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Not only do children who get migraines have to deal with the excruciating pain of the headaches, they may also have sleep problems.

New research from Temple University finds children with migraine are more likely to have sleep disorders, such as sleep apnea and lack of sleep.

The researchers gave 90 children with headache and sleep problems a sleep test that monitors the brain, eye movements, muscle activity, heart rhythm, and breathing. Results showed 60 participants had migraine, 11 had chronic daily headache, six had tension headache and 13 had non-specific headache.

Researchers found the children with migraine were nearly twice as likely as the other children in the study to have sleep apnea — 56 percent versus 30 percent. The condition causes repeated pauses in breathing during sleep because the upper airway is blocked.

Children with severe migraine also had shorter total sleep time, longer total time to fall asleep, and shorter REM sleep — the stage in which you can remember most dreams.

“Sleeping problems can exacerbate the problems migraine causes on a child’s health and may hinder a child’s performance at school,”study author Martina Vendrame, M.D., Ph.D., from Temple University, was quoted as saying. “Parents and doctors need to be aware of the strong likelihood of sleep disorders in children with migraine and seek appropriate preventions and treatments.”

The study also found half of children with tension headache grind their teeth at night compared to 2.4 percent of those with non-tension headache. And sleep apnea was common in children with non-specific headache and in those who were overweight.

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A headache is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. It ranks amongst the most common local pain complaints.

The vast majority of headaches are benign and self-limiting. Common causes are tension, migraine, eyestrain, dehydration, low blood sugar, and sinusitis. Rare are headaches due to life-threatening conditions such as meningitis, encephalitis, cerebral aneurysms, extremely high blood pressure, and brain tumors. When the headache occurs in conjunction with a head injury the cause is usually quite evident.

Treatment of an uncomplicated headache is usually symptomatic with over-the-counter painkillers such as aspirin, paracetamol, or ibuprofen, although some specific forms of headaches may demand other, more suitable treatment. It may be possible to relate the occurrence of a headache to other particular triggers, which can then be avoided.

Diagnosis for headaches

While, statistically, headaches are most likely to be harmless and self-limiting, some specific headache syndromes may demand specific treatment or may be warning signals of more serious disorders. Some headache subtypes are characterized by a specific pattern of symptoms, and no further testing may be necessary, while others may prompt further diagnostic tests.

Headache associated with specific symptoms may warrant urgent medical attention, particularly sudden, severe headache or sudden headache associated with a stiff neck; headaches associated with fever, convulsions or accompanied by confusion or loss of consciousness; headaches following a blow to the head, or associated with pain in the eye or ear; persistent headache in a person with no previous history of headaches; and recurring headache in children.

The most important step in diagnosing a headache is for the physician to take a careful history and to examine the patient. In the majority of cases the diagnosis will be a “primary headache” which means that the headache, whilst unpleasant is not an occurring as a manifestation of a more serious condition. The main types of primary headache are tension headache, migraine and the trigeminal autonomic cephalalgias of which cluster headache is an example. As it is often difficult for patients to recall the precise details regarding each headache, it is often useful for the sufferer to fill-out a “headache diary” detailing the characteristics of the headache. When the headache does not clearly fit into one of the recognized primary headache syndromes or when atypical symptoms or signs are present then further investigations are justified. Computed tomography scans of the brain or sinuses are commonly performed, or magnetic resonance imaging in specific settings. Blood tests may help narrow down the differential diagnosis, but are rarely confirmatory of specific headache forms.

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Frequently Asked Questions About Headaches

1. What Types of Headaches Are There?

There are several types of headaches - 150 diagnostic headache categories have been established!

Below is a list of the most common types of headaches.

Tension headaches: Also called chronic daily headaches or chronic non-progressive headaches, tension headaches are the most common type of headaches among adults and adolescents. These muscle contraction headaches cause mild to moderate pain and come and go over a prolonged period of time.

Migraines: The exact causes of migraines are unknown, although they are related to blood vessel contractions and other changes in the brain as well as inherited abnormalities in certain areas of the brain. Migraine pain is moderate to severe, often described as pounding, throbbing pain. They can last from 4 hours to 3 days and usually occur 1 to 4 times per month. Migraines are associated with symptoms such as light sensitivity; noise or odors; nausea or vomiting; loss of appetite; and stomach upset or abdominal pain. When a child is having a migraine they often look pale, feel dizzy, have blurred vision, fever, stomach upset, in addition to having the above listed symptoms.

A small percentage of pediatric migraines include recurrent (cyclic) gastrointestinal symptoms, in which vomiting is most common. Cyclic vomiting means that the symptoms occur on a regular basis — about once a month. These types of migraines are sometimes called abdominal migraines.

Mixed headache syndrome: Also called transformed migraines, this is a combination of migraine and tension headaches. Both adults and children experience this type of headache.

Cluster headaches: The least common, although the most severe, type of primary headache, the pain of a cluster headache is intense and may be described as having a burning or piercing quality that is throbbing or constant. The pain is so severe that most cluster headache sufferers cannot sit still and will often pace during an attack. The pain is located behind one eye or in the eye region, without changing sides. The term “cluster headache” refers to headaches that have a characteristic grouping of attacks. Cluster headaches occur one to three times per day during a cluster period, which may last 2 weeks to 3 months. The headaches may disappear completely (go into “remission”) for months or years, only to recur.

Sinus headaches: Sinus headaches are associated with a deep and constant pain in the cheekbones, forehead or bridge of the nose. The pain usually intensifies with sudden head movement or straining and usually occurs with other sinus symptoms, such as nasal discharge, feeling of fullness in the ears, fever, and facial swelling.

Acute headaches: Seen in children, these are headaches that occur suddenly and for the first time and have symptoms that subside after a relatively short period of time. Acute headaches most commonly result in a visit to the pediatrician’s office and/or the emergency room. If there are no neurological signs or symptoms, the most common cause for acute headaches in children and adolescents is a respiratory or sinus infection.

Hormone headaches: Headaches in women are often associated with changing hormone levels that occur during menstruation, pregnancy, and menopause. Chemically induced hormone changes, such as with birth control pills, also trigger headaches in some women.

Chronic progressive headaches: Also called traction or inflammatory headaches, chronic progressive headaches get worse and happen more often over time. These are the least common type of headache, accounting for less than 5% of all headaches in adults and less than 2% of all headaches in kids. Chronic progressive headaches may be the result of an illness or disorder of the brain or skull.

2. Are Headaches Hereditary?

Yes, headaches, especially migraines, have a tendency to run in families. Most children and adolescents (90%) who have migraines have other family members with migraines. When both parents have a history of migraines, there is a 70% chance that the child will also develop migraines. If only one parent has a history of migraines, the risk drops to 25%-50%.

3. What Causes Headaches?

Headache pain results from signals interacting between the brain, blood vessels, and surrounding nerves. During a headache, specific nerves of the blood vessels and head muscles are activated and send pain signals to the brain. It’s not clear, however, why these signals are activated in the first place.

There is a migraine “pain center” or generator in the mid-brain area. A migraine begins when hyperactive nerve cells send out impulses to the blood vessels, causing constriction, followed by the dilation of these vessels and the release of prostaglandins, serotonin, and other inflammatory substances that cause the pulsation to be painful. Serotonin is a naturally occurring chemical essential for certain body processes.

Headaches that occur suddenly (acute-onset) are usually due to an illness, infection, cold or fever. Other conditions that can cause an acute headache include sinusitis (inflammation of the sinuses), pharyngitis (inflammation or infection of the throat) or otitis (ear infection or inflammation).

In some cases, the headaches may be the result of a blow to the head (trauma) or rarely a sign of a more serious medical condition.

Common causes of tension headaches or chronic nonprogressive headaches include emotional stress related to family and friends, work or school; alcohol use; skipping meals; changes in sleep patterns; excessive medication use; tension and depression. Other causes of tension headaches include eyestrain and neck or back strain due to poor posture.

Headaches can also be triggered by specific environmental factors that are shared in a family’s household, such as exposure to second-hand tobacco smoke strong odors from household chemicals or perfumes, exposure to certain allergens or eating certain foods. Stress, pollution, noise, lighting and weather changes are other environmental factors that can trigger headaches for some people.

Too much physical activity can also trigger a migraine in both adults and children.

Be sure to consult a doctor to find out what is causing your headaches.

4. How Are Headaches Evaluated and Diagnosed?

The good news for headache sufferers is that once a correct headache diagnosis is made, an effective treatment plan can be started.

If you have headache symptoms, the first step is to go to your family doctor. He or she will perform a complete physical examination and a headache evaluation. During the headache evaluation, your headache history and description of the headaches will be evaluated. You will be asked to describe your headache symptoms and characteristics as completely as possible.

A headache evaluation may include a CT scan or MRI if a structural disorder of the central nervous system is suspected. Both of these tests produce cross-sectional images of the brain that can reveal abnormal areas or problems. Skull X-rays are not helpful. An EEG (electroencephalogram) is also unnecessary unless you have experienced a loss of consciousness with a headache. Sinus X-Ray - although the CT scan and MRI provide more details, your doctor may use this test if your symptoms seem to indicate sinus problems. Eye Exam - an eye pressure test performed by an eye doctor (ophthalmologist) will rule out glaucoma or pressure on the optic nerve as causes of headaches. Spinal Tap - a spinal tap is the removal of spinal fluid from the spinal canal (located in the back). This procedure is performed to look for conditions such as infections of the brain or spinal cord. The test can itself cause a temporary headache. Blood Chemistry and Urinalysis. These tests may determine many medical conditions, including diabetes, thyroid problems, and infections, which can cause headaches.

If your headache symptoms become worse or become more frequent despite treatment, ask your doctor for a referral to a specialist. Your family doctor should be able to provide the names of headache specialists. If you need more information, contact one of the organizations in the resource list for a list of member doctors in your state.

5. How Are Headaches Treated?

Your doctor may recommend different types of treatment to try or he or she may recommend further testing, or refer you to a headache specialist. You should establish a reasonable time frame with your family doctor to evaluate your headache symptoms.

The proper treatment will depend on several factors, including the type and frequency of the headache and its cause. Not all headaches require medical attention. Treatment may include education, counseling, stress management, biofeedback and medications. The treatment prescribed for you will be tailored to meet your specific needs.

6. What Medications Can Treat Headaches?

* Aspirin
* Sinus relief medications
* Acetaminophen (Tylenol)
* Non-steroidal anti-inflammatory medications (Aleve)
* Sedatives for sleep
* Codeine and prescription narcotics
* Over-the-counter combination headache remedies containing caffeine (such as Anacin, Excedrin, Bayer Select)
* Ergotamine preparations (such as Cafergot, Migergot, Ergomar, Bellergal-S, Bel-Phen-Ergot S, Phenerbel-S, Ercaf, Wigraine and Cafatine PB)
* Butalbital combination pain-relievers (Goody’s Headache Powder, Supac, Excedrin)

7. What Are Rebound Headaches?

While small amounts of these medications per week may be safe (and effective) — at some point, the continued medication use can lead to the development of low grade headaches that just will not go away.

8. What Food Triggers Headaches?

Some of the most common food, beverages, and additives associated with headaches include:

* Aged cheese, red wine, alcoholic beverages, and some processed meats.
* Food preservatives (or additives) contained in certain foods can trigger headaches. The additives, nitrates and nitrites, dilate blood vessels, causing headaches in some people.
* Cold foods: Cold food, like ice cream, can cause headaches in some people. It’s more likely to occur if you are over-heated from exercise or hot temperatures. Pain, which is felt in the forehead, peaks 25 to 60 seconds and lasts from several seconds to one or two minutes. More than 90% of migraine sufferers report sensitivity to ice cream and cold substances.

9. Is Caffeine a Headache Treatment or a Headache Trigger?

Caffeine can be both beneficial and harmful for a headache sufferer. Caffeine is a common ingredient in many prescription and over-the-counter headache medications. Caffeine additives make pain-relievers 40% more effective in treating headaches. Caffeine also helps the body absorb headache medications more quickly, bringing faster relief.

While caffeine-containing medications can be beneficial, these medications, combined with consuming too much caffeine (coffee, tea, soft drinks or chocolate) from other sources, may make you more vulnerable to getting rebound headaches.

10. What Are Abortive Medications?

Abortive medications, when used at the first sign of a migraine, can stop the process that causes the headache pain. By stopping the headache process, abortive medications help prevent the symptoms of migraines including pain, nausea, and sound and light sensitivity. Some medications should not be used during a migraine aura; please follow the instructions of your doctor.

11. Do Children Outgrow Headaches?

Headaches may get better as your child gets older. The headaches may disappear and then return later in life. By junior high school, many boys who have migraines outgrow them, but in girls, migraine frequency increases because of hormone changes. Migraines are three times more likely to occur in adolescent girls than in boys.

12. Can Headaches Be Prevented?

Headaches can cause untold pain and suffering. But, you don’t have to resign yourself to be a headache sufferer. There are steps you can take to prevent headaches. Here are just a few ways to keep headaches at bay.

o Follow your treatment plan. Avoid taking medications that have not been ordered by your doctor.
o Reduce emotional stress. Take time to relax and take time away from stressful situations. Learn relaxation skills, such as deep breathing and progressive muscle relaxation.
o Reduce physical stress. Proper rest and sleep will allow you to deeply relax so you can face the stressors of the new day. When sitting for prolonged periods, get up and stretch periodically. Relax your jaw, neck and shoulders.
o Exercise regularly. Get at least 20 minutes of exercise three times a week. But, don’t over do it!
o Keep a regular routine. Eat meals and snacks at about the same times every day, and get enough sleep at night.
o Quit smoking. Smoking can trigger headaches and make any headache, especially cluster headaches, worse. Ask your doctor for information about smoking cessation programs in your community.
o Seek help when you are unable to cope. Talk to a friend, family member, religious or health care professional if your problems are getting to you.
o Know your headache triggers. Keep a headache diary to keep track of what triggers your headaches and avoid these triggers in the future.
o Preventive therapy. Women who often get headaches around their menstrual period can take preventive therapy when they know their period is coming.

Additional information about migranes and headaches

Are Migraines Hereditary?

Yes, migraines have a tendency to run in families. Four out of 5 migraine sufferers have a family history of migraines. If one parent has a history of migraines, the child has a 50% chance of developing migraines, and if both parents have a history of migraines, the risk jumps to 75%.

Can Migraines Be Prevented?

* Yes. You can reduce the frequency of your migraine attacks by identifying and then avoiding migraine triggers. You can keep track of your headache patterns and identify headache triggers by using a headache diary.
* Recalling what you ate prior to an attack may help you identify chemical triggers.
* Stress management and coping techniques, along with relaxation training, can help prevent or reduce the severity of the migraine attacks.
* Women who often get migraines around their menstrual period can take preventive therapy when they know their period is coming.
* Migraine sufferers seem to have fewer attacks when they eat on a regular schedule and get adequate rest.
* Regular exercise — in moderation — can also help prevent migraines.

Can Allergies Cause Headaches?

It is a misconception that allergies cause headaches. However, allergies can cause sinus congestion, which can lead to headache pain. If you have allergies, the treatment for your allergy will not relieve your headache pain. The two conditions generally must be treated separately. See your doctor to ensure proper treatment.

What Are Some Techniques I Can Use to Relax?

Below are a few relaxation exercises. But first, be sure that you have a quiet location that is free of distractions, a comfortable body position, and a good state of mind. Try to block out worries and distracting thoughts.

o Rhythmic breathing: If your breathing is short and hurried, slow it down by taking long, slow breaths. Inhale slowly then exhale slowly. Count slowly to five as you inhale, and then count slowly to five as you exhale. As you exhale slowly, pay attention to how your body naturally relaxes. Recognizing this change will help you to relax even more.
o Deep breathing: Imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow exhalation, you should feel more relaxed.
o Visualized breathing: Find a comfortable place where you can close your eyes, and combine slowed breathing with your imagination. Picture relaxation entering your body and tension leaving your body. Breathe deeply, but in a natural rhythm. Visualize your breath coming into your nostrils, going into your lungs and expanding your chest and abdomen. Then, visualize your breath going out the same way. Continue breathing, but each time you inhale, imagine that you are breathing in more relaxation. Each time you exhale imagine that you are getting rid of a little more tension.
o Progressive muscle relaxation: Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain!) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel relaxed.
o Relaxing to music: Combine relaxation exercises with your favorite music in the background. Select the type of music that lifts your mood or that you find soothing or calming. Some people find it easier to relax while listening to specially designed relaxation audio tapes, which provide music and relaxation instructions.
o Mental imagery relaxation: Mental imagery relaxation, or guided imagery, is a proven form of focused relaxation that helps create harmony between the mind and body. Guided imagery coaches you in creating calm, peaceful images in your mind — a “mental escape.” Identify your self-talk, that is, what you are saying to yourself about what is going on with your illness. It is important to identify negative self-talk and develop healthy, positive self-talk. By making affirmations, you can counteract negative thoughts and emotions. Here are some positive statements you can practice.
o Let go of things I cannot control.
o I am healthy, vital, and strong.
o There is nothing in the world I cannot handle.
o All my needs are met.
o I am completely and utterly safe.
o Every day in every way I am getting stronger

In order to receive proper treatment, a correct diagnosis of your headaches must be made. To properly diagnose the cause(s) of the headaches, your doctor will first take a headache history.

Headache History

The most important part of your doctor’s evaluation of your headaches is what’s called the headache history. It is important to describe your headache symptoms and characteristics as completely as possible. Your headaches can be better diagnosed if you tell your doctor:

· How old you were when the headaches started
· How long you have been experiencing them
· If you experience a single type of headache or multiple types of headaches
· How often the headaches occur
· What causes the headaches, if known (for example, do certain situations, foods or medications trigger the headaches?)
· Who else in your family has headaches
· What symptoms, if any, occur between headaches
· If your school or work performance has been affected by the headaches

It is also important to tell your doctor how you feel when you get a headache and what happens when you get a headache, such as:

· Where the pain is located
· What it feels like
· How severe the headache pain is, using a scale from 1 (mild) to 10 (severe)
· How long the headache lasts
· If the headaches appear suddenly without warning or with accompanying symptoms
· What time of day the headache usually occurs
· If there is an aura (changes in vision, blind spots or bright lights) before the headache
· What other symptoms or warning signs occur with a headache (such as weakness, nausea, sensitivity to light or noise, appetite changes, changes in attitude or behavior)
· How frequent you get headaches

You should also tell your doctor if you’ve been treated in the past for headaches and what medications (both prescribed and over-the-counter) you have taken in the past and what medications are currently being taken. Don’t hesitate to list them, bring the bottles, or ask your pharmacist for a printout.

Studies performed by other doctors who may have evaluated your headaches in the past, including X-rays and other imaging tests are also very important — you should bring these to your appointment as well. This may save time and repetition of tests.

Physical and Neurological Examinations

After completing the headache history portion of the evaluation, the doctor will perform a complete physical and neurological examination. The doctor will look for signs and symptoms of an illness that may be causing the headaches, such as:

· Fever or abnormalities in breathing, pulse, or blood pressure
· Infection
· Nausea, vomiting
· Changes in personality, inappropriate behavior
· Mental confusion
· Seizures
· Loss of consciousness
· Excessive fatigue, wanting to sleep all of the time
· High blood pressure
· Muscle weakness, numbness or tingling
· Speech difficulties
· Balance problems, falling
· Dizziness
· Vision changes (blurry vision, double vision, blind spots)

Neurological tests focus on ruling out diseases of the brain or nerves that may also cause headaches, such as epilepsy or multiple sclerosis. Some of the tests may also look for a physical or structural abnormality in the brain that may cause your headache, such as:

· Tumor
· Abscess (an infection of the brain)
· Hemorrhage (bleeding within the brain)
· Bacterial or viral meningitis (an infection or inflammation of the membrane that covers the brain and spinal cord)
· Pseudotumor cerebri (increased intracranial pressure)
· Hydrocephalus (abnormal build-up of fluid in the brain)
· Infection of the brain such as meningitis or Lyme disease
· Encephalitis (inflammation and swelling of the brain)
· Blood clots
· Head trauma
· Sinus blockage or disease
· Blood vessel abnormalities
· Injuries
· Aneurysm (an outpouching of the wall of a blood vessel that can leak or rupture)

Psychological Evaluation

An interview with a psychologist is not a routine part of a headache evaluation, but may be done to identify stress factors triggering your headaches. You may be asked to complete a computerized questionnaire to provide more in-depth information to the doctor.

After evaluating the results of the headache history, physical examination, neurological, and psychological examination, your doctor should be able to determine the type of headache you have, whether a serious problem is present, and whether additional tests are needed. Possible additional tests you may be given include diagnostic tests.

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A tension headache is the most common headache, and yet it’s not well understood. A tension headache generally produces a diffuse, usually mild to moderate pain over your head. Many people liken the feeling to having a tight band around their head. A tension headache may also cause pain in the back of your neck at the base of your skull.

Although headache pain sometimes can be severe, in most cases it’s not the result of an underlying disease. The vast majority of headaches are so-called primary headaches. Besides tension headaches, these include migraines and cluster headaches.

In many cases, there’s no clear cause for a tension headache. Fortunately, effective treatments for tension headaches are available. Managing a tension headache is often a balance between fostering healthy habits, finding effective nondrug treatments and using medications appropriately. In addition, a number of preventive, self-care and alternative treatments may help you deal with headache pain.

Signs and symptoms

A tension headache can last from 30 minutes to an entire week. You may experience these headaches occasionally, or nearly all the time. If your headaches occur 15 or more days a month for several months, they’re considered chronic. Unfortunately, chronic tension headaches sometimes persist for years.

A tension headache may cause you to experience a dull, achy pain or sensation of tightness in your forehead or at the sides and back of your head. Many people liken the feeling to having a tight band of pressure encircling their heads. In its most extensive form, the pain feels like a hooded cape that drapes down over the shoulders. The headache is usually described as mild to moderately intense. The severity of the pain varies from one person to another, and from one headache to another in the same person. Many people report that the pain starts first thing in the morning or late in the day when work stress or conflict at home is anticipated.

Some people with tension headache experience neck or jaw discomfort. There may also be:

* Tenderness on your scalp, neck and shoulder muscles
* Difficulty sleeping (insomnia)
* Fatigue
* Irritability
* Loss of appetite
* Difficulty concentrating

Unlike some forms of migraine, tension headache usually isn’t associated with visual disturbances (blind spots or flashing lights), nausea, vomiting, abdominal pain, weakness or numbness on one side of the body, or slurred speech. While physical activity typically aggravates migraine pain, it doesn’t make tension headache pain any worse. A few people with tension headache experience an increased sensitivity to light or sound, but this isn’t a common symptom.

Causes

Experts continue to debate the causes and even the name of tension headaches. Over the years, as different theories emerged about the origins of this type of headache, it was known by names such as muscle contraction headache, psychogenic headache, depressive headache, essential headache and ordinary headache.

The exact cause or causes of tension headache are unknown. Until a few years ago, many researchers believed that the pain of tension headache stemmed from muscle contraction in the face, neck and scalp, perhaps as a result of heightened emotions, tension or stress. But many researchers have questioned this idea.

More recent research discredits this theory. Studies using a test called an electromyogram, which records the electric currents generated by muscle activity, haven’t detected increased muscle tension in people diagnosed with tension headache. In addition, people with migraine have as much muscle tension as do people with a tension headache, if not more.

As a result, The International Headache Society uses the term “tension-type headache” instead of “tension headache,” calling attention to the fact that muscle tension may not be the main cause of this kind of head pain.

Chemical changes

Researchers now believe that tension headache may result from changes among certain brain chemicals — serotonin, endorphins and numerous other chemicals — that help nerves communicate. These are similar to biochemical changes associated with migraine. Although it’s not clear why the chemical levels fluctuate, the process is thought to activate pain pathways to the brain and to interfere with the brain’s ability to suppress the pain. On one hand, tight muscles in the neck and scalp may contribute to a headache in someone with altered chemical levels. On the other hand, the tight muscles may be a result of these chemical changes.

Because both tension headache and migraine involve similar changes in brain chemicals, some researchers believe that the two types of headache are related. Some experts speculate that migraine may develop from the regular occurrence of tension headache. The distinctive migraine features form as the pain becomes more severe. Other research suggests that mild migraine is in reality a type of tension headache.

Two classifications

Tension headache is classified into two forms: episodic and chronic. These forms distinguish between occasional headaches separated by varying lengths of time between attacks and frequent headaches that occur, in many cases, almost daily.

* Episodic. Episodic tension headaches occur on fewer than 15 days a month. These headaches are usually brief, lasting a few minutes to a few hours. Episodic tension headaches may cause scalp and neck muscle tenderness in addition to head pain. People with increasingly frequent attacks of the episodic form may be at higher risk of developing the chronic form of the headache over a period of years.
* Chronic. Chronic tension headaches occur on 15 days a month or more for at least three months. Compared with the episodic form, chronic tension headache is less common, but twice as many women as men have the chronic form. The duration and the severity of episodic and chronic tension headaches are similar, although for many people with the chronic form, pain is daily and almost continuous. Like the episodic form, chronic tension headache can be with or without scalp tenderness.

In some cases, depression and anxiety may cause chronic tension headaches. If you do have a mood disorder, it’s critical to treat this condition as well as your headache to achieve the best possible outcome. For example, if you have both depression and tension headache, treatment for your headaches may be less effective if the depression goes undiagnosed and untreated.

Controversy surrounds the issue of whether chronic tension headache is really a separate entity from chronic migraine. Doctors often have trouble distinguishing between the two types of headache. Both disorders are thought to stem from episodic headaches after pain pathways become sensitized, and both involve similar biochemical changes in the brain.

Triggers and aggravators

There are many possible triggers of tension headache. You may have no identifiable or consistent trigger, or have several obvious ones. Potential triggers include:

* Stress
* Depression and anxiety
* Lack of sleep or changes in sleep routine
* Skipping meals
* Poor posture
* Working in awkward positions or holding one position for a long time
* Lack of physical activity
* Occasionally, hormonal changes related to menstruation, pregnancy, menopause or hormone use
* Medications used for other conditions, such as depression or high blood pressure
* Overuse of headache medication

Half the people with tension headache report that they felt stressed or hungry before their headache began.

Tension headache may be made worse by jaw pain from clenching or grinding teeth (bruxism) or by head trauma, such as a blow to the head or whiplash injury. People with stiff joints and muscles due to arthritis of the neck or inflammation of the shoulder joints may develop tension headache.

Headaches in children

Chronic tension headaches in children are similar to headaches in adults and are often caused by stress, anxiety or depression. Although adults may not always realize it, children can experience tremendous stress — ranging from peer pressure and unreasonable parental expectations to difficulty in school and physical or sexual abuse. And all children, even very young ones, can experience depression.

Risk factors

Tension headache probably accounts for a majority of all primary headaches. And it’s more common in women than in men. Almost 90 percent of women and about 70 percent of men experience tension headaches during their lifetimes. Tension headache is most prevalent in people between the ages of 20 and 50. The majority of people who get migraines also get tension-type pain.

When to seek medical advice

Pain is often one of your body’s ways of signaling illness. But headache pain, even when it’s severe, usually isn’t the result of an underlying disease. Occasionally, however, headaches may indicate a serious medical condition, such as a brain tumor or rupture of a weakened blood vessel (aneurysm). Always be sure to tell your doctor about any headache that concerns you. Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.

If tension headache disrupts your life, don’t hesitate to talk to your doctor. The condition is a biological disorder for which there’s effective treatment. Many people can manage their headaches by working with their doctors to develop a comprehensive, individualized treatment plan that involves lifestyle changes, medication and complementary therapies.

In addition, see your doctor or go to the emergency room immediately if you have any of these warning signs and symptoms:

* Abrupt, severe headache, often like a thunderclap
* Headache with a fever, stiff neck, rash, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties
* Headache after a head injury, especially if it gets worse
* Chronic, progressive headache that is precipitated by coughing, exertion, straining or a sudden movement
* Onset of new headache pain after age 50

Call your doctor if your child has head pain that’s severe or that causes him or her to miss school or other activities. A child who’s too young to tell you what’s wrong may cry and hold his or her head to indicate severe pain.

Screening and diagnosis

If you have chronic or recurrent headaches, your doctor may try to pinpoint the type and cause of your headaches using these approaches:

* Getting a description of your pain. Your doctor can learn a lot about your headaches from your description of the type of pain, including its severity, location, frequency and duration, and other signs and symptoms you may have.
* Conducting tests. If you have unusual or complicated headaches, your doctor may order tests to rule out serious causes of head pain, such as a tumor or an aneurysm. Two common tests used to image your brain are computerized tomography (CT) and magnetic resonance imaging (MRI) scans. A CT scan is a diagnostic imaging procedure that uses a series of computer-directed X-rays to provide a comprehensive view of your brain. An MRI doesn’t use X-rays. Instead, it combines a magnetic field, radio waves and computer technology to produce clear images.
* Asking you to keep a headache calendar. One of the most helpful things you can do is keep a headache calendar for at least two months. Each time you get a headache, jot down a description of the pain, including how severe it is, where it’s located and how long it lasts. Also note any medications you take. A headache calendar can offer valuable clues that may help your doctor diagnose your particular kind of headache and discover possible headache triggers.

Complications

Because tension headache is so common, its impact on job productivity and overall quality of life is considerable. When your head is “gripped in a vise,” as the pain is often described, you may feel unable to attend family and social activities. You might need to stay home from work, or if you do go to your job, you work at only a fraction of your normal efficiency.

Treatment

Few people with episodic tension headache seek medical attention. One reason is that tension headache usually is easy to treat with over-the-counter medications. Other reasons may be a fear of not being taken seriously by the doctor or the misperception that tension headache is purely psychological in nature, that admitting you have one means you’re weak or neurotic.

While much remains unknown and even controversial about tension headache, the condition is widely recognized as a biological disorder. And fortunately, while doctors may disagree about what causes this type of headache, they do know how to help you.

Medication:

A variety of medications, both over-the-counter (OTC) and prescription, are available for treating tension headache. You may find fast, effective relief by taking pain relievers such as aspirin, ibuprofen (Advil, Motrin, others) or acetaminophen (Tylenol, others). These medications are inexpensive and readily available and don’t require a prescription from your doctor. People with severe or chronic tension headaches may require stronger painkillers or preventive medications to reduce the frequency and severity of head pain.

Which drug works best varies from one person to another.

Whether you have episodic or chronic headaches, don’t overuse OTC medications. Limit your use of painkillers to two days a week. Try to take the medications only when necessary, and use the smallest dose needed to relieve your pain. Overusing pain medications can cause rebound headaches or the development of chronic daily headaches, triggering the very symptoms you’re trying to stop. In addition, all medications used to treat headache have side effects, some of which may be serious. For prescription medications, of course, follow the recommended dosage and do not exceed it.

Acute therapy

Acute therapy aims to stop or reduce the pain of an existing headache attack. Many different medications are used for the acute treatment of tension headache:

* Analgesics. Analgesics are pain relievers. Acetaminophen (Tylenol, others) and a class of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in reducing headache pain. Side effects of acetaminophen are rare, but if you take the drug in large doses for long periods of time, it can cause serious liver damage. NSAIDs include the OTC drugs aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Prescription NSAIDs include naproxen (Naprelan, Naprosyn), indomethacin (Indocin) and ketorolac tromethamine (Toradol). Side effects include nausea, diarrhea or constipation, stomach or abdominal pain, stomach bleeding, and ulcers. You can reduce or eliminate these symptoms by taking NSAIDs after meals or with milk.
* Combination medications. Aspirin or acetaminophen (or both of these analgesics) are often combined with caffeine or a sedative drug in a single medication. For example, Excedrin combines aspirin, acetaminophen and caffeine. Combination drugs such as this may be more effective than are pure analgesics for pain relief. Although many combination drugs are available over-the-counter, analgesic-sedative combinations can be obtained only by prescription because they may be addictive and can lead to chronic daily headache. Don’t use these drugs more than two days a week, and use them only with careful monitoring by your doctor.
* Other medications. For people who experience both migraine and episodic tension headaches, a triptan can effectively relieve the pain of both headaches. Opiates, or narcotics, are rarely used because of their side effects and potential for dependency. These include codeine combined with acetaminophen (Tylenol With Codeine No. 3).

Medications don’t cure headaches, and over time painkillers and other medications may lose their effectiveness. In addition, all medications have side effects. If you take medications regularly, including products you buy over-the-counter, discuss the risks and benefits with your doctor. Also, remember that pain medications aren’t a substitute for recognizing and dealing with the stressors that may be causing your headaches.

Prevention

Although medications can provide temporary relief, lifestyle changes are ultimately the best way to combat tension headaches. Make sure you’re following a regular sleep schedule and eating balanced meals. In addition, the following tips may help:

* Exercise regularly. Regular aerobic exercise, such as walking, swimming or biking, can help reduce the frequency and intensity of headaches. Exercise relieves stress, relaxes your muscles and increases the levels of one of your body’s natural stress relievers, beta-endorphin. Yoga, massage, stretching and posture classes also can help prevent tension headaches. If you already have a headache, exercise can help relieve the pain. In some cases, however, exercise may bring on a headache, so check with your doctor before starting any exercise program. Your doctor may recommend that you work with a physical therapist to learn exercise techniques that may specifically benefit people with chronic tension headaches.
* Manage stress. In addition to regular exercise, techniques such as biofeedback training and relaxation therapy can help reduce stress. Biofeedback teaches you to control certain body responses that help reduce pain. During a biofeedback session, you’re connected to devices that monitor and give you feedback on body functions such as muscle tension, heart rate and blood pressure. You then learn how to reduce muscle tension and slow your heart rate and breathing yourself. The goal of biofeedback is to help you enter a relaxed state so that you can better cope with your pain. Ask your doctor whether such a program might help you.Cognitive behavior therapy also may help you learn to manage stress and reduce the frequency and severity of your headaches. During this type of talk therapy, a counselor helps you learn ways to view and cope with life events more positively.Other relaxation techniques include deep breathing, yoga, meditation and progressive muscle relaxation, which is accomplished by tensing one muscle at a time, and then completely releasing the tension, until every muscle in your body is relaxed. You can learn relaxation techniques in special classes or at home using books or tapes. Many of them may also be helpful for children.

Preventive medications

Certain medications taken at regular intervals may reduce the frequency and severity of attacks. Your doctor may prescribe these if you have more than two headaches a week or have tension headaches that aren’t relieved by acute medication and nondrug therapy. Your doctor also may recommend preventive medication if your headache lasts longer than three to four hours, if severe pain becomes disabling or causes you to overuse acute medication, or if you can’t take acute medication because of other medical conditions.

Doctors often prescribe antidepressants to prevent tension headache, especially the chronic form. These drugs aren’t painkillers. Rather, they work to stabilize the levels of brain chemicals such as serotonin, which may be involved in the development of a headache. You don’t have to have depression in order to use these drugs.

Preventive medications may include:

* Tricyclic antidepressants. Tricyclic antidepressants, including amitriptyline and nortriptyline (Pamelor), are the most commonly used medications to prevent tension headache. They’re effective against both the episodic and chronic forms. Side effects of these medications may include weight gain, drowsiness, dry mouth, blurred vision and constipation. Older adults also may experience confusion or faintness when taking tricyclic antidepressants.
* Selective serotonin reuptake inhibitors (SSRIs). Antidepressants such as paroxetine (Paxil), venlafaxine (Effexor) and fluoxetine (Prozac, Sarafem) produce fewer side effects than do the tricyclic antidepressants but generally are less reliable in preventing headaches. Further studies are needed to demonstrate their effectiveness.
* NSAIDs. Chronic tension headache may be effectively managed with NSAIDs such as ibuprofen (Advil, Motrin IB, others) and ketoprofen (Orudis). In these circumstances, you take the medication daily.
* Other medications. Other medications that may prevent tension headache include anticonvulsants such as divalproex (Depakote) and muscle relaxants such as tizanidine (Zanaflex). If you experience migraine-like symptoms, your doctor may prescribe a medication commonly used to treat migraines, such as beta blockers or calcium channel blockers.

Preventive medications may require several weeks to build up in your nervous system before they take effect. So don’t get frustrated if you haven’t seen improvements shortly after you begin taking the drug — it may take a couple of months or longer. You may need a combination of different medications for maximum effectiveness. Also be aware that overusing caffeine or painkillers for acute relief may reduce the effect of a preventive drug.

To obtain the greatest benefit from preventive medication, keep your use of acute pain relievers to a minimum. Your doctor will monitor your treatment to see how the preventive medication is working. If your headaches are under control, your dose of medication may be reduced gradually over time.

Self-care

Rest, ice packs or a long, hot shower may be all you need to relieve a tension headache. A variety of nonmedication strategies can help reduce the severity and frequency of chronic headaches. This approach can be a vital part of any treatment plan for headache. Try some of the following suggestions to see which work best for you.

Healthy lifestyle. Behaviors that promote general good health also may help prevent headache. These lifestyle measures include following regular eating and sleeping schedules and avoiding excess caffeine. It’s also important to stay physically active. Regular aerobic exercise, such as walking, swimming or biking, can help reduce the frequency of tension headache. If you already have a headache, exercise may help relieve the pain. But be sure to talk to your doctor before starting any exercise program.

Stress management. Stress is a commonly reported trigger for tension headache. One way to help reduce stress is by planning ahead and organizing your day. Another way is to allow more time to relax. And if you’re caught in a stressful situation, consider stepping back and allowing emotions to settle. A variety of relaxation techniques are useful in coping with tension headache, including deep breathing and biofeedback. If anxiety or depression is an issue, behavior therapy may be helpful for dealing with stress and pain.

Muscle relaxation. Muscle tension is associated with tension headache. Applying heat or ice to sore muscles may ease the tension. Which treatment to apply is a matter of personal preference. Some people find heat more effective, while others prefer cold. If heat is your choice, you may use a heating pad set on low, a hot-water bottle, a warm compress or a hot towel. A hot bath or shower also may help. If cold is your choice, wrap an ice pack in a cloth before use to protect your skin.

Massage is a wonderful way to relieve muscle tension. For some people, it may also provide relief from headache pain. Gently massage the muscles of your head, neck and shoulders with your fingertips. Or have someone else do the massage for you.

Perfecting your posture. Good posture can help keep your muscles from tensing up. It places minimal strain on your muscles, ligaments, tendons and bones. Good posture supports and protects all parts of your body and allows you to move efficiently. When standing, hold your shoulders back and your head high. Pull in your abdomen and buttocks and tuck in your chin. When sitting, make sure your thighs are parallel to the ground and your head isn’t slumped forward.

Try to avoid sitting, standing or working in one position for long periods of time. Wearing poorly fitting shoes or high heels also can cause posture problems. Do regular stretching and strengthening exercises for your neck and shoulders. Here are other tips for improving your posture:

* Stand with your weight on both feet.
* When standing in one place, put one foot up on a stool or chair rung and switch to the other foot periodically.
* Don’t carry a shoulder bag that weighs more than 2 pounds.
* Sit in a straight-back chair with your back supported.
* When sitting for long periods, occasionally elevate your legs by placing your feet on a footstool. If possible, get up and move around every half-hour or so.

Coping skills

Living with chronic pain can be extremely difficult. In addition to the physical symptoms, chronic pain can make you anxious or depressed. Ultimately, it may affect your relationships with friends and family, your productivity at work and the overall quality of your life.

You may find that talking to a counselor or therapist can help you cope with the effects of chronic pain. Or you may find encouragement and understanding in a headache support group. Although support groups aren’t for everyone, they can be good sources of information. Group members often know about the latest treatments and tend to share their own experiences. If you’re interested, your doctor may be able to recommend a group in your area.

Complementary and alternative medicine

The following nontraditional therapies may help if you have chronic headache pain:

* Acupuncture. Acupuncture may provide relief from chronic headache pain, among other benefits, according to researchers at the National Institutes of Health. Acupuncture practitioners treat you using extremely thin, disposable needles that generally cause little pain or discomfort. The American Academy of Medical Acupuncture Web site provides referrals to medical doctors who use acupuncture in their practices.
* Massage. Massage is a wonderful way to reduce stress and relieve tension. It’s especially effective for relieving tight, tender muscles in the back of your head, neck and shoulders. For some people, it may also provide relief from headache pain.

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Over the centuries there have been a lot of theories, and some very strange cures, for what causes headaches and how to combat them. An understanding of what causes headaches begins with an understanding of how the brain sits in the skull and what goes on around the brain.

When you have a discussion of what causes headaches you can instantly eliminate the brain because the brain feels no pain. This is probably why they are called headaches and not brainaches. It is the elements around the brain, the blood vessels and the muscles, that get irritated and this is primarily what causes headaches. Of course there is the condition of head trauma which can leave permanent damage and cause headaches for years.

Headaches are caused by a series of relatively unexplainable events that occur around your brain. Chemicals within the blood system get unbalanced or agitated and cause the blood vessels around the brain to expand or contract and this pressure on the skull is part of what causes headaches. If you get muscle spasms in your skull then these muscles pulling and tugging on the different areas of your skull can cause painful headaches.

Migraine headaches are thought to be caused by an imbalance in the chemicals of your blood stream while some headaches are said to be caused by our own thoughts. So it is a combination of an imbalance of chemicals in the blood, expanding and contracting blood vessels, and muscle spasms in the skull that cause headaches. Well, that is the theory right now anyways. Always remember that medical science is still not exactly sure what causes headaches but these are the best guesses right now.

The Job! The Kids Keep Screaming! My Foot Is Killing Me!

Headaches come from a variety of sources and some of them are self induced and some of them we have no control over yet. I say yet because since there is no solid explanation for headaches then it is not fair to say there cannot be a cure. Tension headaches develop from the feeling of stress or over exertion.

The stress and daily issues in our life build up to the point where we begin to feel a pulling in the front of our skull that can sometimes reach all the way to the back. These tension headaches are thought to be the variety that can be explained with muscle spasms in the skull because tension has a way of tightening your muscles up and causing pain. Relaxing is probably a good way to get rid of a tension headache.

Other headaches like sinus headaches come from definable physical ailments like your sinuses are agitated and this causes pressure in the front of your skull. Migraines are said to be the blood vessels in your skull expanding or contracting until there is pain. Headaches are difficult to treat because there are so many factors involved in creating them and they are difficult to correctly diagnose as well. Ironically, they really are headaches!

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Good posture is an effortless, non tiring stance that can be maintained for a long time. Your posture can be a reflection of your body attitude. A curvature is any deviation of the spine from its normal direction or position.

There are two basic spinal curves, which can be viewed from the side. When the posture is faulty, these curves become exaggerated or reduced. Lordosis exists when the neck and lower back dips in to display a ­curve. Seen from behind, lordosis is an exaggerated hollowing of the back. After time, this may result in a hollow, saddle, or sway back. Kyphosis occurs when the curve dips in the opposite direction, from the nape of the neck to the waist. Seen from behind, kyphosis is an exaggerated rounding or hump. After time, this may result in a humpback.

Viewed from the back, the shoulders and pelvis should be parallel and the head in line above the tail, displaying a straight vertical line. Scoliosis is a deviation from that straight line, where the spine curves from its central axis from side to side, resembling an S.

Poor posture results in a multitude of symptoms, such as back pain, headaches, general breathing and digestive difficulties, malaise, and feet problems.

Causes of bad posture include

* training (children copy parental posture)
* asymmetrical body use (maintaining the same stance for long periods)
* fatigue (insufficient energy to maintain constant good body posture)
* poor seating habits
* illness (which may also cause fatigue and through that poor posture)
* psychological problems (which are often manifested as introverted posture and hunched shoulders)
* birth abnormalities (such as dislocated hips)
* disease (such as polio and arthritis)
* mechanical faults (including problems with the back, pelvis, knees, or feet).

Treatment

The conditions that are causing the postural problems must always be diagnosed and addressed in the first instance. When illness, disease, or congenital defects have been ruled out, the following treatments may be found appropriate.

Alexander Technique This will involve retraining with exercises. It is the most useful therapy for longterm postural improvement.

Diet and Nutrition Where energy problems or disease are at the root of the postural problems, vitamin and mineral supplements may be appropriate.

Osteopathy and Chiropractic The manipulanll therapies are excellent for overall postural treatment and retraining.

Feldenkrais Treatment will involve the restoration of natural energy flow, breathing, and less stressful patterns of alignment.

Rolfing Structural treatment breaks the cycle that can exist between pain/muscle tension/worse posture.

Yoga This is appropriate for mental and physical integration.

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Here are nine more things you may not know about tension headache:

* Although sleep may be possible, whensoever the sufferer awakens, the is present.

* Most sufferers will complain of squeezing (non-throbbing) and tightness- ‘like a tight band around the head’ which aches rather than pains. The ache is usually generalized rather than localized to any particular part of the head.

* It can occur in children, adolescents and adults. Females are more afflicted than males. Stress at work/home is an weighty precipitant.

* The onset of a given attack is more gradual than is seen in migraine.

* It is a common continued for both tenseness cephalalgy and common migraine to coexist in the same individual. The management of such persons may need treatment of both types of headache.

* In contrast to migraine, in which pain is periodic and lifelong, with tendency to lessen in late adult years, tension headache occurs more often in middle age and may persist for many years.

* The ache is more due to dilatation of blood vessels in the head rather than sustained muscle .

* A common feature of tension headache is that analgesic remedies have little effect in alleviating the uneasiness. Relaxation almost through all ages relieves it. Such relaxation could include bed rest, massage, and/or formal biofeedback .

* Psychological studies of groups of patients with tension headaches have revealed prominent symptoms of depression and anxiety. It is on record that 65% of depressed patients have tension headache and that over 60% of patients with tension headache have depression.

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Nowadays headache is very common in our day-to-day life. Sometime headache get healed within few hours but sometimes it take days to heal. For the people who experience headache very frequently, the best feeling is how to get rid of it. They really find themselves plagued with Chronic Headache and have to deal with it on a constant basis. These chronic headaches can be as close together as every few hours with little break in between, or spread out over a week.

Besides obvious ailments such as brain tumors and other serious head injuries, chronic headaches can affect anyone for a multitude of reasons. The following information will impart know how about chronic headache, its causes and its remedy.

What Causes Chronic Headaches There are many causes for Chronic Headache; some are very easy to change while others are really difficult to tackle. Bad Diet is the most common causes of headache. Some people are allergic to some food items, they consume it unknowingly and as result they experience chronic headache (a symptom of these allergy).

Headaches are also caused by wide variety other reasons too such as stress, muscle tension, high blood pressure, medication usage, and spinal misalignment. While the causes of headache vary person to person thats why its very necessary to first analyze the cause and then go for medication. thanks to studies and medical perseverance, there are several remedies for headaches and various ways to avoid chronic headaches.

Avoiding and Dealing With Chronic Headaches There are different ways of handling chronic headache. Following the same remedy for chronic headaches, which you follow, may also help you to eliminate future incidents. Changing your diet is probably the easiest way to avoid and remedy headaches, as it only takes simple changes and is primarily in your control.

many people have unknown allergies to dairy, chocolate products, processed food such as lunch meats, and wheat or white flour and avoiding these products on daily basis can make headaches disappear almost instantaneously.

Practicing relaxation methods like meditation, yoga and massage can really help you when headache are caused by stress and subsequent muscle tension. high blood pressure resulting from stress, tension and particular medication can also cause headaches, as it increases the pressure in the blood vessels putting pressure on the head.

Spinal misalignment can easily be taken care of by getting treated by a chiropractor. They try to keep your back and thus your neck in alignment, making sure that misaligned vertebrae do not affect your head.

Put simply, you need to find out what is the main cause of your headaches and the right remedy for it. There are umpteen causes of headaches but few simple steps and care can help you in long way.

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Whether they’re pounding and throbbing or dull and aching, headaches are no picnic for kids. A lot of the time, they’re caused by something simple - such as staying up too late, playing in the sun too long, or taking a bump to the head. But sometimes, headaches last longer or are accompanied by other symptoms.

Headaches can have a wide range of causes and many levels of severity. It’s important to understand how to recognize when a headache is just a passing pain, and when it’s something more and your child needs medical treatment.

What’s a Headache?
Most headaches happen outside the skull, in the nerves, blood vessels, and muscles that cover the head and neck. The muscles or blood vessels can swell, tighten, or go through other changes that stimulate or put pressure on the surrounding nerves. These nerves send a rush of pain messages to the brain, which brings on a headache.

What Causes Headaches?
In general, kids get the same types of headaches as adults. And headaches often are hereditary, so if you or your partner get them, your child may get them too.

Some of the many potential headache triggers include:

1. certain medications (headaches are a potential side effect of some)
2. too little sleep or sudden changes in sleep patterns
3. skipping meals
4. becoming dehydrated
5. being under a lot of stress
6. having a minor head injury
7. using the computer or watching TV for a long time
8. menstruation
9. experiencing changes in hormone levels
10. taking a long trip in a car or bus
11. listening to really loud music
12. smoking
13. smelling strong odors such as perfume, smoke, fumes, or a new car or carpet
14. drinking or eating too much caffeine (in soda, coffee, tea, and chocolate)
15. consuming certain foods (such as alcohol, cheese, pizza, chocolate, ice cream, fatty or fried food, lunchmeats, hot dogs, yogurt, aspartame, or anything with the seasoning MSG)
16. In some cases, headaches are caused by certain infections, such as:

* ear infections
* flu
* Lyme disease
* sinus infections
* strep throat
* urinary tract infections
* But most headaches aren’t signs that something more is wrong. Only 10% of headaches are caused by other medical conditions, such as infections or other serious illnesses.

What Are the Common Types of Headaches?
Two of the more common kinds of headaches that kids get are tension headaches and migraines.

Tension Headaches
Fairly common in kids, tension headaches (also called muscle-contraction headaches) are caused by tension in the muscles of the neck and head, which can be brought on by a variety of emotional and physical stressors. The pain is often described as:

* constant pressure around the front, top, and sides of the head, almost like someone stretched a rubber band around it
constricting
* dull
* aching
* A major distinction between tension headaches and migraines is that tension headaches typically are not accompanied by nausea or vomiting, and they’re usually not made worse by physical activity - symptoms that do often occur with migraines.

Migraines
About 5% of school-age kids and up to 10% of teens get migraine headaches, recurrent headaches with additional symptoms. Often triggered by things like stress, sleep deprivation, and certain foods and beverages, migraine headaches can cause the following symptoms:

* pounding, throbbing pain on one or both sides of the head
* dizziness
* stomachaches
* nausea and/or vomiting
* seeing spots or halos
* sensitivity to light, noise, and/or smells
* Most migraines last anywhere from 30 minutes to 6 hours. Some can last as long as a couple of days. Some people:

Just don’t feel right. Light, smell, or sound may bother them or make them feel worse. Sometimes, if they try to continue with their usual routine after the migraine starts, they may become nauseated and vomit. Often the pain begins only on one side of the head. Trying to perform physical activities may make the pain worse.
Get auras, a kind of warning that a migraine is on the way (usually about 10 to 30 minutes before the start of a migraine). The auras may only be seen in one eye. The most common auras include: blurred vision, seeing spots, jagged lines, or flashing lights, or smelling a certain odor.
Experience a migraine premonition hours to days prior to the actual headache. This is slightly different from auras and may cause cravings for different foods, thirst, irritability, or feelings of intense energy.
Have muscle weakness, lose their sense of coordination, stumble, or even have trouble talking either just before or while they have a headache.
Unfortunately, parents of an infant or toddler probably won’t be able to tell if their little one is having migraines because little kids are often unable to explain or detail what hurts. Young kids with headaches may be cranky, or have symptoms of clumsiness or look pale.

There are also migraine variants that are thought to happen only to kids and are precursors to the more common migraines of adulthood. These include paroxysmal vertigo and cyclic vomiting.

Paroxysmal vertigo is described as a sensation of spinning or whirling that comes on suddenly and disappears in a matter of minutes. Kids who experience this may momentarily appear frightened and unsteady, or unable to walk. The vertigo typically goes away by the time a child is 5 years old.

Cyclic vomiting also occurs in young kids and involves repeated episodes of vomiting. The episodes can last for hours or days and are not associated with headache or any other symptoms. Cyclic vomiting usually goes away by the time kids grow into teens.

When Should I Call My Child’s Doctor?