Migraine in children and teenagers: Are there ways of preventing migraines without using medication?

Relaxation training plus biofeedback or behavioral training might be able to reduce the severity of migraines in children and teenagers. No specific diet has been shown to definitely prevent migraines in children, although eliminating some foods that trigger migraines might help.

Migraine is fairly common in children and teenagers. By the time they reach puberty, somewhere around 1 in 10 young people have migraines every now and then. In childhood, boys and girls are affected about equally. In puberty, however, girls have migraine more often than boys do.

A migraine headache lasts at least four hours in adults and teenagers, and at least two hours in children. One typical symptom is a sudden, bad and pounding headache, usually on just one side of the head.

Besides headache, migraines may also be associated with nausea and sensitivity to light or noise. Children could be pale and have to vomit, and they could also have abdominal pain (pain in the lower belly). Movement and activity usually make the headache worse. It is not known yet what exactly causes migraines. You can read more about the different types of headache and how to tell if it is a migraine in our text “Signs of a migraine”.

When children or teenagers have a migraine attack, it is a good idea for them to lie down in a quiet and dark place until the pain gets better. Using a cold pack on the side of the head that is hurting can help too. There are different drugs that can relieve migraine symptoms in children and teenagers. You can find out more about them in our research summary “Migraine in children and teenagers: Which drugs can relieve the symptoms?”.

Preventing migraine attacks

One of the main techniques for learning more about what is causing migraines is to keep a headache diary. A headache diary involves writing down or recording the symptoms and what happened shortly before the attack. This can give you an idea of what is causing the migraine attacks. You can find a migraine diary here.

You should be careful, however, about jumping to conclusions. It is easy to overlook something that is causing problems, and to think something else is triggering the migraines although it may have nothing to do with them. So it is important to keep a thorough headache diary over several weeks or months before making any assumptions. This makes it more likely that you will find out what is causing the migraine.

If a child has migraines, it does not necessarily mean that they will have migraines their whole life. However, this happens more often if migraines run in the family. If migraines first start during puberty, it is also more likely that the person will continue to have troubles with migraines in the future.

Non-medical options for preventing migraines

It is thought that feeling tense or being stressed might trigger migraine attacks. If you find this is the case for your migraines, relaxation techniques can help to prevent attacks or relieve them when they happen. Other treatments that are used to prevent migraines include changing certain habits – for example, diet or sleeping habits. It is also important to take enough breaks throughout the day to keep things less hectic.

There are different types of relaxation therapy. The most common are progressive muscle relaxation and autogenic training. Both techniques require training, either in a course or using recorded training materials to teach yourself. Progressive muscle relaxation – and often other techniques, too – teaches a person to tense particular muscles and then relax them again consciously and repeatedly. This aims to bring about deep relaxation and calm both the body and mind.

Autogenic training is a relaxation technique that aims to help people achieve a kind of “self-hypnosis”. They sit or lie comfortably, so that their muscles can relax. They concentrate on becoming aware of one body part after the other, and then relaxing it in different exercises. The person imagines particular ways of feeling – for example, calm, heaviness, warmth or coolness. This is meant to bring about deep relaxation that aims to reduce stress and negative feelings. Using these kinds of techniques several times a day is meant to make you generally more relaxed.

The aim of biofeedback therapy is to gain more control over your body. A specific type of biofeedback called thermal biofeedback is used to treat migraine. In this approach a sensor that measures temperature is attached to one of your fingers. Then you try to concentrate on making your hand warmer. If successful, the sensor beeps. This way you learn to gain control of your body – and, according to the theory, to keep a headache under control when it first arises.

Different forms of cognitive behavioral therapy can help people to change the way they think about their pain so that they experience their symptoms as less agonizing. For example, a child might learn to reduce worrying and negative thoughts related to their headaches in order to deal with the pain better.

Although it is not known for sure what causes migraines, some research suggests that sleeping habits might have something to do with it. Some of the changes in sleeping habits that are suggested to possibly prevent migraines include avoiding drinking caffeinated soft drinks in the evening, and avoiding listening to loud music before going to bed. You can read more about sleep habits in the feature “Insomnia”.

Research results: a combination of relaxation techniques and biofeedback or behavioral therapy could help

To find out whether these kinds of techniques can really prevent migraines in children and teenagers, a group of researchers from the Netherlands looked for trials that tested the treatments described.

Researchers can test whether a treatment works with the help of a research method called a randomized controlled trial. Here volunteers agree to be randomly divided up among two groups. The people in one of the groups use a certain treatment, and those in the other group do not. At the end of the trial the groups are compared to see whether the treatment has led to an improvement. You can read more about how randomized controlled trials are done in the category "Evidence-based medicine".

The researchers found 19 controlled trials of non-medical techniques for trying to prevent migraines in children and teenagers. The trials included more than 800 children and teenagers between the ages of 3 and 18. In two of these trials, which looked at the influence of diet on migraines, the participants changed their diet during the trial.

The results suggest that relaxation therapy, in combination with biofeedback or cognitive behavioral therapy, might prevent migraines in children and teenagers. However, there has not been enough research to be sure about this. Relaxation training alone might not be enough to make a clear difference. The researchers concluded that there need to be more trials before it is possible to say how much improvement children and teenagers could expect from using these techniques.

A change in sleeping habits might also help, but there are even fewer research results on this.

The research on dietary changes has produced conflicting results. Two trials reported that a low-allergen (oligoantigenic) diet can improve migraine symptoms. This kind of diet involves avoiding certain foods, such as cheese, milk, eggs or foods that contain additives. But the data from these two trials are not enough to really draw reliable conclusions about the effect of low-allergen diets. Other trials did not report any difference between a special diet and a normal one in terms of how well they prevent migraines. It is important to talk with your doctor before eliminating key foods from the diet of children or teenagers.

Other non-medical techniques that have been tested include acupuncture and wearing tinted glasses. However, there has not been enough research on these to be certain of whether they can help.

One of the most important elements of care for children and teenagers who have migraines is reassurance and support: although migraines can be very painful, it does not mean that there is a terrible health problem. People can learn to manage their migraines. We have put together information on drug treatment and prevention of migraine attacks in children and teenagers in the feature “Migraines”. You will also find a fact sheet for children and teenagers as well as a migraine diary.


Author: Institute for Quality and Efficiency in Health Care (IQWiG)



Next planned update: March 2015. You can find out more about how our health information is updated in our text "Informed Health Online: How our information is produced".

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