Headache

This pack has been produced with by Frimley Health NHS Trust in partnership with Healthier Together

Headaches in children are common. Most of the time they are mild and only happen from time to time.

There are plenty of things you can do to help your child to feel better such as making sure they drink plenty of water, taking regular exercise and ensuring they are sleeping well.

Stress can often play a part in children's headaches, especially the older they get so make sure you have a good chat about what is going on in their life.

Sometimes headaches can be a sign of something more worrying. Please see the table below for some of this things to look out for.

What Are Headaches?

Tension Headaches

This is the most common type of headache, and occurs more in teenagers and adults, especially women. It can feel like a constant ache affecting both sides of the head. This is typically accompanied with the neck muscles tightening and pressure behind the eyes. These symptoms usually last less than 15 days out of a single month and the cause is unknown.

Tension headaches can be caused by cold or flu, stress, skipping meals, and dehydration. Some females experience headaches as a symptom of the drop in oestrogen levels just before their periods.

Cluster Headaches

Cluster headaches are severe attacks of pain over one side of the head, often felt around the eye. These headaches are more common in men and typically occur in adulthood. They begin very quickly, and unlike some migraines, have no warning. The pain has been described as a sharp, burning or piercing sensation on one side of the head, around the eye temple and/or face. These attacks can make you feel agitated, anxious and stressed. Cluster headaches are sometimes accompanied by a red watery eye, swelling of one eyelid, constriction of one pupil, sweating and a blocked or runny nostril.

The causes of cluster headaches is still unclear, some research suggests a genetic component, sensory triggers and smoking, whereas others suggest the cause lies in brain activity levels.

Migraine Headaches

Migraines are usually a moderate to severe ‘throbbing’ headache on one side of the head. Many people have symptoms such as feeling nauseated and being sick, as well as increased sensitivity to light and sound. Migraines are a common health condition which affects around 1:5 women and 1:15 men. They usually being occurring in the late teenage years/early adulthood.

There are several types of migraine:

Migraine with an aura – this is when there is a specific clue that a migraine is about to being, for example seeing flashing lights or spots.
Migraine without an aura – this is when a migraine occurs without any warning signs.
Migraine aura without the accompanying headache – this is also known as a silent migraine; an aura or other migraine symptoms are experienced, but a headache does not occur.

Migraines have been linked to the hormone changes occurring during menstruation. Furthermore, migraines can be triggered by stress, fatigue and the ingestion of some foods including chocolate.

The Connections Between the Thoughts, Feelings, and Behaviour

Some people experiencing headaches can get caught in an unhelpful cycle. It is important to recognise what this cycle is so we can break it.

Tips: For younger children exploring their emotions using this model, try using a smiley face system.

Physiological Self Help for Headaches

Water

Headaches caused by dehydration may occur after sweating, especially on a hot day or after lots of physical activity! The body loses essential fluids which contribute towards its functioning. Most of the time, the amount of fluid lost is balanced through the consumption of water and fluid-rich foods. However, in some cases, the body loses water quicker than it is replenished. This can lead to dehydration, with one of the main symptoms being a headache. Research has suggested that dehydration is a trigger for migraine, therefore, water is found to be effective in migraine frequency and severity reduction. Drinking too quickly can sometimes cause vomiting in those with dehydration, so it is best to take slow steps; sucking on an ice cube has been found useful in younger children.

Electrolyte Drinks

Electrolytes are minerals your body requires to function, your body gets them through dietary intake. Dehydration can disrupt the important balance of electrolytes in your body, so replenishing them with a low-sugar sports drink may make you begin to feel better.

Regular Meals

The body needs energy to function, most of the body’s energy comes from the consumption of carbohydrates. The body converts carbohydrates into glucose, which is then transported through the blood into areas where energy is required. The brain requires a constant supply of glucose to function. If glucose levels fall the brain is one of the first organs affected, hence why headaches can appear shortly after skipping meals. Thus, it is important to have regular meals, meeting the ‘Healthy Living Plate’ guidelines. For some, eating regular meals means eating breakfast, having a small snack mid-morning, eating at lunch time, having a mid-afternoon snack, and eating at dinner time. Foods should be healthy and low in sugar.

Menstrual Headaches

Many headaches are linked to changing levels of hormones, specifically oestrogen and progesterone, which occur during menstruation. Whilst some birth control may worsen headaches for some women, they can actually lessen them for others. you suffer from headaches and are using, or planning to use, a hormonal method of contraception, you should discuss this with your GP or a family planning nurse.

Changing How I Cope with Pain: Doing too Much or Too Little

Pacing

Some people who suffer with headaches choose to do less activity. This makes sense; however, it can result in you missing out on important and fun activities. However, we know that missing out can negatively impact your mood. Some people try to stay very active on days they feel better. Again, this approach makes sense but can be counterproductive. You may push yourself too hard and end up suffering, resulting in exhaustion and low mood. This is referred to as a boom-and-bust pattern:

Pacing is a skill which enables you to consistently carry out activities without causing excessive tiredness or inactivity. Pacing is the middle ground between doing nothing and doing too much. Over time you may notice that pacing enables you to do more.

Choose an activity, such as seeing your friends or school work.
Measure the length of time you feel physically and emotionally comfortable doing this. Do this at least 3 separate times on good and bad days.
Take the average of these times. This helps you find your comfortable starting point (amount of time) to spend on these activities. Try to stick to this time, no more and no less.

Remember:

Pacing can give you more control.
Pacing is about judging when to stop an activity based on time and not mood.
The comfortable starting point should be used on both good, and bad days. It is normal to find it difficult to limit yourself on good days.
Using a comfortable starting point leads to improved tolerance and achievement.

Changing How I Cope with Abdominal Pain

Headaches can prevent us from doing things we like, such as going to the cinema, swimming, or spending time with friends. However, you cannot let them stop you, it is important that you practice fighting against avoidance! Ultimately, you need to face your fears if you want to overcome your headaches. It may seem overwhelming in the beginning, however, it is much easier if you break the process down into smaller steps.

Construct a ladder of places or situations that you avoid because of your headaches. At the top of the ladder, state the situation that you are most anxious about. At the bottom of the ladder, put places or situations you avoid , but don’t bother you as much. Give each item a rating of 0-10 according to how anxiety provoking the situation is.

Overcome your headaches by approaching these situations, starting from the bottom of the ladder. Make sure you write down what you think will happen, before approaching the task, and compare this with what happened.

For a printable version of this exercise, please click here.

Contents: Guided Self Help Worksheets

Calming The Body - Feeling relaxed can help reduce symptom severity

Progressive Muscle Relaxation (PMR)

Muscle tension is commonly associated with stress and anxiety, it is the body’s natural response to potentially dangerous situations. Even when there is no danger, our bodies can still respond in the same way. You may not always realise that your muscles are tense, it may be as subtle as your jaw clenching, or as obvious as your shoulders feeling tight and hunched. PGR is a deep relaxation technique which is based upon the simple practice of tensing one muscle group at a time . This is followed by a relaxation phase with release of tension. This is very useful before bedtime.

Deep Breathing

You can do this standing up, sitting in a supportive chair, or lying down comfortably. Let your breath flow deep into your stomach without forcing it. Breath in through your nose and out through your mouth. Counting to five will help you to breath calmly and regularly. Hold your breath for five seconds, as you exhale say ‘relax’. Repeat this process for 3-5 minutes.

Calming The Mind - Strategies for managing the anxiety and stress that is often associated with abdominal pain

Worry Tree

Worry Trees are helpful in reducing levels of anxiety surrounding both hypothetical situations and current problems.

Visualisation

Help yourself to feel more relaxed by thinking about things that make you feel calm and rested. For example, picturing your favourite place. This can be either independent, or you can take a guided visualisation approach. A guided visual imagery relaxation task has been provided in this pack.

Safe Place Visualisation

A powerful stress reduction and relaxation tool, that can be applied at any time, in any location.

Self-Soothing Strategies

This is a useful technique for remaining grounded in the present, to alleviate symptoms of stress and anxiety.

Developing Coping-Self Talk

These are phrases that you can say to yourself that are supportive. For example “Just because it has happened before it does not mean it will happen again”