What is a headache?

A headache is a pain, ache or throbbing sensation in any area of the head. Headaches are common in children and teenagers.

Signs and symptoms of headache

A headache can feel like a sharp pain, throbbing sensation, or a dull ache. The pain may occur on one or both sides of the head.

Observe your child and ask about any associated symptoms, such as:

  • changes in concentration, memory or speech
  • weakness of an arm or leg
  • any vision or hearing changes
  • fever
  • congestion, runny nose or muscle aches
  • nausea or vomiting (throwing up)
  • trauma or accidents

Make note of possible triggers relating to the headaches, such as:

  • lack of sleep or change in sleep pattern
  • skipping meals
  • dehydration
  • stress
  • using video games or watching TV for a prolonged period of time
  • smelling a strong odour or perfume
  • menstruation in girls

Causes of headache

Headaches can be primary or secondary. Primary headaches do not have a serious underlying medical cause. This category includes tension-type headaches, migraines and cluster headaches.

Tension-type headaches

A tension-type headache feels like there is a tight band around the head. They are usually mild to moderate in intensity and last anywhere from 30 minutes to several days. They are not associated with nausea or vomiting. Treatment involves emotional support and pain medication.


Children can suffer from migraine headaches. Children who develop migraines are likely to have one or more relatives with migraines. Migraine headaches are usually recurrent. This means they come back repeatedly. They can last from two to 72 hours and are often described as feeling pulsatile.

Migraine headaches are associated with other symptoms such as nausea, vomiting, abdominal pain, and sensitivity to noise and light. They are severe in intensity and often interfere with activities of daily living. Symptoms get worse with activity and improve with rest.

There are medications which can be used to prevent migraine headaches from recurring and medications to treat a migraine once it starts. Speak to your doctor for more details of these medications.

Cluster headaches

Cluster headaches are severe and last less than three hours. However, a child can have up to eight attacks in one day. The headache is localized to one side of the head. On that same side, the child also has other symptoms such as pain in or above the eye or pain over the temporal area, tearing or redness of the eye, swelling of the eyelid, sweating or flushing of the face or forehead, a sensation of fullness in the ear, or a sense of restlessness. These types of headaches are rare in children under the age of 10.

Secondary causes of headache

A secondary headache is caused by another medical condition that your child already has. There are many possible causes which include:

  • minor illness (such as a cold) or major infection (such as meningitis)
  • allergies
  • effects of medications
  • head injury or trauma
  • sinus infection
  • elevated blood pressure
  • dental or TMJ (temporomandibular joint) problems
  • exposure to drugs or toxins
  • brain tumour
  • bleeding in the brain

Taking care of your child with a headache at home

First try to address any simple issues that could improve the headache such as ensuring that your child has had enough sleep and enough food to eat. Resting in a calm and peaceful setting may also help your child feel better.

If the headache is very strong, you can offer your child pain medications such as acetaminophen or ibuprofen. If your child has been diagnosed with migraine or recurrent headaches, give pain relief as soon as your child feels the headache coming on. This will help stop the headache early.

Before going to the doctor

If your child complains of repeated or recurring headaches, take him to the doctor. Before the appointment, take notes on the details of the headache, such as:

  • the type of pain
  • the location of the pain (where it is)
  • how long the pain lasts (minutes or hours)
  • the time of day when your child feels the pain (morning, afternoon, or evening)
  • triggers (Is there a bright light? Is it during a certain class at school?)
  • any treatment that helps lessen the pain

If your child has recurrent headaches, record the timing of the headaches in a "headache diary." This helps the doctor find a pattern.

When to see a doctor

Make an appointment with your child’s regular doctor if:

  • headaches last longer than two days
  • headaches do not improve, or get worse, despite using acetaminophen or ibuprofen or other headache remedies
  • headaches affect your child’s usual habits or routines such as play, school, eating, drinking or sleeping
  • recurrent headaches happen more often or are worse than usual
  • recurrent headaches are not improving with recommended treatments and medications
  • the headaches are waking your child at night or are associated with vomiting

Go to your nearest Emergency Department or call 911 if your child has a headache with the following symptoms:

  • sudden severe pain in the head
  • a headache that gets worse or continues to come back following a head injury
  • dizziness, fainting or loss of consciousness
  • fever
  • stiff neck
  • nausea or vomiting (throwing up)
  • slurred or altered speech
  • weakness of a part of the body
  • difficulty sleeping
  • changes in vision

Key points

  • Headaches in children are uncomfortable and may cause you to worry. They are rarely associated with a more serious medical condition.
  • Care for simple headaches by making your child feel comfortable. Give over-the-counter medications like acetaminophen or ibuprofen.
  • A doctor does a medical assessment to help identify the cause of a recurrent or persistent headache.

Elly Berger, BA, MD, FRCPC, FAAP, MHPE​