Dr. Jill Murphy
Doctor of Physical Therapy
As a mom of three, there isn’t a day or week that goes by when one of my children complains about pain. Whether they bumped their elbow or stubbed their toe running around the corner of the living room too fast, kids tend to have pain frequently and tend to tell us about it. Then they run off and play like nothing really ever happened.
When it comes to headaches, kids can certainly have headaches just like adults. They may have a neck ache and headache after sleeping the wrong way (although kids get away with the craziest sleep positions with no ill effects typically). They may have a headache due to lack of sleep, a long car ride with a touch of car sickness, low blood sugar, dehydration, and so on. Probably the most common reason for kids to complain of headache is illness, i.e., the flu, congestion, strep throat, and a host of other common childhood maladies. Kids also can have headaches following a head injury like a concussion or a fall or bump to the head. A concussion headache will increase with cognitive and physical activity, but should dissipate a little each day following the head injury without additional treatment. If the headache is severe and/or accompanied by nausea, vomiting, light sensitivity, lightheadedness, dizziness, and cognitive difficulties, or just simply is not improving, don’t wait- seek medical advice on how to help the symptoms resolve.
Alarmingly severe headaches with a fast onset that are the “first and worst” along with neck stiffness demands a trip to the ER to rule out something more severe such as meningitis. Also, any headache, dizziness, vision changes, and weakness on one side of the body are also signs to get immediate medical care. Both of these situations though, are thankfully, highly unusual in kids.
So when should you pay attention to a run of the mill headache in your kids? When the headache is daily, weekly, month in and month out and not going away or diminishing in frequency, this is the time to act. What should you do first? First, know that your child is in pain, so feel free to give your child something to relieve that pain. Tylenol or Advil usually work just fine, and using heat for tight neck muscles can help as well. If the headache is particularly severe, sometimes a cold compress on the head is relieving. If nausea is not an issue, encourage your child to drink a glass of water as well, in case they are dehydrated. If you child looks quite ill with a “wash-out” look, send them to bed with curtains drawn for a long nap in a dark room.
Once the acute headache has passed, ask questions. Are you having headaches frequently? When? During the week at school? On the weekends? On your days off of school? Are you eating at lunch? Are you drinking enough fluids both at school, and on the weekends? Do you feel you are straining your eyes to see the teacher, white board, or bulletin board? If the child is in elementary, middle, or high school, a safe bet may just be a trip to the optometrist to determine if it is indeed an eye strain headache. This type of headache would come on as the day progresses, and may not be present on the weekends, during the summer, and when school is not in session. If you are thinking your child needs help for their headache, this is a logical and necessary first step, since your child’s headache will simply not improve from the typical headache treatment if this is the reason for their headaches.
Also check your child’s postures during typical activities, such as homework, computer/device use, and reading postures in bed or in the living room. Being crouched in a fetal position for hours at a time can be a big postural source of headaches, and is relatively simple to correct with changes in posture to head and neck positions closer to neutral, and homework and computer stations suited to their height and proportions. Limiting device time as well as encouraging an upright spine posture while using devices will help prevent tension headaches.
Finally, just as adults can feel stressed and may end up with a headache, kids can too. Are they worried or anxious about a big project, test, or try-out? Are they being bullied at school or on social media? Are they in the middle of a stressful household situation or family stress such as a divorce, a move, or job instability? Sometimes this stress can be evidence physically in a variety of ways, including frequent headaches. If this might be the case, talk to your child about it in a non-threatening way, inviting their thoughts and feelings with an unbiased approach. If you feel the reason for their headaches is more complex and beyond your ability to offer suggestions, consider some individual or family counseling. Offer your child ways to de-stress, relax, feel safe, and non-threatened. Try to address the stressor in a positive way with the powers that be if necessary, going to bat for your child, changing what is in your power to change, be it schools, neighbors, friend groups, social media access, etc.
If you have gone through these steps, and/or your child’s headaches are moderate to severe, frequent (one or more per week), are reducing their ability to function in school, play, and participate in extra-curricular activities and/or are accompanied by neck pain, light and sound sensitivity, dizziness, unsteadiness, lightheadedness, nausea, and vomiting, it’s time to take further action. You can schedule a visit with the pediatrician or schedule directly with a physical therapist who specializes in manual (hands-on) therapy and headache treatment. The hands-on approach for head and neck pain is highly effective, and involves no medications at all. A physical therapist will work to find the reasons and triggers for the headaches, as well as offering solutions like posture education, sleep hygiene, eating and drinking regularly, and hands-on treatment to the head and neck to reduce soft tissue tightness that creates head pain. If treated right away, kids respond faster to frequent headache treatment than adults. However, if left to continue for months to years, kids may need the help of stronger medications in addition to physical therapy if their problem becomes chronic. Have questions about whether your child can benefit from physical therapy from a headache specialist? Contact us at 920-215-2050 or email firstname.lastname@example.org, and our headache specialist will be happy to speak with you and help guide you in the right steps to effectively address your child’s pain.