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Advice for Patients
March 2013

Treating Headaches in Children and Adolescents

JAMA Pediatr. 2013;167(3):308. doi:10.1001/jamapediatrics.2013.230

Headaches are very common in children. About 50% to 75% of children report having a headache each month. Serious causes of headaches in children and adolescents are rare, and very few require computed tomographic (CT) scans or magnetic resonance imaging (MRI). Among children and adolescents, headaches are most often a symptom of other medical or emotional problems. For example, headaches can be caused by a cold or strep throat. Headaches can also be caused by stress, worry, or lack of sleep. There are types of headaches that may be ongoing or that happen every once in a while for a child. These include the following:

  • Tension headaches: Tension headaches are often described as a headache that feels tight, or like a band is tight around the head.

  • Migraines: Migraine headaches are often described as a throbbing type of headache, as though someone were hitting the head with a hammer. Migraine headaches can include other symptoms such as nausea, abdominal pain, or an aura. An aura is when one sees a visual disturbance, such as flashing lights or blurring, prior to or during the headache.

  • Chronic daily headache: Chronic daily headache usually involves a headache more than 15 days per month, sometimes every day.

Headache treatments

For many headaches, rest and/or pain medication may help. Rest may include lying down or other quiet activity. Pain medications often include acetaminophen or nonsteroidal anti-inflammatory drugs such as ibuprofen. If headaches happen frequently, other medications and treatments may be considered to help the headaches. There are 2 general types of medicines for headaches: acute or abortive medications are meant to stop a headache that is happening right now. Prophylactic medications are meant to reduce future headaches, either in how often they happen or in how severe the headache is. Prophylactic treatments include antiepileptic medicines that are often used to control seizures, antidepressants, and blood pressure medications. There are also complementary medicine approaches to treating headaches; these include chiropractic care, massage, acupuncture, relaxation training, and biofeedback training. A study in this month's JAMA Pediatrics issue reviewed the effectiveness of medications that are commonly used for children's headaches. Keeping a headache diary can help you and your doctor determine how well the medications are working. When choosing any headache treatment for your child, your doctor can work with you to consider effectiveness, safety, and costs.

For more information

American Academy of Pediatrics

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Article Information

Source: American Academy of Pediatrics

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The Advice for Patients feature is a public service of JAMA Pediatrics. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child's medical condition, JAMA Pediatrics suggests that you consult your child's physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.