Headaches affect both adults and children in the United States. It is estimated that as many as 45 million Americans suffer from chronic or recurring episodes.  Severe episodes can impact employment and daily activities including school attendance and performance.  As many as 20% of school-age children have frequent, recurrent headaches.

 

Fortunately, most headaches do not result from severe disease and are classified as primary headaches.  These include tension headaches, migraine headaches and cluster headaches.  Secondary headaches result from less common causes such as infection, growths in the brain, or head injury.

 

What causes head pain?  Bones of the head and actual brain tissue does not hurt because there are no pain sensitive nerve fibers present in this area.  There are however pain sensitive nerve fibers in the scalp, face, mouth, throat, muscles in the head, and blood vessels along the surface and at the base of the brain.  These nerves can be stimulated by a number of triggers such as stress, muscle tension, and dilated blood vessels.  These nerves then send a message to the brain that tells us where the pain is located. Natural chemicals in our bodies also play an important role in sending ‘pain messages’. 

 

Migraine is the most common cause of recurrent headache in children and are reported as early as 6 years of age.  Before puberty, migraines occur equally in boys and girls, but after puberty, female migraine sufferers outnumber males by 3:1.  Characteristics of migraines vary but can include feeling sick to your stomach, vomiting, localized pain to one side of the head, relief with sleep, pounding pain, vision changes, and a family history of headaches.  Times between headaches are pain free.

 

Situations that can precipitate migraine headaches (also called triggers), can be in the form of food, unusual odors, or stressors and depend on the individual. Food triggers can include: cheese, chocolate, non-white vinegar, sour cream, yogurt, nuts, peanut butter, some beans, MSG, canned figs, bananas, pizza, pork, fermented sausages, pepperoni, hotdogs, food dyes, sauerkraut, caffeine.  More commonly, stresses such as school work, excess extra-curricular activities, fatigue, poor sleeping habits, or intense feelings of sadness can also act as migraine triggers. 

 

Muscle contraction or tension headaches are also common.  In this type, there are no warning signs, the pain is dull and in the front or lower back of the head, and rarely is associated with feelings of nausea or vomiting.   They can last for a long period of time but they do not get progressively worse and do not interfere with activities.

 

When should children see their health care provider?  The following situations require consultation with a health care provider:  if headaches start to occur more than once per week, if they increase in severity, affect school attendance or performance, if there are changes in personality, behavior, or the ability to balance or walk normally, or a history of head injury.

 

Management of headaches include medicine and non-medicine options.  The identification and avoidance of headache triggers, relaxation and stress-management training, biofeedback, acupuncture, and massage are some non-medical options.  Medications can be used to treat and sometimes to prevent headache episodes.

 

Helpful web sites: http://www.achenet.org/ and www.headaches.org/consumer/educationindex.html

 

   Mary Lou Pulcino, PNP

   West Irondequoit Central School District