How do I help my son who has chronic daily headaches?

Dr. Pat

By Patrick J. McGrath, OC, PhD, FRCSC

Question:

My 10 year-old son has had a headache for 5 weeks. Doctors have ruled out serious medical issues but what can we do to help his pain and emotional state until he is seen by neurologist? Ibuprofen, Zomig, Chlopromazin and Metoclopramide have not helped.

Dr. Pat responds:

Chronic daily headache is usually of unknown causes but it is a good idea to have him seen by a neurologist as there are rare serious problems causing daily headache. The best thing to do in the short run is to keep a headache diary that will track any events that might be making his headache worse or better. A diary should include rating of severity of headache (0 to 10), four times a day and should examine possible triggers.

These might include:

• missing meals
• bright sunlight
• change in weather
• specific foods
• hot bedroom
• not drinking enough water
• mood changes

You could also track other symptoms such as being sensitive to light, noise, or movement. Does he have an upset stomach at some times? What about changes in his vision or his hearing?

Record what happened that might have made the headache even a bit better or worse and what was tried to make it better. Try some cold packs or some hot packs. See if a change in his pillow might make a difference. Try a gentle massage.

The diary will do two things. First of all, it will help in the diagnosis of the headache, and second, you might be able to figure out some things that help. Take the diary to the neurologist appointment.

Be careful that your son does not take too much medication. Excessive use of analgesics can cause daily headaches.

It is important to balance concern and sympathy for your son with expectations that he cope with his headaches. He should not be excused from his chores or his school work, but it may be necessary at times for him to do a bit less.

Depression can sometimes cause chronic daily headache. Have there been challenges at home or school? If your son is having difficulties in his life, he may need some help.

Your support and caring is very important for your son.

Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. Read more "Ask Dr. Pat" columns Ask Dr. Pat a question