Symptoms and Treatment of Tension Headaches in Children

Tension-type headaches, which is a headache that feels like a tight band around your head, is the most common type of headache experienced by children.

Interestingly, while scientists used to think that tension-type headaches weren't inherited, research now suggests that some people, especially those who experience more frequent headaches, may have specific genes that influence their headaches.

Let's dive deeper into understanding tension-type headaches in children, like how they are different from migraines, and how you can help your child treat one (under the guidance of his or her healthcare provider).

Anxious student rubbing forehead doing homework
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It can be tricky to tell the difference between a tension-type headache and a migraine in children. In a tension-type headache, your child may have:

  • Pain on both sides of the head, anywhere on the head (although some children do experience tension-type headaches on one side of their head)
  • Pain that's often described as band-like, dull, pressing or aching
  • Mild to moderate pain, plus tenderness of the head
  • Tight muscles in the neck and shoulders
  • Trouble concentrating
  • Heightened sensitivity to light or noise, but not to both at the same time
  • Trouble sleeping or waking up earlier than usual

Lastly, the pain of a tension-type headache can last 30 minutes up to seven full days (a huge variability). Migraines in children, on the other hand, only last up to 72 hours. The pain of a migraine headache is generally throbbing, more severe than that of a tension-type headache, and is worsened with physical activity.


When a child suffers from tension-type headaches, the individual headache episodes can be triggered by various things in the child's life. The triggers will vary from child to child, and may include:

  • An irregular sleep schedule or not enough sleep
  • Stress/tension at home or school
  • Problems with self-image
  • Missed meals
  • Bright lights
  • Cigarette smoke, including second-hand smoke
  • Death of or separation from a loved one

One study indicated that tension-type headaches in children were associated with having higher body fat levels and with being bullied. In that same study, the headaches also were associated with higher scores on a screening test that measures overall difficulties in the areas of hyperactivity, emotion, conduct, and relationships with other children.


If a tension-type headache can be relieved by relaxing, taking a warm bath, using an ice pack, or taking a nap, that's the best course of action. This does work in some cases.

If these simple strategies are not effective, your child's doctor most likely will advise trying medications, beginning with the simplest of over-the-counter analgesics like Tylenol (acetaminophen) and moving up from there to prescription medications. That said, avoid medications with aspirin due to the possibility of a complication called Reyes Syndrome.

If your child starts to experience tension-type headaches too frequently, your pediatrician may prescribe medications intended to prevent the headaches.

It should be noted that finding effective preventive therapy does not happen overnight. A fair trial can take up to up to six months of healthcare provider supervision. A headache diary should be kept faithfully during this period. Giving up after a short period of time robs the patient of the potential benefits of the preventive medications.

In addition to medications, stress management education and counseling are often helpful for children, especially teens, who are experiencing tension-type headache. Adults sometimes forget just how stressful those years of high expectations and peer pressure can be.

Additional treatment methods that have proven useful are biofeedback and relaxation techniques. For many children, the most successful method of management is a combination of medications and other methods.

A Word From Verywell

The good news about tension-type headaches in your child is that they can often be relieved easily and eventually prevented with sufficient sleep, regular and balanced meals, minimization of stress, and drinking plenty of fluid (4 to 8 glasses of water per day).

That said, be sure to contact your healthcare provider for guidance on how to help manage your child's headaches. In addition, contact your practitioner if your child's headaches are frequent, severe, feel different from prior headaches, wake your child up from sleep, are injury-related, or are associated with worrisome symptoms like a fever or a stiff neck.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • Headache Classification Committee of the International Headache Society. "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia 2013;33(9):629-808.
  • Pacheva I et al. Evaluation of Diagnostic and Prognostic Value of Clinical Characteristics of Migraine and Tension Type Headache Included in the Diagnostic Criteria for Children and Adolescents in International Classification of Headache Disorders —Second Edition. International Journal of Clinical Practice. 2012 Dec;66(12):1168-77.
  • Russell MB. Genetics of Tension-Type HeadacheThe Journal of Headache and Pain. 2007 Apr;8(2):71-6.
  • Waldie KE. Risk Factors for Migraine and Tension-Type Headache in 11 Year Old Children. The Journal of Headache and Pain. 2014 Sep 10;15:60.

By Teri Robert
 Teri Robert is a writer, patient educator, and patient advocate focused on migraine and headaches.