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    Weekend Wellness: Tracking headaches may help teen see patterns, avoid triggers

DEAR MAYO CLINIC: My daughter, 16, has had headaches off and on for the past year. Ibuprofen seems to help, and she says the headaches are not severe. But I am concerned that they are so frequent. What could be the cause of recurring headaches in teens? young teenaged woman with migraine or tension headache

ANSWER: Headaches in teens are common. In most cases, they are not symptoms of a larger medical problem. But when headaches continue, it is a good idea to have them evaluated. There also are steps to take at home that may help reduce headaches.

There are many kinds of headaches. Two of the most common are tension headaches and migraine headaches. Tension headaches are often described as feeling like a tight band around the head. A migraine headache usually causes intense throbbing on one side of the head. It can be accompanied by nausea, vomiting and sensitivity to light and sound.

Different kinds of headaches have a wide variety of triggers. For tension headaches, common triggers include stress, anger, anxiety, depression, muscle strain, fatigue, poor posture, lack of exercise, neck or jaw problems and certain medications. For migraine headaches, certain foods, hormonal changes, medications, changes in sleep or exercise, environmental factors (such as bright lights, strong scents or loud noises), stress and release from stress can play a role in provoking an attack in some individuals.

To get a clearer picture of her headaches, encourage your daughter to create a headache log. It should include when a headache starts, how severe it is on a pain scale of zero to ten, activities of the day, her sleep habits and her diet. This log may help your daughter see patterns in her headaches and may be useful in identifying and avoiding headache triggers and monitoring response to treatment.

If daily headaches continue or if they become more severe, make an appointment for your daughter to see her primary care provider for a physical and neurological exam. The provider should also do a thorough evaluation of possible headache triggers. Bring your daughter’s headache log to the appointment.

Your daughter’s care provider may ask about changes that are happening in her life. Has she had an increase in her stress level? Is she getting at least eight to nine hours of sleep every night? Is she exercising regularly? Has her diet changed?

Tests may be needed to better understand headaches. This often includes brain imaging, typically with MRI. In general, tests are not necessary.

Headache treatment varies based on the type of headache and how much it interferes with a person’s life. It may be tempting for your daughter to miss school or withdraw from activities to rest. But teens usually cope better with headaches when they are fully engaged in school, social events and extracurricular activities. Most teens need to make some lifestyle changes to reduce headaches, including making healthy sleep a priority, exercising regularly, eating a healthy diet and reducing stress.

Over-the-counter drugs and prescription medications are available to treat and prevent headaches. They can be useful. It may be preferable to make lifestyle changes to manage headaches rather than take medications. Improvement with lifestyle changes avoids medication side effects, prevents rebound headaches (a type of headache caused by medications), and promotes sustained well-being.

If her headaches persist after seeing her primary care provider and making some lifestyle changes, your daughter may be referred to a neurologist for additional headache evaluation or a psychologist who specializes in chronic pain management and headache prevention. Psychologists skilled in cognitive behavioral interventions or behavioral medicine can be particularly helpful to adolescents who are attempting to make healthy lifestyle choices and maintain healthy habits over time. Jennifer Fisher, Ph.D., Child and Adolescent Psychiatry, Mayo Clinic, Rochester, Minn.

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