migraines.

The general principles of chronic daily headache:

  • Avoid daily Advil or Tylenol. If you use those more than 3 days a week, you will perpetuate the headaches. I know this sounds odd, but I promise it is true.
  • Try to maximize healthy lifestyle. Good regular sleep, diet, avoiding a lot of preservatives and chemicals, getting regular exercise. Again, I know this sounds odd, but it does help.
  • Try not to miss school. That inevitably makes headaches worse.
  • Consider massage/yoga/relaxation therapy.
  • If there is an overlay of depression/anxiety/mood issues, deal with that. There is often a psychological component, either contributing to the headaches, or being caused by the headaches and missing school and activities.
  • Consider a daily medicine to control the headaches. Not painkillers, but other kinds of medicines that prevent headaches. You will need a physician’s guidance if daily medication is needed.

About CT scans and headaches: they’re almost never necessary for chronic, ongoing, stable headaches (or headaches that come and go in a stable pattern.) Imaging is really only useful for acute, worse-in-a-lifetime headaches, headaches associated with other symptoms (like seizures or neurologic problems), or progressive headaches that are getting worse and worse. CTs (or MRIs) are completely unnecessary in the workup of most children with headaches, and will sometimes give misleading results that lead to wild goose chases and misery.

Another headache myth: Most people out there who think they’ve got sinus headaches have been misdiagnosed.  Recurrent “sinus” headaches are genuinely uncommon. When they do occur, they’re associated with persistent nasal congestion and cough that precede the headache. Migraines themselves, which are far more common than recurrent headaches from sinusitis, can cause nasal or sinus symptoms that begin about the same time as the headache. It’s unlikely that Jenny’s son has headaches from sinus disease without other obvious persistent sinus symptoms, especially with a normal CT scan.

Yet another headache myth to dispel: vision problems rarely cause recurrent headaches in kids. Some people who are nearsighted will squint, and by the end of the day will develop tension-like pain from tightening up the muscles of their face and scalp, but that really is uncommon.

Headaches in children are common, and most commonly are caused by a minor infection, dehydration, hunger, or stress. If they’re recurrent, they’re likely to be one of the common primary headaches, like tension headaches or migraine or chronic daily headache. Headaches that are progressive (worsening), or associated with other prominent or worsening symptoms, need an urgent medical evaluation, but those are fortunately rare. More typically, headaches just need to be treated like, well, headaches.

Don’t forget the simple stuff: rest, a kiss on the forehead, a cool compress, something to help relax. In the long run, those are probably better headache remedy for children than any medication.

Roy Benaroch is a pediatrician who blogs at The Pediatric Insider. He is also the author of Solving Health and Behavioral Problems from Birth through Preschool: A Parent’s Guide and A Guide to Getting the Best Health Care for Your Child.

ADVERTISEMENT

Prev

Climate change and cancer screening: Leave causation to the experts

October 9, 2013 Kevin 0
…
Next

When electroconvulsive therapy is the right choice

October 9, 2013 Kevin 1
…

Tagged as: Neurology, Pediatrics

Post navigation

< Previous Post
Climate change and cancer screening: Leave causation to the experts
Next Post >
When electroconvulsive therapy is the right choice

ADVERTISEMENT

More by Roy Benaroch, MD

  • Goodbye, Benadryl: It is time for you to retire

    Roy Benaroch, MD
  • Telemedicine overprescribes antibiotics: Are you really receiving the best care over the phone?

    Roy Benaroch, MD
  • No, phones don’t cause horns to grow on skulls

    Roy Benaroch, MD

More in Conditions

  • Facing terminal cancer as a doctor and mother

    Kelly Curtin-Hallinan, DO
  • Why doctors must stop ignoring unintentional weight loss in patients with obesity

    Samantha Malley, FNP-C
  • Why hospitals are quietly capping top doctors’ pay

    Dennis Hursh, Esq
  • Why point-of-care ultrasound belongs in emergency department triage

    Resa E. Lewiss, MD and Courtney M. Smalley, MD
  • Why PSA levels alone shouldn’t define your prostate cancer risk

    Martina Ambardjieva, MD, PhD
  • Reframing chronic pain and dignity: What a pain clinic teaches us about MAiD and chronic suffering

    Olumuyiwa Bamgbade, MD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Managing chronic headaches in children
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...