Tension Headaches in Children: Symptoms, Triggers and Treatment

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Tension-type headache — a headache that feels like a tight band around your head — is the most common type of headache for children. In fact, about three-quarters of children who experience frequent headaches are diagnosed with tension-type headache.

There are actually two types of tension-type headache: episodic, which means you get headaches several times per month, and chronic, which means you get headaches 15 or more times per month.

Scientists used to think that tension-type headaches weren't inherited, but more recent research indicates that some people, especially those who experience more frequent headaches, may have specific genes that influence their headaches.

Symptoms of Tension-Type Headache in Kids

It can be tricky to tell the difference between a tension-type headache and a migraine, especially in children. In a tension-type headache, your child may have:

  • pain on both sides of the head, anywhere on the head
  • pain that's often described as band-like, dull, pressing or aching
  • mild to moderate pain, plus tenderness of the head
  • tight muscles in the neck and shoulders
  • trouble concentrating
  • heightened sensitivity to light or noise, but not to both at the same time

The pain in this type of headache can last 30 minutes up to seven full days. Some kids will have trouble sleeping or will awaken earlier than usual. In a few children — about 20% — the pain of a tension-type headache will occur only on one side of the head.

These Factors Can Trigger Headaches in Kids

When a child suffers from tension-type headaches, the individual headache episodes can be triggered by various things in the child's life. The triggers will vary from child to child, and can include:

One study indicated that tension-type headaches in children were associated with having higher body fat levels and with being bullied. In that same study, the headaches also were associated with higher scores on a screening test that measures overall difficulties in the areas of hyperactivity, emotion, conduct and relationships with other children.

Treating Your Child's Tension-Type Headaches

If a tension-type headache can be relieved by relaxing, taking a warm bath, using an ice pack, or taking  a nap, that's the best course of action. This does work in some cases.

If it's not effective, your child's doctor most likely will advise trying medications, beginning with the simplest of over-the-counter analgesics and moving up from there to prescription medications. Medications with aspirin are generally not recommended for children under 14 because of the possibility of a complication called Reyes Syndrome.

Some of the medications used to treat these headaches include:

  • Midrin (a combination of acetaminophen and two other drugs used to treat headaches)
  • Norgesic Forte (another drug combination that includes aspirin)
  • indomethacin (an anti-inflammatory drug)

If your child starts to experience tension-type headaches too frequently, your pediatrician may prescribe medications intended to prevent the headaches. Some of the medications used in this case include:

  • Depakote (an anticonvulsant)
  • Elavil, Prozac, Zoloft, Paxil (all antidepressants)
  • Aleve, Naprosyn, Anaprox, Ansaid, Orudis (non-steroidal anti-inflammatory medications)

Occasionally your doctor may try a combination of two of these medications.

It should be noted that finding effective preventive therapy does not happen overnight. A fair trial can take up to up to six months of physician supervision. A headache diary should be kept faithfully during this period. Giving up after a short period of time robs the patient of the potential benefits of the preventive medications.

In addition to medications, stress management education and counseling are often helpful for children, especially teens, who are experiencing tension-type headache. Adults sometimes forget just how stressful those years of high expectations and peer pressure can be.

Additional treatment methods that have proven useful are biofeedback and relaxation techniques. For many children, the most successful method of management is a combination of medications and and other methods.


Pacheva I et al. Evaluation of diagnostic and prognostic value of clinical characteristics of migraine and tension type headache included in the diagnostic criteria for children and adolescents in International Classification of Headache Disorders--second edition. International Journal of Clinical Practice. 2012 Dec;66(12):1168-77.

Russell MB. Genetics of tension-type headache.The Journal of Headache and Pain. 2007 Apr;8(2):71-6.

Waldie KE. Risk factors for migraine and tension-type headache in 11 year old children. The Journal of Headache and Pain. 2014 Sep 10;15:60.

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