Red flags & when to go in person for Tension Headache in Children

Audience: pediatric

Tension headaches are common in children and often feel like a tight band around the head. They can be caused by stress, tiredness, or poor posture. Most tension headaches are mild and can be managed at home or through telemedicine visits. However, certain warning signs, called red flags, mean a child should see a healthcare provider in person promptly. These include very severe headaches, headaches that suddenly worsen, headaches with other symptoms like fever or vision changes, or headaches after a head injury. Telemedicine can help assess symptoms, provide advice on managing headaches, and suggest when to seek urgent care. This guide helps parents and caregivers understand when telemedicine is appropriate and when in-person care is needed for children with tension headaches.

Red flags — go in person / ER

• Sudden onset of a very severe headache unlike any before — seek emergency care immediately.
• Headache accompanied by fever, stiff neck, confusion, or vomiting — go to emergency care promptly.
• Headache after a head injury, even if mild — get in-person evaluation quickly.

What telemedicine can do

• Assessment of mild to moderate tension headaches without red flags.
• Providing advice on home care and headache management.
• Monitoring headache patterns and deciding when to escalate care.

What telemedicine cannot do

• Evaluation of headaches with red flag symptoms.
• Diagnosing serious underlying conditions causing headache.
• Performing physical exams or imaging that require in-person visit.

What is a Tension Headache in Children?

Tension headaches often feel like a tight band squeezing the head. They are usually caused by muscle tension in the head and neck. Children may describe the pain as dull or pressing. These headaches often come on gradually and can last from 30 minutes to several hours. Common triggers include stress, lack of sleep, hunger, or poor posture.

When to Use Telemedicine for a Child’s Headache

Telemedicine can be a good first step for mild to moderate tension headaches without other concerning symptoms. A healthcare provider can ask about the headache, its triggers, and how it affects the child. They can suggest home care tips like rest, hydration, and over-the-counter pain relief. Telemedicine can also help monitor the headache over time and decide if further care is needed.

Red Flags: When to Go In Person or Seek Emergency Care

Certain signs mean a child needs to be seen in person right away or go to emergency care:

If any of these occur, do not delay in-person evaluation.

Preparing for a Telemedicine Visit

Before the telemedicine visit, gather information to help the provider:

After the Telemedicine Visit: What to Do Next

Follow the healthcare provider’s advice carefully. This may include:

Keep a headache diary if advised to track patterns and triggers.

How to prepare for your tele-visit

• Note the start time and frequency of headaches.
• Describe the headache’s location, intensity, and type of pain.
• List any other symptoms such as nausea, dizziness, or vision changes.
• Prepare a list of current medications and treatments tried.
• Ensure a quiet, well-lit space with stable internet for the tele-visit.

After your tele-visit

• Follow provider’s recommendations for home care and medications.
• Monitor headache frequency and severity and keep a headache diary if advised.
• Schedule follow-up telemedicine or in-person visits as recommended.
• Seek immediate in-person care if any red flag symptoms develop.

FAQs

Can stress cause tension headaches in children?

Yes, stress is a common trigger for tension headaches in children. School pressure, family issues, or changes in routine can contribute to muscle tension and headaches.

Are tension headaches dangerous for children?

Most tension headaches are not dangerous and can be managed at home or with telemedicine guidance. However, if headaches have warning signs like sudden severe pain or other symptoms, in-person care is important.

What home treatments help with tension headaches?

Rest, drinking plenty of water, gentle neck stretches, good posture, and over-the-counter pain relievers (as advised by a healthcare provider) often help reduce tension headaches.

When should I take my child to the emergency room for a headache?

If your child has a sudden, very severe headache, fever with neck stiffness, confusion, vomiting, vision changes, weakness, or headache after a head injury, seek emergency care immediately.

Sources

1. Tension Headache — MedlinePlus, U.S. National Library of Medicine.
2. Headache in Children and Adolescents — American Academy of Pediatrics.
3. Headaches in Children — Mayo Clinic.
4. Headache — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has any red flag symptoms or if you are concerned about their health, seek prompt evaluation by a healthcare professional in person.