Types of headaches

The most common headaches for teens are tension-type headaches and migraines.

• Tension-type headaches often feel like a tight squeezing or pressing band is around your head. The pain is dull and achy and is usually felt on both sides of the head, but may be in front and back as well. There is usually no sense of nausea or vomiting with tension-type headaches.

• Migraines are very painful episodes of headache. A migraine often lasts for hours up to 2 days. It may feel like the inside of your head is throbbing or pounding. Migraines are usually felt on only one side of your head, but may be felt across the forehead. A migraine may make you feel light-headed or dizzy, and/or make your stomach upset. You may even vomit with a migraine. Sometimes, you may see spots or be sensitive to light, sounds, and smells. If you get migraines, chances are someone in your family also has this problem.

If you have headaches more than 15 days per month, see your doctor as soon as possible.

What causes headaches?

The good news is that only rarely are headaches caused by bad things like brain tumors.

Common causes of headaches

• Stress—Pressure at school or at home, arguments with parents or friends, having too much to do, and feeling anxious or depressed can all cause a headache.

• Illness—Headaches often are a symptom of other illnesses. Viral infections, strep throat, allergies, sinus infections, and urinary tract infections can be accompanied by headaches. Fever may also be associated with headaches.

• Skipping meals—Even if you're trying to lose weight, you still need to eat regularly. Fad diets can make you hungry and also can give you a headache. Not getting enough fluids—which leads to dehydration—also may cause a headache.

• Drugs—Alcohol, cocaine, amphetamines, diet pills, and other drugs may give you a headache

Other causes of headaches

• Sleep problems like not getting enough sleep, trouble falling asleep, or waking too early.

• Minor head injuries.

• Certain foods (aged cheeses; chocolate; food additives like nitrates, nitrites, and monosodium glutamate).

• Prescribed medication, such as birth control pills, tetracycline for acne, and high doses of vitamin A.

• Caffeine—Too much caffeine is a common cause of headache in many teens. Sodas, coffee, and energy drinks sometimes have a lot of caffeine.

Rare causes of headaches

• Dental problems—Dental infection or abscess, and jaw alignment problems (TMJ syndrome) are less common causes of headache.

• Eye problems—Although headaches are only rarely caused by eye problems, pain around the eyes—which can feel like a headache—can be caused by eye muscle imbalance or not wearing glasses that have been prescribed for you.

• Serious illness—Only in very rare cases are headaches a symptom of a brain tumor, high blood pressure, or other serious problem.

When should I see the doctor?

If you are worried about your headaches—or if this problem begins to disrupt your school, home, or social life—see your doctor. Also call your doctor if you experience any of the following:

• Head injury—Headaches from a recent head injury should be checked right away—especially if you were knocked out by the injury.

• Seizures/convulsions—Any headaches associated with seizures or fainting require immediate attention.

• Frequent headaches—You get more than one headache a week.

• Severe pain—Headache pain is severe and prevents you from doing activities you want to do.

• Headaches in the middle of the night—Headaches that wake you from sleep or occur in early morning.

• Eye problems—Headaches that cause blurred vision, eye spots, or other visual changes.

• Other symptoms—If fever, vomiting, stiff neck, toothache, or jaw pain accompany your headache, you may need an exam—including laboratory tests or x-rays.

How are headaches treated?

Whichever type of headache you get, and whatever the cause, your doctor can explain why you get headaches and how they can be controlled. Be sure to ask any questions you may have.

Treatments may include

• For tension headaches or mild migraines—Acetaminophen or ibuprofen and rest in a cool, quiet place. It is very important to take the pain medicine as soon as possible after the headache starts; if you wait too long, even the best of medicines may not work.

• For more severe headaches, like migraines—Prescription medicines and rest in a cool, quiet place. Also, keeping track of what is triggering the headaches may help (see "Headache diary").

• For frequent headaches—For teens with frequent headaches, it is good to remember some basic lifestyle changes that may, by themselves, help reduce the frequency of headache attacks. Regular sleep, regular exercise, and regular meal schedules (no skipping breakfast!) can help to reduce the frequency and severity of headaches!

• If headaches are caused by food—A change in your diet may be necessary. You may need to stop eating certain foods.

• If headaches are caused by stress—Your doctor can suggest ways you can cope, like meditation or exercise. Stress caused by emotional or psychological problems may require counseling with your doctor or referral to other health care professionals to get to the cause of the problem. Sometimes entire families need counseling to eliminate the stress that is causing headaches.

Headache diary

Keeping a headache diary can help you figure out what's causing the headaches. Every time you get a headache, write down the following:

When it started:

How long it lasted: ____________________________________________

What you ate before the pain started:_____________________________

How much sleep you had: ______________________________________

What you tried to feel better: ____________________________________

It's not "all in your head"

It's important to know that, whatever the cause, headache pain is real. More importantly, with your doctor's help, you can identify the source of your headaches and get this problem under control.