Plenty of teenagers will tell you that nearly everything about adolescence is a headache. But what many of them and their parents don’t know is that headaches themselves may suggest that the teenager should see a doctor.
The most important thing to understand about adolescent headaches is the same for adult headaches — that is, usually they’re nothing to worry about. But in some cases headaches can mean more serious conditions requiring a doctor’s attention. Understanding the difference between types of headaches can help you determine whether or not you should seek medical attention.
Anatomy of a Teen Headache
For starters, “headache” is something of a misnomer. It’s really how we perceive what’s going on in the nerves, blood vessels, and muscles of the neck and shoulders, rather than the brain itself (which can feel no pain), that determines whether we have a headache or not. Like adults, virtually all teenagers get headaches, with as many as 75 percent of teens reporting at least one headache a month.
According to Charles J. Wibbelsman, M.D., FAAP, Chief of the Teenage Clinic at Kaiser Permanente in San Francisco, “The most common adolescent headaches are tension headaches, specifically related to stresses in their lives — school, exams, sports, and extracurricular activities.”
The discomfort of tension headaches, Wibbelsman points out, are generally felt as the familiar “band around the head” sort of pain, as well as the back of the neck and upper shoulders. “Many tension headaches go away in the summer, when school’s out,” Wibbelsman says with a laugh.
The causes of tension headaches can often be traced to equally common (if unfortunate) teenage experiences and habits:
Staying up too late and not getting enough sleep
Overexertion or overexposure to the sun
Stress at home or school (exam time is a prime time for teenage headaches)
Dehydration or lack of proper nutrition
- Tobacco, alcohol, or caffeine (including caffeinated soft drinks)
Excessive “screen time” (TV, video games, and the Internet)
Tension headaches that occur once a month or so (or when there are obvious outside factors such as “all-nighters” studying for exams) are not cause for excessive concern. You can help by encouraging your teenager to change the habits that contributed to the headache in the first place.
Additionally, most common tension headaches will go away after a fairly brief period of time, as a result of rest and, if necessary, using over-the-counter medicines, such as acetaminophen or ibuprofen. Avoid aspirin — children or adolescents should not take it. In rare cases, aspirin can cause Reye Syndrome, a serious and potentially fatal condition.
When It’s More Serious
Frequent headaches — even if they’re mild — could indicate a deeper problem. If they continue, you should take your teen to your pediatrician. If your teenager is having headaches a couple of times a week, or waking up with a headache, you need to see your pediatrician.
Less common and more serious are migraine headaches. These are far more painful and last far longer — from a couple of hours to a couple of days — than tension headaches. In addition to being more intense, the pain of a migraine headache often is located on one side of the head, rather than the milder, all-over discomfort of a tension headache.
“It’s important to get a correct diagnosis of migraine headaches,” Dr. Wibbelsman points out. “It’s important as well to be aware that migraines do run in families.”
Additional indications of a migraine headache include:
Nausea or vomiting
- Extreme sensitivity to light
- Throbbing pain that’s different from the more even pain of a tension headache
- Pain that grows worse with exercise
- Headache that does not diminish with time
- Headache that does not respond to over-the-counter medicines
- History of migraines among other family members (migraines can be hereditary)
If your child has any of these symptoms, let your pediatrician know. She will examine the teenager and determine whether or not migraine headaches are the problem. While there is no cure for migraine headaches, they can be managed through a combination of prescription medicines and lifestyle changes. Your pediatrician will explain a migraine treatment plan to you and your child.
One increasingly common migraine trigger is an activity familiar to many teenagers. “We know more and more about migraine triggers,” Doctor Wibbelsman notes, “and among those triggers are flashing lights and loud sounds — the sorts of lights and sounds that accompany video games.”
Teen Headaches and Emotional Issues
A third and rarer type of headache is the psychogenic headache, which has some of the same symptoms as a tension headache but is caused by emotional problems, such as depression. Parents concerned about frequent teenage headaches should be alert for the signs of depression and other emotional disorders, including:
Any of these symptoms — whether or not accompanied by headaches — should spur you to talk with your teenager and determine if depression or other emotional concerns are an issue. Naturally, a visit to the pediatrician is in order if your feel your concerns are justified. Your pediatrician will be able to determine if your child should see a therapist or other specialist in children’s emotional problems.
Other Causes of Head Pain
There are circumstances and conditions that can cause head pain and should always be examined by a doctor immediately. These include headache with:
In such cases the headache and related symptoms may mean concussion or other serious result of a head injury; nervous system or neurological (brain and central nervous system) conditions; or problems that require further tests and the medical attention of specialists.
Most headaches, of course, are unrelated to injuries, and most do not indicate more serious problems. Making that determination, though, is a doctor’s responsibility. “Proper medical evaluation of headaches is crucial,” says Dr. Wibbelsman, who serves on the AAP’s Committee on Adolescence. “The pediatrician will be able to evaluate the nature of the headache and determine the proper treatment.”
He notes as well that the majority of adolescent headaches are just that — just headaches. “Parents should know,” he says, “that headaches are a normal part of adolescence, as they are a normal part of adulthood.”
If any type of headache occurs more than once a week, persists throughout the day, or is accompanied by any of the symptoms discussed in this article, take your teen to the pediatrician. That’s the best way to be sure that your adolescent’s headache won’t weigh too heavily on your head.
This article was featured in Healthy Children Magazine. To view the full issue, click here.