Specialties & Conditions Headaches
Headaches
Specialty
Program
What Is a Headache?
Headaches involve pain or discomfort in the head or face area. They can happen once or may keep coming back.
Primary headaches aren’t caused by a separate health condition. These include migraine headache or tension-type headache.
Secondary headaches are a symptom of another health condition, such as a cold or a head injury.
This page focuses on primary headaches in children.
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What Are the Most Common Types of Headaches in Children?
The most common types of headaches in children are migraine and tension-type (or stress) headaches.
Sinus headaches are uncommon in children because their sinuses have not fully formed. Many sinus headaches, in both children and adults, are misdiagnosed as migraine.
What Are Common Causes of Headaches in Children?
Lifestyle factors cause about 80% of headaches in children. Addressing these issues is often the first line of treatment. These factors include:
- Dehydration
- Excessive screen time
- Poor sleep
- Skipped meals
- Stress
Genetic factors can also play a role, especially with migraine. Children whose parents have migraine are more likely to develop them as well.
What Are the Signs and Symptoms of Headaches in Children?
Headache symptoms vary depending on the type of headache.
Tension-type Headaches
Tension-type headaches often cause pressure or tightness in a child’s head and may also cause neck pain. Children with tension-type headaches may be irritable but typically continue their activities, such as playing, despite the pain.
Migraine Headaches
Migraine affects about 8% of children and up to 15% of adolescents, and these percentages increase with age. Compared to tension-type headaches, migraine can be more disruptive to a child’s life. In addition to head pain, symptoms include:
- Sensitivity to light and noise
- Desire to lie down or stop activities
- Nausea or vomiting
- Numbness or tingling in the hands or face
- Visual disturbances, such as an aura or blurred vision
What to Watch For in Younger Children
Unlike older children and teens, very young children often can’t describe their symptoms to you. Instead, they may seek out dark rooms, avoid bright light or stop playing. They may also show sensitivity to light and sound or have nausea and vomiting.
When to Seek Immediate Medical Attention
Most headaches do not pose an immediate danger, but some symptoms require prompt attention:
- Double vision
- Early morning vomiting without other explanation
- Headaches in children under the age of 4
- Headaches that are worse when lying down
- Headaches that awaken the child from sleep
- Sudden, severe headaches that develop quickly
- Weakness in the arms or legs (or other neurological symptoms such as seizures)
How Do Doctors Diagnose Headaches in Children?
Our health team will conduct a thorough evaluation that may include listening to your story about your child’s headache experience and doing a thorough neurological examination.
Symptom Assessment
Doctors may ask older children and teens specific questions about headache duration, frequency, triggers and symptoms like light sensitivity or sound sensitivity.
With younger, especially pre-verbal children, doctors rely on observed behavior — both what they can see and what the parents report.
Medical and Family History
Your care team will consider the medical history of both your child and family. For example:
- A family history of migraine makes it more likely that children will have a migraine.
- A child who has motion sickness or experienced infantile colic may also be more prone to migraine.
- Depending on the exam results, your child’s doctor may recommend neurological testing.
What Is Lurie Children's Approach to Treating Pediatric Headaches?
Lurie Children’s takes an integrative, interdisciplinary approach to pediatric headaches. This means bringing in different specialists and experts to meet the unique needs of each child.
Our care team focuses on immediate headache relief and long-term management. Individualized treatment plans may include one or more approaches:
Lifestyle Changes
Lifestyle counseling is the first line of treatment, focusing on such key factors as:
- Drinking enough water to stay hydrated
- Eating regular, nutritious meals
- Getting quality sleep on a consistent schedule
- Limiting screen time to under two hours each day
For most children, these adjustments significantly reduce headache frequency and severity.
Non-medication Therapies
Non-medication therapies focus on managing underlying stressors and physical contributors to headaches:
- Cognitive behavioral therapy (CBT) can address coping mechanisms for pain. CBT can also address stress, anxiety and mood issues that may be contributing to headaches.
- Physical therapy (PT) can ease muscle tension or deconditioning that contributes to headache. A specialized form of PT, vestibular therapy, focuses on headaches associated with dizziness.
- Clinical nutrition assessments help you understand certain food triggers that contribute to migraine and help you keep a well-balanced diet that may reduce migraine.
Advanced Procedures
For severe or hard-to-treat cases, advanced treatments include:
- Neuromodulation devices: Non-invasive options like Nerivio® (a nerve-stimulating armband) and Cefaly® (a forehead device targeting forehead and upper eyelid nerves) help reduce or prevent migraine.
- Pain-reduction procedures: Doctors may prescribe nerve blocks, sphenopalatine ganglion blocks, trigger point injections and Botox® injections for chronic migraine.
Medications and Supplements
Some children may benefit from medication, either to treat headaches when they occur or to prevent them:
- Rescue medications: NSAIDs (e.g., ibuprofen and naproxen) or triptans (e.g., rizatriptan and sumatriptan) can stop a headache when it begins.
- Preventive treatments: Magnesium and vitamin B2 (riboflavin) supplements, along with prescription medications tailored to your child’s specific needs, can often prevent recurrent (frequent) headaches.
- Infusion therapy: IV treatments are available for persistent migraines that don’t respond to oral medications.
Collaborative, Interdisciplinary Care for Pediatric Headaches
Our interdisciplinary team, including a headache psychologist, addresses the biological, psychological and social components of headaches. For example, your child’s psychologist may assist with:
- Medication adherence
- Strategies to minimize school absences and maintain daily activities
- Stress management
- Coping strategies for dealing with pain and headache
Our interdisciplinary care team ensures that each child receives personalized care to reduce the impact of their headaches and improve their quality of life.
Living With Headaches
Headaches in children are usually nothing to worry about. However, recurrent headaches can lessen a child’s quality of life, disrupting school attendance and social activities. These headaches need treatment. Regular follow-ups allow your child’s care team to monitor progress and adjust treatments as needed.
Lurie Children’s Pediatric Headache Center of Excellence
We provide personalized, comprehensive treatment plans for each patient's needs. Our integrative approach includes lifestyle counseling, herbal supplements, medications, cognitive behavioral therapy, and, when needed, pain-reduction procedures.
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