Headaches are often thought of as an adult problem - but they’re more common in children than you might expect. For many children, persistent headaches can be a very real and life-altering condition. If your child is missing school, struggling to concentrate, or avoiding social activities due to frequent or intense headaches, you may be wondering: Is this normal? What can I do?
The good news is that you’re not alone—and effective, child-focused, holistic care is available.
What Is a Chronic Headache?
In children and adolescents, a headache is considered chronic if it occurs on 15 or more days each month for at least three months, or when it interferes with daily activities over time. Chronic headaches vary in intensity and duration and can include:
- Migraines (often with nausea, light/sound sensitivity)
- Tension-type headaches (more constant, pressure-like pain)
- Medication-overuse headaches (often linked to frequent use of pain relief medications)
- Secondary headaches (caused by an underlying condition – this is typically very rare, but important to rule out)
A Biopsychosocial Perspective: What Causes Chronic Headaches?
Chronic headaches are rarely caused by a single issue. Instead, they typically emerge from a complex interaction of biological, psychological, and social (environmental) factors. This way of thinking recognises that pain is influenced not just by physical changes in the body, but also by how a child feels, thinks, and lives, what they are exposed to in their environment, and what activities they want to and have to do.
Some common contributing factors include:
🧠 Biological
- Genetic predisposition (family history of migraines or headaches)
- Neurological or sensory sensitivity
- Hormonal changes
- Physical conditions (e.g. vision problems, dehydration, underlying medical conditions)
💬 Psychological
- Stress and anxiety (often related to school or friendships)
- Past (or current) trauma or emotional distress
- Sleep disturbances
- Negative thought patterns and fear or worry about pain
🏠 Social / Environmental
- High screen time or poor posture
- Lack of physical activity
- Changes in routine or family stress
- Academic or social pressure
Even if no single cause is clear, a pattern often emerges over time with careful and compassionate assessment of the child, the family and the context.
Signs Your Child Might Be Struggling with Chronic Headache
Children don’t always describe pain the way adults do, and in young children or non-verbal children, they may not have the language to describe their symptoms. Often, as a parent, you’ll notice changes in their behaviour before they tell you what’s wrong. You know your child, and it is important to act on your intuition if you feel something isn’t right.
Watch for:
- Holding or rubbing the head
- Unusual tiredness or irritability
- Avoidance of light or noise
- Complaints of nausea or dizziness
- Trouble concentrating, mood swings, or poor school performance
- General complaints of not feeling well
- Avoidance of play, social engagement or physical activity
🚨 Red Flags (Signs that a serious underlying condition may be present):
Your child should be urgently assessed by a medical professional if he or she presents with sudden, severe headache (if headache is not normally a problem, or if the pattern of ‘normal headaches’ changes suddenly); headaches that wake your child from sleep; vision changes; weakness; balance problems; or seizures.
When to Seek Help
If your child’s headaches are:
- Frequent (more than once or twice a week)
- Severe or interfering with daily life
- Not improving with short-term (10 days or less) medication
- Accompanied by emotional distress or anxiety
…it’s time to talk to a healthcare provider.
Early assessment and treatment can prevent headaches from becoming more entrenched and reduce their impact on your child’s school, social life, and emotional wellbeing.
Treatment Options: A Biopsychosocial, Multi-Faceted Approach
There’s no one-size-fits-all treatment—but when care targets all the factors contributing to pain, outcomes can be excellent.
✅ Medical Management
- Rule out serious underlying causes
- Prescribe medications carefully (when needed)
- Educate families on avoiding medication overuse
✅ Lifestyle Adjustments
- Improve sleep quality, hydration, and nutrition
- Identify and minimise triggers like screen time or irregular routines
- Encourage healthy physical activity and pacing
✅ Psychological Support
Pain can affect how children think, feel, and behave—and vice versa.
- Therapeutic approaches like CBT, play therapy, and narrative therapy can help children:
- Cope with stress and anxiety
- Manage fear of pain
- Build emotional resilience
- Breaking the pain-stress cycle is key to long-term improvement
✅ Physical and Occupational Therapies
- Gentle, age-appropriate pain science education
- Posture, movement, and functional retraining
- Support for returning to play, sport, and academics
- Practical strategies to manage daily tasks and school demands
How PAIN Supports Your Family
If your child’s headaches are persistent, our Paediatric Chronic Pain Service takes a biopsychosocial and interdisciplinary approach. Your child won’t see just one specialist—they’ll be supported by a coordinated team who understand the full picture of chronic pain.
Our team includes:
- A paediatrician with expertise in chronic pain, overseeing medical management
- Occupational therapists who help with daily function, routines, and capacity building
- Physiotherapists who address movement, posture, and physical triggers
- Psychologists offering tailored, evidence-based mental health care
- Social workers who support families and address broader psychosocial needs
Your first appointment includes both the paediatrician and an occupational therapist, giving you a comprehensive and efficient start.
We work closely with families to build a care plan focused on the most treatable aspects of the problem, aiming for the best possible recovery in the shortest time and at the lowest possible cost.
No referral is needed. We accept direct bookings from parents or other providers. We bill at 100% medical aid rates and support privately funded families too.
You Don’t Have to Navigate This Alone
Chronic headaches in children are real, impactful—and treatable with the right approach. By understanding and addressing the biological, psychological, and social aspects of pain, we help children get back to doing what is most important: learning, playing, and thriving.
If your child is struggling, reach out. We're here to help.