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Chronic, hard-to-manage headaches — those that last longer than three months — can affect many parts of a child or teen’s life. That’s why the Chronic Headache Program in Pain Medicine brings together experts specializing in pain management, neurology, psychology, and mind-body medicine to help young people and their families learn to manage these complex headaches. As part of Boston Children’s Pain Treatment Center, we offer specialized, evidence-based treatment for several types of chronic headaches, including migraines, tension-type headaches, post-traumatic headaches, and more.

Is this your child’s first time experiencing headaches?

The Headache Program in the Department of Neurology treats children and adolescents with migraines and other types of headaches. If your child experiences chronic headaches, they may be referred to the Chronic Headache Program in Pain Medicine.

Our approach to chronic headaches in children and teens

In the Chronic Headache Program, we take a team approach to care that views your child as a whole person. At your first visit, your child will be evaluated by a neurologist, psychologist, and nurse practitioner, all of whom specialize in understanding and treating chronic headaches from every potential angle. Using what we learn in this initial visit, our team will work with you to develop a personalized treatment plan for your child.

This multidisciplinary approach to managing chronic headaches involves choosing the best combination of evidence-based treatments for your child’s needs. Treatment often includes prescribing appropriate medications and supplements. It may also include additional medical interventions, such as:

  • Trigger-point injections
  • Nerve blockades
  • Botox injections
  • Medication infusions (such as Toradol, Depakote, lidocaine, and DHE)

Non-pharmacological strategies are also effective in helping young people manage chronic headaches. These strategies allow us to address even more aspects of your child’s headache experience. For example, we often make recommendations about healthy behaviors that will support your child’s overall health and wellness. These can include:

  • Maintaining healthy sleep habits
  • Improving nutrition
  • Increasing hydration
  • Increasing physical activity, sometimes with the support of physical therapists
  • Monitoring screen use

Finally, because of the strong connection between the mind and body, we may also suggest strategies and therapies that use that connection to help your child’s headaches. We call these “biobehavioral strategies” and complementary/integrative medicine: They may include:

  • Daily relaxation activities
  • Active coping and pacing skills
  • Cognitive-behavioral therapy
  • Biofeedback training
  • Acupuncture (or acupressure)
  • Workshops with the Comfort Ability Program

A key element of your child’s care with us involves coordination with the rest of your child’s care team, whether here at Boston Children’s or closer to home. For example, we may ask to collaborate with your child’s primary care provider, local neurologist, school team, or outpatient therapist. For patients outside the Boston area, we can identify and collaborate with specialists in your area who can provide your child’s follow-up care.

For patients requiring intensive treatment focused on restoring function, we collaborate with the Mayo Family Pediatric Pain Rehabilitation Center and the Young Adult Pain Rehabilitation Center to support them before and after admission to this program.

Please note: The Chronic Headache Program does not focus on new- or recent-onset headaches and does not provide urgent care. If your child needs immediate evaluation or care, please call your primary care provider or take your child to the nearest emergency room.

Seated girl in purple shirt holds hand against head, as if suffering a headache

Chronic headaches: 5 things families should know

Chronic headaches can affect many parts of a child or teen’s life. If your child is prone to chronic headaches, or headaches that occur 15 or more days a month, check out five important things you should know to help care for them.