Headaches In Children: Causes, Concerns and Cures

Written by Dr Tamara Bugembe

Headaches are a common complaint in childhood and adolescence, but their impact should not be underestimated. From missed school days to disruptions in sleep, learning, and social interaction, headaches can affect a child’s overall well-being. Studies show that more than half of 15-year-olds have experienced a significant headache, and nearly one in three children aged 10 to 15 experiences migraine headaches.

There are different causes of headaches and also certain types of headaches commonly seen in children. At Integra Healthcare, we help parents know when to seek medical advice, and offer practical strategies for management.

What causes headaches in children?

A child’s headaches can be triggered by a variety of factors. These include disruptions in the blood vessels of the brain, inflammation in the sinuses, or irritation of the meninges (the protective tissues surrounding the brain). Pain signals from these areas are interpreted by nerves, but because of the limited space inside a child’s head, the sensation may be referred to other areas, making diagnosis challenging.

In younger children, symptoms may not be described in detail, and many will not complain until the headache becomes severe. This is why your child’s doctor may ask you to keep a headache diary to help identify patterns and associated symptoms. Common headache triggers include dehydration, skipping meals, poor sleep, excessive screen time, or stress.

For paediatric patients, identifying the cause and pattern of their headache pain is essential to guide treatment and prevent recurrence.

When should I seek medical attention for my child’s headache?

Most childhood headaches are mild, temporary, and resolve with rest, fluids, and over-the-counter pain relief such as paracetamol (acetaminophen) or ibuprofen. However, it is important to speak with your paediatrician or healthcare provider if your child has any of the following:

• Persistent headaches occurring most days of the week
• Headaches that worsen in the early morning or overnight
• Headaches aggravated by lying down
• Fever and neck stiffness alongside headache symptoms
• Changes in vision such as blurred vision or eye turning
• Poor balance or coordination
• Regression in developmental skills
• A sudden and severe headache
• Frequent headaches requiring repeated medication or resulting in missed school days

Children under five years of age presenting with recurrent or unexplained headache symptoms should always be assessed by a qualified paediatrician. In some cases, your primary care provider may initiate evaluation before involving neurology or other specialties.

What are the different types of headache?

Headaches are broadly categorised as either primary or secondary. Primary headaches include conditions by which the headache itself is the main issue. Secondary headaches occur as part of an underlying condition.

Migraine headaches

Migraine is one of the most common primary headache disorders in children. It affects about one-third of adolescents aged 10 to 15 and accounts for the majority of paediatric headache consultations. Migraines have a strong genetic link, with around 70 percent of children affected having a family history of the condition. Symptoms of migraine often include nausea, sensitivity to light or sound, and a preference for lying still in a dark, quiet environment.

There are three recognised types of migraine in childhood:

• Migraine without aura: This is the most common type of headache in children. The pain often affects one side of the head and may worsen with movement.
• Migraine with aura: In these cases, the child experiences sensory symptoms such as visual changes, tingling, or dizziness before the headache begins. Some may also experience a prodrome with fatigue, yawning, or mood changes.
• Migraine equivalent syndromes: These are rare and can include temporary weakness, speech disturbances, or other neurological changes. The headache may not appear immediately but could develop days later.

Treatment of migraine headaches

The most effective treatment for a migraine is early intervention. At the onset of symptoms, rest and appropriate doses of ibuprofen or paracetamol can reduce severity. Children with a consistent aura pattern may benefit from medication designed to interrupt the migraine process before the pain begins. Schools should work with families to ensure that children have timely access to their medications and a space to rest if needed.

For children with frequent or disabling migraines, preventive medication may be considered. These can include antihistamines, antidepressants, or blood pressure medications, depending on the child’s age and symptoms. Preventive strategies should be supported by lifestyle adjustments, such as regular meals, improved sleep hygiene, physical activity, and reduced screen time.

Non-medication approaches such as relaxation techniques, mindfulness, and biofeedback therapy are showing promise in reducing the impact of migraine headaches in children, although more research is needed.

Cluster headaches

Cluster headaches are less common in children and usually appear after the age of 10. They involve intense head pain on one side of the head and may last from 15 minutes to several hours. These episodes often occur in clusters, lasting for days or weeks before disappearing for months or even years.

Unlike migraine headaches, children with cluster headaches may appear restless and agitated. The affected side of the face may be puffy or pale, and the eye may water or become bloodshot. Treatment options include oxygen therapy, steroids, and medications such as triptans.

Tension-type headaches

The most common type of headache in adolescents, tension-type headaches often feel like a tight band around the head. While they do not typically worsen with physical activity, they may be accompanied by sensitivity to light or sound. These headaches can last several hours or days and may cause generalised headache pain rather than affecting just one area.

Tension-type headaches are often linked to stress, posture, or muscular strain from carrying heavy school bags. Understanding and addressing the headache triggers is key to reducing recurrence.

What are secondary headaches?

Secondary headaches occur due to an underlying cause. Your paediatrician will aim to rule out these conditions through a detailed medical history, physical examination, and, where necessary, further testing.

Brain tumours

Although a common worry for parents, brain tumours are rare. Out of every 5,000 children with recurrent headaches, only one is found to have a brain tumour. These children usually present with additional symptoms such as morning vomiting, coordination issues, or changes in behaviour.

Idiopathic (or Benign) Intracranial Hypertension

This condition involves increased pressure around the brain and may lead to daily headaches, visual disturbances, and sensitivity to movement. Diagnosis requires a lumbar puncture to measure spinal fluid pressure. It is becoming more common in children due to increasing rates of childhood obesity. This type of headache can affect vision and should be treated promptly.

Other causes of secondary headaches

• Sinus infection: Pain behind the eyes, forehead, and cheeks
• Eye strain: Often due to vision problems or excessive screen use
• Whiplash injuries or head trauma: Especially relevant following accidents, falls, or sports injuries
• Temporomandibular joint (TMJ) disorders: Pain in the jaw joint that can radiate to the sides of the head

If any of these are suspected, your primary care doctor may make a referral to ENT, dental, ophthalmology, or neurology specialists to ensure all possible sources of the headache are investigated.

Managing a child’s headaches

A collaborative approach between parents, schools, and healthcare professionals can significantly reduce the impact of headaches on a child’s quality of life. Keeping a headache diary is often a useful starting point, allowing you and your child’s doctor to identify headache triggers and symptom patterns.

Over-the-counter medications such as ibuprofen and acetaminophen should be used under guidance from a healthcare provider to avoid side effects or overuse. Children experiencing chronic headaches or severe pain that interferes with daily function should be referred for further evaluation.

Young children may struggle to describe their headache symptoms in detail, which is why routine observation and early paediatric involvement are important. Timely diagnosis and appropriate intervention can reduce the frequency of recurrent headaches and improve a child’s physical and emotional well-being.

For more information on managing paediatric headaches or to schedule a consultation, contact our team at Integra Healthcare.