One way to narrow this down is asking, "What part of your head is hurting?" and "What does it feel like?" (Note! These are some very general guidelines and don't apply to all headaches. Most headache causes however can be found in one of these categories.)

Migraines are typically a one-sided severe, throbbing and intense pain occasionally accompanied by nausea/vomiting and sensitivity to light. Migraines have a genetic component though so we typically want to know about family history of headaches. They can be triggered by things such as: stress, hormones, dehydration, hunger, and lack of sleep.

What about neck/back of the head pain? Think about what is causing those muscles to pull and strain and cause you pain. Heavy backpacks are a BIG offender. Also, body positioning is huge. For example, staring down at the phone/iPad all day? (AKA every teenager). How about arms not on a level surface when studying? What happens is their shoulders are pulled up all day while they study, creating unnecessary tension and/or pain in the neck and shoulders. Oh, and don't forget heavy ponytails too!

Front of the head/forehead pain: Pain here can be caused by eye strain, so let's start by checking their vision. This type of pain can also be caused by allergies/sinus infections, especially if tender to the touch.

General causes of headaches: The number one reason I see headaches is dietary. Not drinking enough water and not having good protein for breakfast or before exercise is a large factor. This can also make them dizzy and feel faint.

Sleep!! I don't care what or how much you change in your life, if you don't sleep enough you are going to get headaches (I have tried to work around this rule- ya just can't). Most children need 9-11 hours of sleep, depending on their exact age.

Some red flags are: severe headache especially with fever or neck pain, headache that is progressively worsening and not responding to usual treatments, waking up in the middle of the night with a headache, early morning headache especially with vomiting, or any with neurological symptoms (not walking right, personality changes, weakness, decreased vision, etc).

Now, not every headache fits exactly into these categories. This is just a general outline to give you some things to take note of before the visit. I have also included a headache journal that, if you filled out before your visit, your provider would do a happy dance for you!!

We are always happy to talk about your headaches and want to do that. I want this to help make your visit and discussions with us more productive! It will be if we have already been taking note of these common types and offenders.

- Sperry, NP

About the author

Sperry Binnicker is a nurse practitioner at Willow Park. Sperry joined Cook Children's in 2009 in the Pediatric Intensive Care Unit (PICU). In that role, she earned the Daisy Award, an award given to a nurse that is nominated and selected by the parents of patients for excellence in patient care. She continued her education while working full time and received her master’s degree from the University of Texas at Arlington in May of 2015.She is a Board Certified Pediatric Nurse Practitioner and a member of the National Association of Pediatric Nurse Practitioners. Learn more about the Willow Park staff here.

It can be a hard thing for adults to deal with. Unfortunately, many children suffer the same pain. For some, it’s a genetic condition that’s been passed along to them. But for others, migraines are the result of injury. For 15-year-old Olivia Gillespie, her migraine problems began when she received her third concussion.

“It happened in cheerleading practice, I was kicked in the head,” says Gillespie. “I was fine. I didn’t think it was that big of a deal.”

Then months later, Gillespie was on a ski trip with her youth group when a headache came on and never went away.

“I just kept doing what I was doing and tried to not let it have an effect on me,” she said.

Gillespie tried to ignore the pain for two months before she said anything to anyone, but then the pain got worse.

“Olivia had an ongoing headache that would not fade. On a scale of one to 10, it was a consistent five," said Amelia Gillespie, the teen's mother. "It wasn't until her pain reached level seven that it really began to affect her.”

When Cynthia Keator, M.D., pediatric neurologist at Cook Children’s, first saw Olivia, she wanted to make sure her headaches could be treated without medication. Together, they worked on her sleep habits and diet. Dr. Keator also suggested supplements such as B2, and Omega 3, which has shown to help with headaches. In addition, Gillespie was referred to the Biofeedback Clinic at Cook Children’s.

“Biofeedback teaches patients how to control their pain by controlling their breathing, heart rate and body temperature,” says Dr. Keator.

Biofeedback specialist Nanny Christie, Ph.D., has been teaching the painless technique for decades.

“We place the child in a reclining chair and use pads to measure their body activity,” says Christie. “The equipment plugs into a laptop so the kids can see everything on the computer screen. If they tighten a muscle, a line goes up. If they relax, the line goes back down.”

Christie says teaching children to harness their breathing and muscle movement this way allows for real time learning. She says about 80 children are seen in her clinic each month. A typical visit is 45 minutes to one hour and each child is seen roughly four times.

While it wasn’t the end-all, be-all cure for Gillespie, it did help. She says she uses the technique to curb her head pain. If she feels a headache becoming worse, she can focus and calm her anxiousness which in turn can help the headache.

Also, ask your doctor about preventative medication. Your doctor may prescribe something prescription strength or a natural supplement to ease the pain.

Make sure you DON’T ask your child this question:

“How’s your headache?”

You may want to, but remember that asking about a headache is like scratching a mosquito bite. By asking, you’re reminding your child about their pain.