Headaches are a common problem in teens and adults.  There are many different causes for headaches ranging from rare, serious diseases to benign, non-life threatening conditions.  These headaches may significantly interfere with participating in activities and school.  They are a health problem.

Repeated or recurrent headaches in children and teens can have many causes including tension-type headache, migraine with aura, migraine without aura, chronic daily headaches, and chronic sinus headaches.

Tension-type headaches: A tension-type headache is steady and not throbbing and usually happens on both sides of the head.  Some people say that it feels like a band tightening around their head.  It can last anywhere from 30 minutes to many days.  It is usually mild to moderate in severity.  Most of the time the headache does not change the person's activity level.

Tension-type headaches can be associated with light or sound sensitivity, but not both.  Children do not have nausea or vomiting with these headaches.

Migraine headaches: Migraine headaches are recurrent headaches that are separated by times without pain.  They may have some of the following symptoms:

-	"warnings" called auras (These auras can include blurry vision, flashing lights, colored spots, strange tastes or weird feelings before the pain starts)
-	headaches starting on one side of the head (This may vary from headache to headache, and in children, they often start in the front or at the temples on both sides)
-	throbbing or pounding pain during the headache
-	nausea, vomiting and/or stomach pain
-	light and/or sounds bother the person
-	pain gets better after rest or sleep
-	pain gets worse with activity
-	someone else in the family has headaches/migraines.

Migraine headaches can last anywhere from hours to days.  They are usually severe enough to make a person stop their normal daily activities.

Chronic daily headaches: These headaches occur at least 15 days of the month for at least 3 months.  Some chronic daily headaches may have started as migraine headaches or tension-type headaches and worsen to every day.  When people take pain medicine (Tylenol, ibuprofen, caffeine, prescription pain meds, etc.) almost every day for their headaches, it can cause analgesic rebound headaches.  This is when your body becomes used to the frequent use of these medicines.  The headache either returns shortly after taking the medicine or it stops working.  The best way to make these headaches better is to stop taking pain medicines for a few weeks.  After that time, pain medicine use is limited to no more than 2-3 times per week.

Prevention: Taking good care of yourself can decrease the frequency and severity of headaches and migraine attacks.  Some good health behaviors to follow include:

-	Make sure you drink enough fluids during the day.  Children and teens need from 1-3 liters of fluid WITHOUT caffeine every day depending on activity level.  Eliminate caffeine- it acts as a diuretic and it's addictive.  Drinking fluids with sugar and salt (sports drink) may also help during a headache or during more activity.
-	Make sure you get plenty of sleep at night (but don't oversleep).  Fatigue and overexertion are two factors that can trigger headaches.  Most children and teens need to sleep 8-10 hours each night and keep a regular sleep schedule to prevent headaches.  Do not oversleep more than 2-3 hours on weekends, especially Sundays.  That means if you're up for school at 6:00 during the week, you shouldn't sleep past 8:00 or 9:00 on the weekends.
-	Be sure that you eat balanced meals at regular times.  Do not skip meals.
-	Try to avoid foods that seem to trigger headaches.  Remember that everyone is different, so your triggers (if you experience them) may be different from someone else's.
-	Plan and schedule your activities sensibly.  Try to avoid over-crowded schedules or stressful or potentially upsetting situations.  Keep up-to-date on school assignments- don't procrastinate and set yourself up for trouble.
-	Exercise at least 3 times per week.  Make sure you're well-hydrated prior to activity and don't engage in heavy exercise close to bedtime.

Management of headaches: Keep a record of your headaches.  Write down everything that might relate to your headache (foods, odors, situations), how long it lasted and how much pain the headache caused.  What was eaten 2-3 hours before the onset of the headache?  Look for a pattern. Hunger, stress and sleep deprivation are very common triggers.

Take medicine for your headache as soon as you feel pain.  You may be taking over-the-counter medicine or prescription medicine when you get a headache.

Follow your doctor's instructions.  Remember that using these pain medicines (analgesics) every day can cause an increase in your headaches.  Drinking more fluids (especially sports drinks) during a headache may also help it go away faster.  Try to drink 24-32 ounces at the onset of the headache.  Substitutions will work when sports drinks are not available (ie: 7-up with pretzels or cheez-its).  Drinking fluids can be done at the onset of all headaches.

Source: Children's Hospital Medical Center Headache Clinic, Cincinnati. Ohio.