Why do people get headaches and migraines? A child neurologist explains the science of head pain and how to treat it

Katherine Cobb-Pitstick, University of Pittsburgh Curious Kids is a series for children of all ages. If you have a question you’d like an expert to answer, send it to CuriousKidsUS@theconversation.com.

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Why do people get headaches? – Evie V., age 10, Corpus Christi, Texas

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Whether sharp and stabbing or dull and throbbing, a headache can ruin your day. But your brain doesn’t actually feel pain. So what is going on when it feels like your head is in a vise or about to explode? I am a child neurologist – that is, a doctor who specializes in diseases of the brain in kids. Most of my patients are kids and adolescents who are struggling with headaches. Head pain is complicated, and there is still a lot to learn about what causes it and how it can be treated. But researchers know there are a few key players that take part in generating pain.

What are headaches?

Nerves communicate information like pain through electrical signals between the body and the brain. While the brain itself doesn’t have any nerve sensors to feel pain, blood vessels in the head and structures that protect and surround the brain do sense pain. When these tissues detect injury or damage, they release chemicals that trigger transmission of electrical signals through nerves to tell the brain the head is hurting. The brain will also use nerves to signal the body to respond to pain with symptoms like feeling tired, teary eyes, runny nose, upset stomach and discomfort in bright or loud environments. It’s not clear why humans evolved to feel these symptoms, but some scientists theorize that this can lead to healthier lifestyle choices to decrease the chance of future headache attacks.

What causes headaches?

Often, headaches are a sign that the body is under some kind of stress. That stress triggers chemical and physical changes to the nerves and blood vessels around your brain, head and neck that can cause headaches. Many types of stresses can cause headaches, including an infection, allergies, hormone changes during puberty and menstrual cycles, not getting enough sleep, not drinking enough water, skipping meals or drinking too much caffeine or alcohol. Sometimes, headaches happen with emotional stress, like feeling anxious or depressed. Even pressure in your sinuses due to changes in the weather can cause your head to hurt. One in 11 kids have had a type of severe headache called a migraine. They feel like a pulsing and pounding pain in your head and come with other symptoms, including nausea or being sensitive to lights and sounds. During a migraine, it can be hard to do everyday activities because they can make the pain worse. It is also very common to feel unwell or irritable before the head pain starts and after the pain is gone.

Migraines occur when the nerves and other structures used in signaling and interpreting pain aren’t working properly, leading to pain and discomfort from stimulation that wouldn’t normally provoke this. There are many environmental and genetic factors that contribute to this dysfunction. Some people are born with a higher risk of developing migraines. Most people with migraines have someone in their family who also experiences them.

What can treat and prevent headaches?

Identifying what type of headache you’re experiencing is crucial to making sure it is treated properly. Because migraines can be severe, they’re the type of headache that most often leads to doctor’s visits for both kids and adults. There are several ways to reduce your chances of having headaches, such as drinking plenty of water and limiting caffeine. Eating, sleeping and exercising regularly are other ways you can help prevent headaches.

While painkillers like ibuprofen are often enough to relieve a headache, prescription medications are sometimes necessary to make head pain more bearable. Some medications can also help control or prevent headache episodes. Physical therapy to exercise the body or behavioral therapy to work on the mind can also help you manage headache pain. There are even electronic devices to treat headaches by stimulating different parts of the nervous system. It is important to talk with a doctor about headaches, especially if it’s a new problem or you experience a change in how they usually feel. Sometimes, brain imaging or blood tests are needed to rule out another health issue. Recognizing a headache problem early will help your doctor get started on helping you figure out the best way to treat it.

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Hello, curious kids! Do you have a question you’d like an expert to answer? Ask an adult to send your question to CuriousKidsUS@theconversation.com. Please tell us your name, age and the city where you live. And since curiosity has no age limit – adults, let us know what you’re wondering, too. We won’t be able to answer every question, but we will do our best. Katherine Cobb-Pitstick, Assistant Professor of Child Neurology, University of Pittsburgh This article is republished from The Conversation under a Creative Commons license. Read the original article.

Joan Taylor, King’s College London

What world was Jesus born into? A historian describes the turbulent times of the real nativity

Every year, millions of people sing the beautiful carol Silent Night, with its line “all is calm, all is bright”. We all know the Christmas story is one in which peace and joy are proclaimed, and this permeates our festivities, family gatherings and present-giving. Countless Christmas cards depict the Holy Family – starlit, in a quaint stable, nestled comfortably in a sleepy little village. However, when I began to research my book on the childhood of Jesus, Boy Jesus: Growing up Judaean in Turbulent Times, that carol started to sound jarringly wrong in terms of his family’s actual circumstances at the time he was born. The Gospel stories themselves tell of dislocation and danger. For example, a “manger” was, in fact, a foul-smelling feeding trough for donkeys. A newborn baby laid in one is a profound sign given to the shepherds, who were guarding their flocks at night from dangerous wild animals (Luke 2:12). When these stories are unpacked for their core elements and placed in a wider historical context, the dangers become even more glaring. Take King Herod, for example. He enters the scene in the nativity stories without any introduction at all, and readers are supposed to know he was bad news. But Herod was appointed by the Romans as their trusted client ruler of the province of Judaea. He stayed long in his post because he was – in Roman terms – doing a reasonable job. Jesus’ family claimed to be of the lineage of Judaean kings, descended from David and expected to bring forth a future ruler. The Gospel of Matthew begins with Jesus’ entire genealogy, it was that important to his identity. But a few years before Jesus’ birth, Herod had violated the tomb of David and looted it. How did that affect the family and the stories they would tell Jesus? How did they feel about the Romans?

A time of fear and revolt

As for Herod’s attitude to Bethlehem, remembered as David’s home, things get yet more dangerous and complex. When Herod was first appointed, he was evicted by a rival ruler supported by the Parthians (Rome’s enemy) who was loved by many local people. Herod was attacked by those people just near Bethlehem. He and his forces fought back and massacred the attackers. When Rome vanquished the rival and brought Herod back, he built a memorial to his victorious massacre on a nearby site he called Herodium, overlooking Bethlehem. How did that make the local people feel?

And far from being a sleepy village, Bethlehem was so significant as a town that a major aqueduct construction brought water to its centre. Fearing Herod, Jesus’ family fled from their home there, but they were on the wrong side of Rome from the start. They were not alone in their fears or their attitude to the colonisers. The events that unfolded, as told by the first-century historian Josephus, show a nation in open revolt against Rome shortly after Jesus was born. When Herod died, thousands of people took over the Jerusalem temple and demanded liberation. Herod’s son Archelaus massacred them. A number of Judaean revolutionary would-be kings and rulers seized control of parts of the country, including Galilee. It was at this time, in the Gospel of Matthew, that Joseph brought his family back from refuge in Egypt – to this independent Galilee and a village there, Nazareth. But independence in Galilee didn’t last long. Roman forces, under the general Varus, marched down from Syria with allied forces, destroyed the nearby city of Sepphoris, torched countless villages and crucified huge numbers of Judaean rebels, eventually putting down the revolts. Archelaus – once he was installed officially as ruler – followed this up with a continuing reign of terror.

A nativity story for today

As a historian, I’d like to see a film that shows Jesus and his family embedded in this chaotic, unstable and traumatic social world, in a nation under Roman rule. Instead, viewers have now been offered The Carpenter’s Son, a film starring Nicholas Cage. It’s partly inspired by an apocryphal (not biblical) text named the Paidika Iesou – the Childhood of Jesus – later called The Infancy Gospel of Thomas.

You might think the Paidika would be something like an ancient version of the hit TV show Smallville from the 2000s, which followed the boy Clark Kent before he became Superman. But no, rather than being about Jesus grappling with his amazing powers and destiny, it is a short and quite disturbing piece of literature made up of bits and pieces, assembled more than 100 years after the life of Jesus. The Paidika presents the young Jesus as a kind of demigod no one should mess with, including his playmates and teachers. It was very popular with non-Jewish, pagan-turned-Christian audiences who sat in an uneasy place within wider society. The miracle-working Jesus zaps all his enemies – and even innocents. At one point, a child runs into Jesus and hurts his shoulder, so Jesus strikes him dead. Joseph says to Mary, “Do not let him out of the house so that those who make him angry may not die.” Such stories rest on a problematic idea that one must never kindle a god’s wrath. And this young Jesus shows instant, deadly wrath. He also lacks much of a moral compass. But this text also rests on the idea that Jesus’ boyhood actions against his playmates and teachers were justified because they were “the Jews”. “A Jew” turns up as an accuser just a few lines in. There should be a content warning. The nativity scene from The Carpenter’s Son is certainly not peaceful. There is a lot of screaming and horrific images of Roman soldiers throwing babies into a fire. But, like so many films, the violence is somehow just evil and arbitrary, not really about Judaea and Rome. It is surely the contextual, bigger story of the nativity and Jesus’ childhood that is so relevant today, in our times of fracturing and “othering”, where so many feel under the thumb of the unyielding powers of this world. In fact, some churches in the United States are now reflecting this contemporary relevance as they adapt nativity scenes to depict ICE detentions and deportations of immigrants and refugees. In many ways, the real nativity is indeed not a simple one of peace and joy, but rather one of struggle – and yet mystifying hope. Joan Taylor, Professor Emerita of Christian Origins and Second Temple Judaism, King’s College London This article is republished from The Conversation under a Creative Commons license. Read the original article.

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