Headaches: What You Need to Know

Headaches are a common problem in children and teens. Learn about headaches, including the different types of headaches and ways to have fewer headaches, and how to track your headaches so your doctor can help you at your next visit.

What is a Headache?

A headache is a pain in your head, face, or upper neck. There are many different types of headaches. The 2 most common types of headaches are primary headaches and secondary headaches.

The two most common primary headaches are:

• Tension-type headaches: These can cause a pressure or tightness that is usually on both sides of your head. Although they are very common, these headaches are usually not bad enough to affect your daily life.
• Migraine headaches: These might affect just one side of your head or both. They can trigger nausea, vomiting, sensitivity to light or sound or changes in your vision. These are often bad enough to cause interruptions in your daily life.

There are also secondary headaches. These headaches are symptoms of other conditions. For example, illnesses like the flu, a cold or sinus infections can cause headaches. In very rare cases, headaches can be caused by a more serious problem like infections, high blood pressure or a tumor.

How Do Doctors Treat Headaches?

There are many ways doctors can treat headaches, including lifestyle changes, activities or medications. Most headaches can be managed or eased with lifestyle changes or activities. For very bad headaches, talk to your doctor about medications.

Lifestyle changes

Lifestyle changes are changes you make to the habits you have and things you do every day. They can help to lower your stress level and distract you from the headache. Lifestyle changes that can help improve headaches include:

• Drink enough water
• Sleep 8-10 hours per night
• Eat 3 meals and 2 snacks a day at regular times. Do not skip meals, especially breakfast.
• Exercise or physical activity 20-30 minutes per day
• Stick to a regular schedule. Too many changes can trigger headaches or make them worse. Do your best to go to school and participate in your normal hobbies and activities.
• Drink no more than 1 small caffeinated drink per day. This includes coffee, soda and energy drinks. Too much caffeine can cause headaches.
• Do not use over-the-counter medications to treat headaches more than 2-3 times a week. This includes acetaminophen (Tylenol®) and ibuprofen (Motrin® or Advil®).

Activities

Activities also help manage stress and distract you from the headache. Activities that can help ease headaches include:

• Yoga
• Art
• Music
• Massage
• Acupuncture
• Meditation
• Counseling or cognitive behavioral therapy (CBT)

Medications

Sometimes, headaches are bad enough that you may need to take medication. There are 2 types of headache medicine:

• Preventative medications help stop headaches before they start. Your care team can talk with you about which type may be best and give a prescription, if needed.
• Pain relievers help ease pain from a headache after it starts. It is best to take these medications within 20-30 minutes after the headache starts. Some of these can be bought without a prescription while others cannot.

Only use pain relievers if your care team recommends them. Do not use pain relievers more than 2-3 times a week. They can start to cause headaches if you use them too often. Doctors call these rebound headaches or medication overuse headaches.

Is There a Good Way to Keep Track of My Headaches?

Yes. There are many headache diaries online and through apps on your phone. These diaries or apps can help track how often you have headaches, how much pain you have and any treatments you use. Tracking headaches can help you and your care team think about what might be triggering your headaches and come up with treatment options.

When Should I See the Doctor About My Headaches?

Call your doctor right away if your headache has any of the following features:

• Starts after a head injury
• Wakes you up from sleep
• Is sudden and severe (worst headache of your life)
• Happens with neck stiffness
• Leads to very bad confusion
• Comes with a fever of 100.4°F (38°C) or higher

Rev. 2/2020. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.