Headaches and Migraines in Kids: How to Tell the Difference

Long days at work, overpacked schedules or tough conversations can trigger head pain and pressure in many of us. Headaches may feel like a typical part of adult life. But kids — even young children — experience headaches too. 

You may wonder what to do when head pain disrupts your child’s school attendance and other activities. Or frequent headaches may have you concerned that your child might have a serious health condition. Attending Physician in Neurology and Director of the Pediatric Headache Program at Lurie Children’s, offers guidance. Below, she explains why children get headaches and migraines and how you can help your child feel better. 

What causes headaches in children?

Headaches occur in kids for many different reasons. The brain reacts constantly to signals from nerve endings (nociceptors) all over the body. When nociceptors become stimulated, they send pain messages to nerves in the brain, and children experience headaches. The two main causes of childhood headaches are migraine and tension headaches.

Tension Headaches in Kids

Tension headaches are more likely to happen if your child is stressed about something. Tension headaches may also occur if your child doesn’t eat, drink or sleep enough.

Kids who have tension headaches often feel pressure or tightness. Their neck may also hurt. Tension headache symptoms can occur in the:

• Back of the head
• Forehead
• Temples

Parents sometimes worry that frequent headaches mean their child has a serious health condition. But this is rare, says Dr. Bicknese. “The vast majority of children that have frequent headaches are actually experiencing migraines,” she says.

Migraines in Kids

A migraine is a specific type of headache. Migraines tend to run in families, says Dr. Bicknese. “Most kids who have migraines have other people in their family who’ve also had severe headaches,” she says.

Pediatric migraine symptoms vary, but all kids who have them feel severe pain, often in the front of their head. The pain may last for a few hours or for days.

Children with a migraine may also experience one or more other symptoms, such as:

• Feeling worse around lights and sounds
• Needing to lay down
• Numbness or tingling in their hands or face
• Nausea 
• Visual disturbances (aura) or blurred vision
• Vomiting

“Migraines have a pattern. They may start out moderate and become increasingly severe,” says Dr. Bicknese. With migraines, the pain can be severe enough that your child won’t want to do things they typically enjoy.

How do I know if my child has a migraine?

Both headaches and migraines cause pain. But the severity of pain is an important difference. With tension headaches, children may feel pain and be irritable, but they typically don’t need or want to stop activities, says Dr. Bicknese. “With migraines, they’re going to be more and more tired, and they’ll probably want to go to sleep. The quality of the headache is worse, and the severity of the pain is worse,” she says.

What are some other reasons why kids get headaches? 

What causes headaches isn’t always easy to determine. Some children develop headaches with certain illnesses or infections. Your child may get a headache if they have a cold. Their head may also hurt when they have:

• Ear infection
• Influenza (flu)
• Sinus infection

A hard hit to the head (head trauma) can also cause a headache. Other causes include weather and hormonal changes and sleep disorders. 

How to Help Your Child Feel Better When They Have a Migraine

The best way to help your child feel better is to catch the headache early. Talk to them about what they’re feeling, says Dr. Bicknese. “Migraines have a cycle and become increasingly severe. I advise people to treat them as early as possible,” she says.

If you’re not sure if your child’s headache is a migraine, you can:

• Have them lie down.
• Give them something to eat.
• Make sure they drink something.

If a short rest or something to eat and drink clears the headache, it’s probably not a migraine, Dr. Bicknese says. If the pain continues, talk to your child’s doctor about whether ibuprofen can help.

When should I call a doctor about my child’s headache?

Talk to a doctor if your child has more than two headaches a month. Headaches can become chronic, defined as 15 or more in a month. That’s why they should be treated before they are chronic, says Dr. Bicknese. If pediatric migraine symptoms occur, a healthcare provider may:

• Offer headache lifestyle counseling around diet, sleep and other daily habits
• Prescribe medication to treat head pain
• Recommend medical procedures to help block nerve signals that cause pain

“When headache pain means the child can’t function or misses school days, I would think about starting a preventive medication,” Dr. Bicknese says.

Headaches in Children: When to Worry

Most headaches in children are not due to underlying health conditions. But there are some symptoms you should tell your child’s healthcare provider about right away. Call your provider if your child has severe head pain that begins suddenly or if they have a headache with:

• Confusion or dizziness
• Difficulty standing, moving or walking
• Fever 
• Nausea and vomiting 
• Shortness of breath
• Stiff neck
• Weakness or loss of sensation

Notice any symptoms that are unusual in your child, says Dr. Bicknese. But remember, migraines are way more common than most people realize. “If they’re starting to become frequent, don’t wait until they’re having headaches every day before you take them to the doctor,” she says.

A clinical trial may also be right for children who experience migraines. Talk to your doctor about whether a trial is an option for your child. 

Learn more about pediatric headache treatment.

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