What is Tension Headache in Children

A tension headache is a feeling of pain, pressure, or aching in the head that is often felt over the front and sides of the head. The pain can be dull, or it can feel tight (constricting). There are two types of tension headache:

• Episodic tension headache. This is when the headaches happen fewer than 15 days a month.
• Chronic tension headache. This is when the headaches happen more than 15 days a month during a 3-month period.

A tension headache can last from 30 minutes to several days. It is the most common kind of headache. Tension headaches are not normally associated with nausea or vomiting, and they do not get worse with physical activity.

What are the causes?

The exact cause of this condition is not known. Tension headaches often occur with stress, anxiety, or depression. Other triggers may include:

• Too much caffeine or caffeine withdrawal.
• Respiratory infections, such as colds, flu, or sinus infections.
• Dental problems or teeth clenching.
• Tiredness (fatigue).
• Holding the head and neck in the same position for a long period of time, such as while using a computer.

What are the signs or symptoms?

Symptoms of this condition include:

• A feeling of pressure or tightness around the head.
• Dull, aching head pain.
• Pain over the front and sides of the head.
• Tenderness in the muscles of the head, neck, and shoulders.

How is this diagnosed?

This condition may be diagnosed based on your child’s symptoms, your child’s medical history, and a physical exam. If your child’s symptoms are severe or unusual, your child may have imaging tests, such as a CT scan or an MRI of the head. Your child’s vision may also be checked.

How is this treated?

This condition may be treated with lifestyle changes and medicines that help relieve symptoms.

Follow these instructions at home:

Managing pain

• Give over-the-counter and prescription medicines only as told by your child’s health care provider. Do not give your child aspirin because of the association with Reye syndrome.
• When your child has a headache, have him or her lie down in a dark, quiet room.
• If directed, apply ice to your child’s head and neck:
  • Put ice in a plastic bag.
  • Place a towel between your child’s skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• If directed, apply heat to the back of your child’s neck as often as told by your child’s health care provider. Use the heat source that your child’s health care provider recommends, such as a moist heat pack or a heating pad.
  • Place a towel between your child’s skin and the heat source.
  • Leave the heat on for 20–30 minutes.
  • Remove the heat if your child’s skin turns bright red. This is especially important if your child is unable to feel pain, heat, or cold. Your child may have a greater risk of getting burned.

Eating and drinking

• Have your child eat meals on a regular schedule.
• Decrease your child’s caffeine intake, or stop letting your child drink caffeine.
• Have your child drink enough fluid to keep his or her urine pale yellow.

Lifestyle

• Help your child get at least 9–11 hours of sleep each night or the amount of sleep recommended by your child’s health care provider.
• At bedtime, remove all electronic devices from your child’s room. Electronic devices include computers, phones, and tablets.
• Help your child find ways to manage stress. Some things that can help relieve stress include:
  • Exercise.
  • Deep breathing exercises.
  • Yoga.
  • Listening to music.
  • Positive mental imagery.
• Make sure your child has some free time. Help your child find a balance between school and activities. Do not overload your child’s schedule.
• Encourage your child to sit up straight and to avoid tensing his or her muscles.

General instructions

• Keep all follow-up visits as told by your child’s health care provider. This is important.
• Help your child avoid any headache triggers. Keep a headache journal to help find out what may trigger your child’s headaches. For example, write down:
  • What your child eats and drinks.
  • How much sleep your child gets.
  • Any change to your child’s diet or medicines.

Contact a health care provider if:

• Your child’s headache does not get better.
• Your child’s headache comes back.
• Your child is sensitive to sounds, light, or smells because of a headache.
• Your child is nauseous or vomits.
• Your child becomes very irritable and complains of stomach pain.

Get help right away if:

• Your child suddenly develops a very severe headache along with any of the following:
  • A stiff neck.
  • Nausea and vomiting.
  • Confusion.
  • Weakness.
  • Double vision or loss of vision.
  • Shortness of breath.
  • Rash.
  • Unusual sleepiness.
  • Fever.
  • Trouble speaking.
  • Pain in the eye or ear.
  • Trouble walking or balancing.
  • Feeling faint or passing out.

Summary

• A tension headache is a feeling of pain, pressure, or aching in the head that is often felt over the front and sides of the head.
• A tension headache can last from 30 minutes to several days. It is the most common kind of headache.
• This condition may be diagnosed based on your child’s symptoms, your child’s medical history, and a physical exam.
• This condition may be treated with lifestyle changes and medicines that help relieve symptoms.