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Headaches vs migraines Children's Wisconsin

Name the pain: Tension headaches versus migraines

Headaches can be a real pain in the, well, head. And they're not just for overworked and stressed adults  kids can get them, too. Some kids get them as a symptom of some sort of illness or as a reaction to something such as dehydration or medication. And some kids get them for no real reason. 

But how can you tell if it’s a tension headache or something more severe like a migraine? And how can you help your child if they are experiencing one?  

Tension headache versus a migraine 

Both tension headaches and migraine headaches involve head pain. However, migraine pain is more severe and is often disruptive to normal activities. Migraines typically cause throbbing on one side of the head that worsens with activity. They may also come with other symptoms including nausea and/or vomiting, vision issues including blurred vision and seeing spots or flashing lights, sensitivity to sound and tingling. 

Migraines can affect kids as young as 5 years old and even younger, although that’s rare. Also, there are studies that show that many colicky babies are more likely to develop migraines later in life. 
Tension headaches are the most common type of headache. Tension headaches are typically described as more of a dull or band-like pain around the head. They often involve both sides of the head, and they can also cause pain down the back of the neck and into the shoulders. They are not usually accompanied by nausea, vomiting, visual changes, or light/sound sensitivity. 

Possible causes and risk factors

There are a few things that may influence headaches in kids. Let’s take a look at a few of them. 

Falls and bumps: If your child falls, gets hit in the head or otherwise bumps their head, they will likely get a headache. It can be really painful, but it’s unlikely to be a migraine. Most of the time, kids hit or bump their heads without causing a concussion. However, if the fall or bump is really hard, you should check with your pediatrician. Concussions are often accompanied with decreased concentration, fatigue, nausea or feeling dizzy. Read this blog post for more information on concussions

Illness: As I mentioned in the beginning, sometimes headaches are a symptom that accompany common illnesses such as colds, sinus infections, the flu, COVID-19, and even seasonal allergies. 

Food and hydration: There are a number of foods that can trigger migraines, and kids who suffer from them are often advised to avoid them. These foods include

  • Cheese

  • Chocolate

  • Food additives including red and yellow food dyes (often found in candy, sports drinks, cereals, etc.)

  • Monosodium glutamate (also known as MSG, often found in cured meats and ranch dressing, which I know is a conduit to vegetable eating for many kids)

  • Artificial sweeteners (often found in reduced sugar foods and drinks)

Additionally, not properly hydrating can cause both migraines and tension headaches. With kids so active in sports year round, it’s important to make sure they are going to practices and games with a water bottle, and drinking before, during and after to stay well-hydrated. 

Stress, screens and sleep: Sadly, kids today face stresses a lot of adults didn’t when they were young. There are pressures to perform well across school, sports, hobbies, and other activities. Compounding that are pressures and stress from social media. Stress can definitely trigger headaches. Allowing too much screen time (TVs, cell phones, tablets) can cause headaches. Stress and screens can also disrupt healthy sleep routines. When sleep is compromised, it can lead to headaches as well. 

Family history: I see this a lot. If a parent has a history of migraines, there is approximately a 1 in 2 chance that the child will get them. If both parents suffer from migraines, it’s nearly a 90 percent chance. 

Taking care of a headaches

Most headaches can be taken care of right at home. When I hear from a parent or a patient that they’ve been experiencing headaches, I suggest rest in a quiet place, focus on hydration, healthy meals and over-the-counter pain relievers

As I mentioned, some kids get headaches due to stress. I encourage parents to help their kids find ways to decompress in a healthy way and work to reduce stress. My colleague wrote a blog post on how meditation can help people of all ages, especially kids. 

Write it down 

If you notice your child experiencing headaches, I recommend that parents write down what’s going on. It will help your pediatrician if you are able to include:

  • What was going on leading up to the onset of the headache (activities, food, hydration)

  • What the headache felt like (i.e. throbbing, tightness, etc.), where on the head your child felt pain 

  • How long it lasted

  • What steps were taken to relieve the pain (i.e. over the counter pain relievers, hydration, rest)

Oftentimes, when we look over this information with families, we see things that can be done preventatively to help reduce the occurrence of headaches. Other times, this information can help inform any additional testing that may need to be done.

When to see a doctor

While most headaches aren't serious, you should call your child’s doctor if your child's headaches:

  • Wake your child from sleep

  • Worsen or become more frequent

  • Change your child's personality

  • Follow an injury, such as a blow to the head. (This could be a concussion as I discussed earlier.)

  • Feature persistent vomiting or visual changes

  • Accompanied by fever and neck pain or stiffness

As always, if you have any questions or concerns about your child’s headache, don’t hesitate to reach out to their pediatrician.