Headaches may be symptoms of other physical conditions. For that reason, it is VITAL that they be properly diagnosed.

As with adults, tension-type headache (TTH) is the most common type of headache for children. Approximately 75% of children who experience frequent headaches are diagnosed with TTH. There are two types of TTH — episodic, which occurs several times per month; and chronic, which occurs 15 or more times per month. It was long thought that TTH did not have the hereditary factor that migraine has, but more recent research leans more toward the presence of strong genetic influence. 

Symptoms:

• pain is usually on both sides of the head, but may be anywhere on the head
• pain is often described as band-like, dull, pressing, or aching
• pain is unilateral (one-sided) in approximately 20% of patients
• pain is usually mild to moderate
• lasts 30 minutes to seven days
• tenderness of the head
• tightness of the muscles in the neck and shoulders
• difficulty concentrating
• heightened sensitivity to light or noise, but not both
• some kids will have trouble sleeping or will awaken earlier than usual

Triggers:

Though the root cause of TTH is now thought to be a genetic susceptibility to such headaches, the individual headache episodes are triggered by various and differing things in the child's life. These triggers will vary from child to child. Some of the more common triggers of TTH are:

• irregular sleep schedule or not enough sleep
• stress/tension at home or school
• problems with self image
• missed meals
• bright lights
• cigarette smoke, including second-hand
• the death of or separation from a loved one

Treatment:

If a tension-type headache can be relieved by relaxing, taking a warm bath, using an ice pack, or taking  a nap, that's the best course of action. This does work in some cases. If not, medications are tried, beginning with the simplest of over-the-counter analgesics and moving up from there to prescription medications. Medications with Aspirin are generally not recommended for children under 14 because of the possibility of Reyes Syndrome. Some of the medications used are:

• Acetaminophen
• Aspirin
• Naproxen
• Ibuprofen
• Aspirin-Caffeine combinations
• Ibuprofen-Caffeine combinations
• Midrin
• Norgesic Forte
• Indomethacin
• Vioxx

When TTH is occurring too frequently, medications may be prescribed to prevent the headaches. Some of the medications used are:

• Depakote (anticonvulsant)
• Elavil, Prozac, Zoloft, Paxil (antidepressants)
• Aleve, Naprosyn, Anaprox, Ansaid, Orudis (Nonsteroidal Anti-Inflammatory)
• Occasionally a combination of two of these medications

It should be noted that finding effective preventive therapy does not happen overnight. A fair trial can take up to up to six months of physician supervision.  A headache diary should be kept faithfully during this period. Giving up after a short period of time robs the patient of the potential benefits of the preventive medications.

In addition to medications, stress management education and counseling are often helpful for children, especially teens, who are experiencing TTH. As adults, we sometimes forget just how stressful those years of high expectations and peer pressure can be. Additional treatment methods that have proven useful are biofeedback and relaxation techniques. For many children, the most successful method of management is a combination of medications and and other methods.

Want to read more about Tension-type headache?
Check out Tension-Type Headache, Most Common of All

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© 2001, Teri Robert
About, Inc.