Analgesic headache in children

Tension-type Headaches in Children and Adolescents

September 6, 2013 – 11:04

BiŽers: Ana Baletić, Senior Art Director — Bruketa&Žinić OM – full

What are tension-type headaches?

Tension-type headaches are the most common type of headache in adolescents. They are commonly referred to as muscle contraction headaches, stress headaches, daily headaches, or chronic non-progressive headaches. When a patient has both tension-type headaches and migraine, the headache is often referred to as chronic migraine or transformed migraine.

A tension-type headache might occur periodically (episodic, less than 15 days per month) or chronically (daily or > 15 days per month). The headache is described as a mild to moderate constant band-like pain or pressure that lasts from 30 minutes to all day in duration. Tension headaches usually begin gradually, and often occur in the middle of the day.

The "severity" of a tension headache may increase significantly with its frequency. Severe tension-type headaches occur daily or almost daily and the pain is usually described as a throbbing pain affecting the front, top, or sides of the head. Although the intensity of the pain may vary throughout the day, the pain is almost always present. It is important to realize that although tension headaches come and go over a prolonged period of time and might impair your day-to-day function, they do not cause neurological damage, or affect vision, balance, or strength.

What causes tension-type headaches?

There is no single cause for tension-type headaches. This type of headache syndrome may be an inherited trait that runs in families. In some people, tension-type headaches are thought to be associated with or result in tightened muscles in the back of the neck and scalp. This muscle tension may be caused by (1) inadequate rest, (2) poor posture, or (3) emotional or mental stress, including depression. This stress may be known (overt) or unknown (covert) to the patient and his or her parents. The most common sources of stress in children and adolescents include school, family, and friends or peers. Examples of stressors (not in any particular order) include:

  • Not getting enough sleep
  • Being on the honor role or a straight-A student
  • Having problems at home/difficult family life
  • Going to a new school
  • Having overly permissive or overly strict parents
  • Having a substitute or strict teacher
  • Having a new brother or sister
  • Being a "teacher’s pet"
  • Having no close friends or having bad friends
  • Being bullied
  • Preparing for school tests or exams
  • Learning to drive
  • Joining too many extra-curricular activities
  • Starting a new part-time job
  • Going on a field trip or vacation
  • Being overweight
  • Having other children make fun of you
  • Competing in sports or other activities
  • Learning difficulties
  • Recent move
  • Divorce
  • Death of a family member

Having the adolescent seen by a headache specialist might be helpful, particularly when the cause of tension-type headaches is difficult to identify. Once the evaluation is completed, it is important to reassure the patient that the headache pain they are experiencing is NOT due to a brain tumor.


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