A new study provides the first clear evidence that vision or eye problems are rarely the cause of recurring headaches in children, even if the headaches usually strike while the child is doing schoolwork or other visual tasks.

Figuring out what is causing a child’s headaches can be a challenge for pediatricians, who are often consulted for this common childhood complaint.  Parents usually fear the worst when they schedule an appointment for recurring headaches, and they should be reassured that their pediatrician does too!  A thorough history and physical exam should rule-out something really bad in almost all cases, and really bad things are really quite rare.  In fact, the most common things happen most commonly.

Headache complaints can be categorized two ways:  One, in which the pain affects everyday activities and the ability of the child to be happy, is significant; the other, in which the pain has virtually no bearing on the child’s day-to-day life and overall happiness, is not.  With the latter, if your child tells you they have a headache and, two minutes later, they are outside bouncing around like a monkey on a trampoline, then you probably shouldn’t be too concerned.  If your child requires only a little quiet after a busy day at school, or maybe a snack in the middle of the day to resolve their complaint instead of an Advil, then that too is usually reassuring.  These kinds of “headaches” are not very significant.

The headaches that bother kids the most are migraines and they are significant.  Migraine headaches hurt.  You can’t jump up and down on a trampoline with a migraine headache.  Usually the pain is on one side, frequently felt behind an eye or in the temple area, and throbbing.  It will get worse with activity, especially when moving from lying to sitting, or from sitting to standing.  Sometimes the headache will cause some nausea and, when very severe, vomiting. Sufferers of migraine headaches usually need to lie down in a dark and quiet place until the headache goes away.  Ibuprofen (Advil, Motrin) will most likely help; Acetominophen (Tylenol) will not.  Some people need to sleep it off.

When kids get these painful headaches, they  are not able to do what kids do.  It’s hard to succeed in school when your head hurts, in the classroom or while doing homework.  Student-athletes can’t play their sports when they have migraines.  A bad headache can ruin a child’s enjoyment of a special event like birthday party, a holiday, a field trip, a ball game, or a day at the beach.  Kids who get significant headaches like these look and act significantly miserable when they have one.

It’s probably worth consulting your pediatrician if your child has more than two or three of these severe headaches every month.  If they are missing school, or sports, or events because of them, we want to help.  If they vomit with every headache, we want to see them.  If their grades in school are deteriorating, or their mood and behavior are changing, that too is a good reason for an extended office visit.

Migraine headaches can be difficult to manage in some children.  But for most kids, understanding their triggers (like not getting enough sleep; eating junk; not getting regular exercise; hormonal factors; tobacco, drug, and alcohol use in teens — really, anything that stresses your body) and having a strategy for anticipating and treating them are skills we can teach both kids and their parents to improve the frequency and severity of pain symptoms.

Most kids with headaches don’t need brain scans or other fancy tests, and most don’t need to see specialists, like eye doctors:

“We hope our study will help reassure parents that in most cases their children’s headaches are not related to vision or eye problems, and that most headaches will clear up in time,” said Zachary Roth, M.D., who led the research team.

Read article from Medical News Today here.