Breaking the Cycle of Pediatric Headaches

By Laura Granetzke, FNP-C, Family Practice Nurse Practitioner and NHF Certified Headache Practitioner, Wake Forest Baptist Health

Your child or teen has a headache, so you reach for an over-the-counter (OTC) pain reliever like Tylenol® or Ibuprofen®. After all, anything sold at the drugstore is harmless, right? The medication seems to work, and your child’s headache temporarily improves. But then the pain comes pack later in the day or some time the following day. So, you give your child another dose of the OTC medication, and the same thing happens—the pain goes away, but then rebounds. To make matters worse, you start to notice that your child’s headaches are lasting longer and becoming harder to treat.

This is a common and frustrating cycle known as “medication overuse headache.” It can happen when someone with pre-existing headache disorder takes OTC analgesics more frequently than two days a week. We see it more in adults, but it’s a fairly common disorder in kids too.

Finding Alternatives

If your child is stuck on the merry-go-round of OTC overuse, it can be hard to jump off. Breaking this cycle is the first step toward finding more effective relief.  When I speak to a family about a new approach to tackling chronic headaches, the first thing I recommend they do is discontinue or limit OTC pain relievers. This is extremely important because patients rarely respond to preventive therapies while overusing pain medication.

From there, we can talk about other strategies for preventing and managing headaches. The ideal approach can vary based on the severity of the child’s headaches and his or her individual needs. However, one we’ve found to be safe and effective from a preventive point of view is natural supplement therapy—specifically, the use of riboflavin (vitamin B2), magnesium, CoQ10 and/or melatonin.

We’ve seen great results in pediatric patients who use supplements for the prevention of headaches. Plus, there are far fewer side effects. Most OTC pain relievers come with potential risks of stomach, liver or kidney damage. Supplement risk factors, however, are much milder. As a result, no lab monitoring is necessary with a supplement regimen.

If you’re interested in this treatment path for your child, contact our office or talk to your pediatrician to ensure you’re addressing any underlying medical needs related to your child’s headaches. From there, speak to someone who can help you devise a supplement plan that will work best for your child. This could be a pediatric neurology provider (such as myself) who specializes in integrative approaches. These experts will recommend the supplement combinations and dosages that are best for your child.

A preventive regimen of supplements is ideal for kids who have more than two days of headaches a week, or who have headaches that are debilitating enough to prevent them from participating in and enjoying the daily functions of life, like school, sports and extracurricular activities.

Because supplements are preventive, they need to be taken daily. Don’t expect overnight results; it can take up to three months before your child starts experiencing an improvement in his or her headaches. Over time, however, you should notice that the intensity, frequency and duration of your child’s headaches have lessened.

It is also important to note that your child may still need other treatments and therapies, including prescription medication, to address his or her headaches.

Cutting Out Caffeine

OTC medications aren’t the only drugs that can lead to medication overuse headaches; caffeine can too. As you start your child on a new preventive regimen for headaches, make sure you don’t reactivate the headache cycle by allowing him or her to drink excessive or frequent amounts of caffeine. Even a small amount of caffeine on a daily basis can cause more headaches in some children and adolescents.

The Headache Program at Wake Forest Baptist Health/Brenner Children’s Hospital treats the entire family. To schedule an appointment for your child or yourself, call (336) 716-WAKE.

*Sponsored by Wake Forest Baptist Health/Brenner Children’s Hospital


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