By Sue Hubbard, M.D., www.kidsdr.com
A recent study revealed that about 1 percent to 2 percent of adolescents have chronic daily headaches, defined as more than 15 headache days per month for greater than three months.
When school begins, teens’ stress levels increase with each week of classes, and with that come more complaints of chronic headaches. It’s not unusual for me to see several teens a week who complain that they have headaches every day.
Despite these persistent headaches, the majority of adolescents continue to participate in their school activities, sleep well once they fall asleep and spend their weekends doing whatever it is that teens all do.
I see very few teens who look like they’re in “severe” pain, although they may insist that their heads are “killing” them while they chatter away about where it hurts, how often it hurts, etc. It’s quite reassuring to watch their faces and expressions as they go into detail about their headaches.
In these cases, it’s important to obtain a good history to rule out any underlying pathology, as well as to inquire about any family history of migraines.
In the study, the authors followed adolescents ages 12 to 14 who met criteria for chronic daily headaches. They followed the group after both one and two years, and then again after eight years. The results showed that after 1 year, 40 percent of adolescents still complained of chronic headaches.
After two years, only 25 percent reported headaches. After eight years, only 12 percent reported chronic headaches. Most participants reported substantial or some improvement in headache intensity and frequency during the eight-year follow-up.
The most significant predictor for ongoing problems with headaches was onset of chronic headaches before the age of 13. For the most part, 75 percent of adolescents with chronic daily headaches improved over the eight-year period, which is reassuring.
If a good history and physical exam is performed and there seem to be no underlying problems that contribute to a young person’s headaches, it’s best to discuss the natural history of chronic headaches.
It’s important to spend time with adolescents to explore ways to alleviate stress as a trigger for chronic daily headaches. Basic changes in lifestyle, such as healthy eating, regular exercise and a good night’s sleep will often help reduce headaches. Relaxation techniques and cognitive behavioral therapy may also be utilized.
At least we know that the headaches fade with time, perhaps as part of the natural maturational process, like many things!
(Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at http://www.kidsdr.com. The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.)
