Headaches (HA) are common in children and adolescents. In fact, more than 50% of school-age children will have complaints of HA at one point or another.  In adolescents, HA are more likely in females. Having a first degree relative with HA does increase the likelihood  someone will have HA. Thankfully, the majority of HA are not caused by serious underlying illnesses. Let's talk about a couple of important types of HA and things to watch out for. 

• Tension HA- Tension headaches are the most common type of HA. These are typically mild-moderate pain that is symmetric (on both sides of the head) and steady pain that is distracting, but not debilitating. Triggers include stress and increased muscle tension. They tend to occur later in the day. Most tension HA respond well to OTC pain relievers. 

• Migraines- These types of headaches are one of the most common ailments I deal with in the office everyday; and unfortunately, I suffer with migraines myself. Migraines are typically very intense pain that usually occurs on one side of the head. The pain tends to be in the same place each time. These can be triggered by different things including hormone changes, weather fronts, and certain foods to name a few.  A migraine HA is associated with nausea, vomiting, light sensitivity, and sound sensitivity. There are more severe types of migraines that are associated with numbness or tingling of the extremities or face, vision changes, and difficulty speaking. 

RED FLAGS- Sudden onset with severe pain (aka “the worst headache of my life”), increasing frequency or intensity of typical headaches, position changes that increase the intensity of the headache, weakness or other neurologic signs, and neck stiffness send up a red flag. If any of these symptoms occur, you should go see your doctor right away. 

Typical treatment options include Acetaminophen and NSAIDs (non-steroidal anti-inflammatories) like Aleve or Ibuprofen. Some people also respond well to Excedrin migraine which contains acetaminophen, aspirin, and caffeine. However, this medication should not be given to children under 16 unless you have spoken with your child’s doctor. 

There are specific abortive medications that can be given for migraine sufferers when the typical treatments fail.  One example class of medicines are called the Triptans (Maxalt, Imitrex). There are some contraindications for using these medicines so it is not safe for everyone to take them. 

One of my favorite, well-studied treatments for chronic HA is a combination of Vitamin B2 and Magnesium. These supplements help promote smooth muscle relaxation, stabilize the energy producing cells in the body, and can be used as a preventative, or to decrease frequency of HA. Doses typically start at 100 mg and will work up to a maximum of 400 mg depending on how symptoms respond. Major side effects to watch for are GI upset and diarrhea. 

Although it sounds very simple, one of the best ways to prevent HA is to drink plenty of water (at least 64 oz/day), eat regular meals, and get at least 8 hours of sleep at night. 

If your child suffers from frequent headaches, please visit your doctor for evaluation and to discuss treatment options as each patient needs to be treated individually. 

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