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When Your Child Has Tension Headaches

It is not uncommon for children to get a type of headache called tension headaches. These headaches can be painful. But they are rarely a sign of a major health problem. Treatment can help your child feel better. Also, certain things can be done to help prevent tension headaches.

Understanding headache pain

Father giving son liquid medication.

The two most common types of headaches are tension and migraine. Tension headaches are one of the most common types of headaches. Your child’s healthcare provider has told you that your child’s headaches are tension headaches. With a tension headache, pain can come from many areas of the head. These include the muscles, joints, eyes, blood vessels, or nerves. In some cases, your child feels referred pain (pain from another part of the body). For example, tense muscles in the shoulders or neck may lead to headache pain.

What causes tension headaches?

Tension headaches can have many causes. Common causes in children are:

  • Tension (physical or emotional)

  • Hunger

  • Trouble with eyesight

  • Eyestrain due to reading, video games, or computer use

  • Exposure to very strong smells (such as perfume or tobacco)

  • Fatigue (tiredness)

  • Sinus infection or allergies

  • Overheating

  • Dehydration (not enough fluid in the body)

What are the symptoms of tension headaches?

Every child is different. And your child’s headaches may feel different each time. Your child may have some or all of these symptoms:

  • Head pain that is focused in the front of the head

  • Neck pain along with head pain

  • Pain behind both eyes or in both temples

How are tension headaches diagnosed?

The healthcare provider will start by ruling out migraine headaches and headaches due to other causes. He or she will also examine your child and ask questions.

  • You will likely be asked about the times of day your child most often has headaches. You may also be asked about health issues, such as frequent sinus infections.

  • You and your child may be asked to keep a “headache diary” for a short period. This means writing down what time of day your child gets headaches, where the pain is felt, how often the headaches happen, and how bad the headaches are. You may also be asked to write down things that make the headache better or worse. The diary can help the healthcare provider learn more about the headaches and determine the best treatment.

How are tension headaches treated?

Treat your child at the first sign of a headache. The longer you wait, the longer the pain can take to go away. Give your child a dose of acetaminophen or an over-the-counter nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen. Do this as soon as possible. Your child may wish to lie down and rest until the headache is gone. A cold compress over the face and eyes may also be helpful.

How are tension headaches prevented?

To prevent headaches, avoid your child’s specific triggers. Triggers are things or events that cause headaches to occur. Some common triggers are hunger, eyestrain, strong odors, and fatigue. You and your child should learn his or her triggers and avoid them when possible. Be sure your child is eating well, getting enough sleep, getting daily physical activity, and limiting computer and TV time.

Call your child’s health care provider right away if your child has any of the following:

  • Fever and a stiff neck with a headache

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher

    • In a child of any age who has a temperature of 103°F (39.4°C) or higher

    • A fever that lasts more than 24 hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • A seizure caused by the fever

  • Headache that doesn’t respond to NSAIDs

  • Headache that seems different or much worse than previous headaches

  • Headache upon awakening or in the middle of the night

  • Vomiting due to headache (especially vomiting upon awakening)

  • Dizziness, clumsiness, slurred speech, or other changes with a headache

  • Blurred or double vision with headache


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