By the time they reach high school, most young people have experienced some type of headache. Fortunately, less than 5% of headaches are the result of serious disease or organic problems, such as a tumor, abscess or head trauma.

Most headaches are tension-type, the result of good and bad stress, sleep issues, or, in a few instances, environmental or food triggers. About 5% of chronic headaches will be diagnosed as migraine.

A chronic headache is hard to define because the term is viewed differently depending on the person; some of us do not notice pain as quickly as others do and may not pay attention to frequency. Pain tolerance also varies from person to person. If, however, a child who has only had an occasional headache (once or twice a month) starts experiencing them more frequently (two, three or four times a week), then these should be considered chronic and medical attention should be sought as soon as possible. (Also refer to "Organic Headaches.")

One of the most frustrating aspects of chronic headaches is the stress factor. Avoiding a known trigger is usually easier than avoiding stress. Young people want to do well on tests and in school, and they want to attend important events. But anticipating a math quiz or musical recital, or eagerly looking forward to a party or being in the school play, can result in anxiety or excitement. And, for some kids, this leads to a headache.

As we mentioned earlier, a few children do have their first headaches before they reach elementary school, and they may not yet know how to describe pain. If a young child has been crying or not eating, or has been inexplicably restless or irritable, consult with your doctor about finding the source of discomfort or pain.

The more school health professionals and educators, as well as parents, know about children and headaches - their triggers, symptoms, prevention, and treatments - the easier it will be to identify them and help kids live with them for a full and rewarding life.

So, to distinguish among the different types of headaches, let's start with migraines.