Headaches in Children by Dr Jennifer Barham-Floreani
Just like adults, children can become “out of sorts” and end up with headaches due to knocks or falls, poor diet, a lack of sleep or a lack of water. Interestingly, they are also susceptible to stress particularly when it relates to family matters – one such presentation for stress even in children may be headaches or abdominal migraines.
Headaches are a common problem for adults however they also affect a large number of children. A 2006 study reported that over 3.7 million American children between the ages of 4 and 17 experienced headaches in the previous 12 months (1). A study of Australian children found that only 36.8% of 10-18 year olds had never experienced a headache (2). Headaches are in fact one of the top 5 health problems experienced by children (3).
Should parents worry about their child’s headache?
Any headache in a child should be discussed with a health practitioner. It is possible for headaches in children to be caused by serious underlying conditions, however this is rare and there are generally other highly concerning signs and symptoms such as paralysis, drowsiness or loss of consciousness (3). A new headache that is progressively worsening over days to weeks, or a persistent one-sided headache are cause for concern (3). Most commonly however, childhood headaches are tension-type and migraine, and in 60% of cases they run in the family (1,4). Aside from pain and discomfort, childhood headaches can lead to missed days at school, poor school performance and emotional difficulties (4).
What symptoms do children with migraine or tension headaches experience?
Children that are too young to verbalise their pain may instead grab or hold their face, hit their head against the floor, show sensitivity to light or be disinterested in food (5). Infants may display ineffective latching, grimacing or positional discomfort when feeding from the breast or a bottle (5).
Parents who are aware that their child suffers from migraine can sometimes predict when a migraine is about to start. Their child may become lethargic, have mood changes, yawn excessively, crave food or become thirsty, or turn pale with dark circles under the eyes (4). Migraine does not always involve headache but can instead manifest as episodes of abdominal pain, cyclical vomiting or dizziness, and children with migraine often seek refuge in a quiet and darkened bedroom (4). Tension-type headaches tend to occur frequently (daily or several times per week), can be associated with stress at home or at school and are more common in anxious or highly emotional children (1).
What are potential causes of childhood headaches?
Headaches can be due to a number of environmental factors and may also have genetic links. A significant finding in a chiropractic study of thirteen cases found that birth trauma and assisted birth (forceps, ventouse extraction or caesarean) were associated with each case of headache (5). In this study all children demonstrated significant dysfunction of the upper neck joints and musculature.
Click HERE to read the importance of the child’s upper neck.
The authors stated: “Forces of 30-70N show transient neurological effects when applied to the upper cervical spine (neck) in infants. The forces exerted upon the cervical spine during assisted deliveries range from 77-199N. These forces would likely be sufficient to cause muscular and mechanical joint impairments considering the increased laxity of the infant spine”. Along with damage or irritation of the neck region, the birth process can also lead to jaw problems in infants that are particularly painful when trying to latch and breastfeed. Interestingly, jaw problems and headache often overlap in adults (5).
Is it safe to offer children medication?
Many parents will give medication to a child who has a headache, as this is what they might do for their own pain. However, studies that specifically look at the safety and effectiveness of medication for children are very limited (3). A number of medications are shown to have serious side-effects in children and some of the more common-place medications such as paracetamol can have longer-term effects on the integrity of the immune system (3,6). Children also have a particularly high placebo response rate of up to 70%; oftentimes children report feeling better after they are unknowingly given a sugar pill than after being given a medicine itself (3).
What alternatives to medication are there?
Although chiropractic does not treat headaches per se, many case studies demonstrate that by enhancing the function of the spine and nervous system, headaches and other symptoms may then resolve (5,7,8). In considering the number of children who have difficult births, and the number of children showing strain to the spinal joints and surrounding muscles, it is logical to prioritise a chiropractic check-up. In addition to chiropractic, other alternative approaches for chronic headaches that have been shown to be effective include cognitive behavioural therapy, relaxation training, and self-hypnosis (1).
A holistic approach for children including chiropractic, good nutrition and play, and mindfulness for reducing stress, may not only help with headaches but bring more energy and vitality into their life!
References.
- Strine TW, Okoro CA, McGuire LC, Balluz LS. Difficulties, and Health Care Use: The Associations Among Childhood Headaches, Emotional and Behavioral. Pediatrics 2006; 117:1728-1735.
- King NJ, Sharpley CF. Headache activity in children and adolescents. J Paedtr Child Health 1990;26:50-4.
- Brna PM, Dooley JM. Headaches in the Pediatric Population. Semin Pediatr Neurol 2006; 13:222-230.
- Pogliani L, Spiri D, Penagini F, Di Nello F, Duca P, Zuccotti G. Headache in children and adolescents aged 6-18 years in Northern Italy: Prevalence and risk factors. European Journal of Paediatric Neurology 2011;15:234-240.
- Marchand AM, Miller JE, Mitchell C. Diagnosis and Chiropractic Treatment of Infant Headache Based on Behavioural Presentation and Physical Findings: A Retrospective Series of 13 Cases. J Manipulative Physiol Ther 2009;32:682-686.
- Beasley R, Clayton T, Crane J, von Mutius E, Lai C, Montefort S, Stewart A. Association Between Paracetamol Use in Infancy and Childhood, and Risk of Asthma, Rhinoconjunctivitis, and Eczema in Children Aged 6–7 Years: Analysis From Phase Three of the ISAAC Programme. Lancet 2008;372(9643):1039–1048.
- Roberts J, Wolfe T. Chiropractic care of a 6-year–old girl with neck pain; headaches; hand, leg, and foot pain; and other nonmusculoskeletal symptoms. Journal of Chiropractic Medicine 2009;8:131–136.
- Alcantara J, Pankonin KJ. Chiropractic Care of a Pediatric Patient with Migraine-Type Headaches: A Case Report and Selective Review of the Literature. Explore 2010; January/February 6(1): 42-46.