Is headache in schools a problem?

Headache in children is the most frequent neurological symptom and commonest manifestation of pain in childhood. A recent systematic review showed a pooled annual prevalence of 62% for primary headache. The prevalence of migraine was 11% and tension type headache 17%.  Headache has a significant impact upon the quality of life of young people and is comorbid with mental health issues. Despite the availability of effective interventions, only 10% of young people with headache will visit their GP, and when they do so the condition is not well managed. Migraine continues into adulthood in many children. It is the third highest cause of years with disability in the age group 15-49 and is associated with considerable multimorbidity.

Early intervention to stop long term problems?

Although evidence is still awaited, there is a theoretical argument that reducing the recurrent inflammatory load of migraine through early identification and adequate management may prevent the transformation to chronic migraine in adulthood.  Schools can offer an important context to identify and manage  problematic headache in children, improving the quality of life of young people and potentially preventing long term consequences.

Our work in schools

In 2009 we undertook a survey of 1000 of our local school and found that 20% of this population had headache two or more times a week that bothered them. We have recently repeated this study and found this figure has gone up to 30% with significant correlation with quality of life measures. We suspect this may be a post-COVID phenomena as there are a number of associated consequences including a marked reduction in school attendance an increase in mental health issues.

Developing a toolkit to help

An interventional project is underway within the context of our local school Academy Trust developing a simple toolkit for use in schools. This will contain information for teachers, students at whole school and individual level and parents. We are fortunate to have a senior school teacher allocated one day a week for this project and have targeted the end of the autumn term to complete this work.

David Kernick, GP with an Extended role in Headache, Exeter Headache Clinic

To learn more about managing headache in children, look our BASH educational video