Treating Headaches: finding what works best for your child

Dr. Anna Esparham, headache-trained specialist, director of the Headache Treatment Center

Ninety percent of children will have a headache before they’re an adult. Most adolescents and teens experience headaches every few months, which can be treated at home.

However, many children also suffer from migraines, which is a moderate-to-severe headache. Migraines are one of the top leading causes of disability in the country and early treatment is key to help control the debilitating pain. If a child has a headache or migraine more than three times a month, it may be time to see a headache specialist.

Getting the right treatment, at the right time, is important. There are several pharmaceutical and non-pharmaceutical treatments available, whether treating same-day headache pain or developing a long-term plan for headache care and management.

Rescue Medications

Rescue medications are a treatment designed to stop a headache in progress. Two most common at-home rescue medications include Triptans, which are a class of prescription medications that can be administered by nasal spray, injection or taken by mouth. The other is a headache cocktail, which is a combination of over-the-counter medications (such as Naproxen, Tylenol, Excedrin or Ibuprofen) taken in conjunction with anti-nausea medications.

Rescue medications, which are noninvasive and have minimal side effects, can be used for kids who have occasional or frequent headaches. However, to avoid rebound headaches or medication overuse, limit rescue medications to 2-3 times per week and no more than 10-15 times per month.

Prevention Supplements

Nutraceuticals are natural supplements derived from food sources, such as magnesium, riboflavin or Coenzyme Q-10 that have additional health benefits related to headache management.

Taken on a daily basis, nutraceuticals can prevent reoccurring headaches, headache frequency, worsening headaches and headache intensity. It can take 8-12 weeks for the prevention supplements to take effect, so children who live with chronic headaches may need a nerve block to act as a bridge until the supplements begin to work.

Cranial Nerve Blocks

A cranial nerve block is when a needle is placed under the skin superficially and numbing medication is injected into overactive nerves, which helps break the cycle of headaches. It usually takes 2-3 days for a cranial nerve block to work. Once the treatment is effective, patients will have on average 4-6 weeks of pain relief.

IV Infusions

There are many different IV infusions that can help provide pain relief, but the most common IV treatment includes Compazine, Benadryl and plus or minus Toradol.

IV infusions take several hours to become effective and only treats the headache that day.

Cefaly®

Cefaly is a first line treatment plan for kids that suffer from frequent migraines. Cefaly is an FDA approved external trigeminal nerve stimulation device that attaches to the forehead and sends electrical signals to treat and prevent migraine headaches when used 20 minutes daily.

Acupuncture

Acupuncture is an ancient Chinese technique that stimulates points in the body through a series of hair-thin type needles placed in the ear, forehead, scalps, hands and feet, and strengthens the body’s ability to stop pain.

Acupuncture works best when administered accumulatively over the course of 4-6 visits. If headaches or intensity of migraines decrease, patients can continue acupuncture biweekly or monthly.

Botox®

Botox may be best known for its cosmetic benefits to remove wrinkles and fine lines by temporarily paralyzing facial muscles, but Botox can also treat chronic migraines when other treatment hasn’t work.

Botox is a series of injections given to patients who have more than 15 headaches a month (eight of those being a migraine) for the past three months and have trialed other medications without relief.

Self-Regulation and Biofeedback

Emotional issues, stress, being overwhelmed or having difficulties in relationships can all contribute to worsening headaches. Self-regulation is being aware of tension in the body and learning how to stop stress before it happens.

Relaxation strategies such as diaphragmatic breathing, progressive muscle relaxation, and mental imagery relaxation can help transform how a body reacts to stress, as long as practiced on a regular basis.

A healthy lifestyle is also key to controlling migraines, so drink plenty of water, get plenty of sleep and stay physically active on a daily basis.

Comprehensive Treatment

No two headache sufferers are the same, so having a comprehensive approach to headache treatment can lead to better outcomes. That means having all evidence-based therapies available, so individuals can find the pharmaceutical and non-pharmaceutical treatments that work best for them. It’s also important to integrate pain psychologists and social workers into the treatment plan, since headaches can be enhanced by life stressors. It’s this overall holistic approach that is crucial to help reduce headache pain.

Learn more about headache relief, relaxation techniques and headache services at Children’s Mercy.

Watch Dr. Esparham’s Headache and Medication Overuse video.

Watch Dr. Esparham’s Back-to-School Headache Tips video.