Understand throbbing headache symptoms, including 10 causes & common questions.
Symptoms of a throbbing headache
A painfully throbbing headache can be among the most debilitating of illnesses. Headaches can be difficult to treat, but once you can pin down exactly what type you have the diagnosis and proper headache treatment can become easier to find.
The throbbing sensation is caused by dilated blood vessels in the head and brain, which can be very painful. A throbbing headache might commonly be called a migraine, a hangover, or a caffeine headache.
- The pain may be severe and localized, meaning it is in a certain spot on the front or side of the head. There may also be:
- The pain may be generalized, meaning it seems to be throughout and all around the head. There may also be:
Duration of symptoms:
- A throbbing headache often lasts for several hours, but rarely goes much longer than this.
Who is most often affected by throbbing headache symptoms?
- Anyone using caffeine on a regular basis.
- Anyone binge-drinking alcohol.
- Women, due to fluctuating hormone levels.
When are throbbing headaches most likely to occur?
- When skipping caffeine and you are accustomed to consuming it each day.
- The morning after binge drinking.
- When neglecting to eat and going too long between meals, allowing blood sugar to drop too low.
- During a period of severe emotional stress.
Are throbbing headaches serious?
- A throbbing headache caused by skipping caffeine, or by an alcohol binge, will eventually clear up and can be prevented by using these substances with more care or by not using them at all.
- A migraine headache, with throbbing that is localized and severe and accompanied by other symptoms, can be quite debilitating and interfere with work, school, and relationships.
- Any headache that also has symptoms of stroke including loss of use of one side of the body is very serious and must be seen by a medical provider immediately.
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Throbbing headache causes
We've listed several different throbbing headache causes here, in approximate order from most to least common:
Medications: Overuse of over-the-counter pain relievers can cause you to take more of the pain reliever if the headache returns, thus building up a tolerance for the pain reliever and the cycle begins. The only way to end the cycle is to wean off of the pain relievers and try to control the headaches another way.
Caffeine: If you suddenly stop consuming the amount of caffeine you are used to getting each day, you may end up with rebound headaches. This is because caffeine constricts the blood vessels makes them tighter and narrower and they will suddenly dilate again once the caffeine wears off, sometimes painfully so. This is common soon after surgery because patients were permitted to eat or drink before.
Alcohol: Moderate, occasional social drinking usually causes no problems, but binge drinking can lead to:
- Dilation and irritation of the blood vessels in the brain and in the surrounding tissue.
- Dehydration the next day, which can cause severe headaches.
- Some foods may trigger allergies or other sensitivities, leading to a headache.
- Low blood sugar due to hunger may cause a throbbing headache.
Hormonal imbalance, primarily in women: Anything that impacts the proper balance may trigger a migraine headache in some women:
- Birth control pills.
- Hormone replacement therapy in menopausal women.
Severe emotional stress and upset: these types of stress can cause a headache, mostly due to tension and constriction of the muscles of the head.
This list does not constitute medical advice and may not accurately represent what you have.
Caffeine withdrawal headache
While many people can consume caffeine without any problems, some people might experience symptoms due to caffeine use. Caffeine can be found in many food and drink products like coffee, tea, soda an chocolate. Anti-headache medication often also contains caffeine. When the body gets accustomed to a certain amount of daily caffeine intake, stopping this intake suddenly can cause withdrawal symptoms. These symptoms often include headaches, fatigue and difficulty concentrating.
Symptoms that always occur with caffeine withdrawal headache: headache
New, or new-onset, migraine means the person has never experienced a migraine headache before. A migraine is a one-sided headache that causes intense pain and throbbing due to blood vessels dilating in the brain.
The exact reason for new-onset migraine headache is not known, but a number of causes are being studied:
- Soy isoflavone supplements, especially in men.
- Use and overuse of certain medications.
- Traumatic head injury.
- Angioma, which is a cluster of dilated blood vessels in the brain.
- A complication of surgery for some heart conditions.
Anyone with a sudden severe headache should be seen by a medical provider, so that a more serious cause can be ruled out. A transient ischemic attack, also known as TIA or mini-stroke, can have symptoms similar to a migraine but is far more serious.
Diagnosis is made through patient history, physical examination, and imaging such as a CT scan.
Treatment for migraine varies with the individual. Lifestyle changes may be recommended and there are a number of medications that may be tried.
Top Symptoms: new headache, fatigue, nausea, mild headache, headache that worsens when head moves
Symptoms that always occur with new migraine: new headache
Symptoms that never occur with new migraine: fever, diarrhea, productive cough, headache resulting from a head injury
Cluster Headache (first attack)
A "new onset" cluster headache means that the person has never experienced a cluster headache before. These headaches most commonly start after age 20.
A cluster headache is characterized by intense pain on one side of the forehead, especially over one eye. It often strikes in "clusters," meaning the headache comes and goes frequently. It may occur at about the same time of day for several days or weeks in a row.
The specific cause for cluster headache is not known. Drinking alcohol, breathing strong fumes, exercising to the point of becoming overheated, and heavy smoking are all possible triggers.
Diagnosis is made through patient history, since there is no specific test for cluster headache. Blood tests, neurologic tests, and imaging such as a CT scan or MRI may be done to rule out any other cause for the new onset of head pain.
Referral will be made to a headache specialist, who can offer new treatments to help the patient manage the symptoms and improve quality of life.
Top Symptoms: new headache, severe headache, nausea, throbbing headache, congestion
Symptoms that always occur with cluster headache (first attack): severe headache, new headache
Urgency: Hospital emergency room
A subarachnoid hemorrhage is characterized by a leakage of blood into the space between the first and second membranes surrounding the brain. The accumulation of blood causes the pressure inside the skull to increase, which can lead to brain damage and death.
Insomnia disorder is a short-term or chronic condition whereby individuals have difficulty sleeping. Other common symptoms include fatigue, difficulty with concentration, social dysfunction, reduced motivation, and behavioral changes.
Sinus headache, also called sinusitis or rhinosinusitis, is caused by either a bacterial or a viral infection of the sinuses (open spaces) behind the eyes and nose.
Symptoms include fever; thick nasal discharge which may be clear, white, greenish or yellowish; some loss of sense of smell; foul-smelling breath; and pain, congestion, and pressure over the sinus areas of the face, especially if bending forward or lying down.
A self-diagnosed "sinus headache" very often turns out to be a migraine headache with a few sinus symptoms. This requires very different treatment from an actual sinus headache, and is an important reason to see a medical provider about any sort of ongoing headaches.
Diagnosis is made through patient history, physical examination, and sometimes CT scan or MRI of the head to look for changes in the sinuses.
A true sinus headache, if caused by a bacterial infection, will be treated with antibiotics. If caused by a viral infection, the symptoms can be treated with over-the-counter pain relievers and alternating hot and cold compresses.
Top Symptoms: headache, headache that worsens when head moves, facial fullness or pressure, mucous dripping in the back of the throat, sinus pain
Symptoms that always occur with sinus headache: headache
Symptoms that never occur with sinus headache: fever, being severely ill, sore throat, muscle aches, cough, drooping eyelid, wateriness in both eyes
Acute viral sinusitis
Acute viral sinusitis, also called viral rhinosinusitis or "sinus infection," occurs when viruses take hold and multiply in the sinus cavities of the face.
It is most often caused by the same viruses that cause the common cold and spreads the same way, through an infected person's coughing or sneezing.
Because children have small, underdeveloped sinuses, this illness is far more common in adults.
Symptoms include clear nasal discharge (not greenish or yellowish,) fever, and pain if facial sinuses are pressed.
If there is rash, severe fatigue, or neurologic symptoms (seizures, loss of sensation, weakness, or partial paralysis,) see a medical provider to rule out more serious conditions.
Diagnosis can usually be made through history and examination alone.
Antibiotics only work against bacteria and cannot help against a viral illness. Therefore, treatment consists of rest, fluids, and fever/pain reducers such as ibuprofen. (Do not give aspirin to children.) Symptoms of viral sinusitis last for about seven to ten days. As with the common cold, the best prevention is frequent and thorough handwashing.
Top Symptoms: headache, cough, sinusitis symptoms, sore throat, congestion
Symptoms that always occur with acute viral sinusitis: sinusitis symptoms
Symptoms that never occur with acute viral sinusitis: being severely ill
Influenza, or "flu," is a contagious respiratory illness caused by viruses. It is spread through the air by coughing, sneezing, or even talking.
Anyone can get the flu, but those who are very young, over 65, and/or have pre-existing medical conditions are most at risk for complications.
Symptoms include fever, chills, cough, sore throat, body aches, and extreme fatigue. The symptoms may appear very suddenly.
Flu can bring on secondary bacterial infections in the lungs or ears. Dehydration is a great concern because the patient rarely wants to eat or drink.
Diagnosis is usually made by symptoms. There are tests that use a swab taken from the nose or throat, but they are not always accurate or necessary.
Treatment consists mainly of good supportive care, which means providing the patient with rest, fluids, and pain-relieving medication such as ibuprofen. Do not give aspirin to children.
Antibiotics cannot help with the flu, since antibiotics only work against bacteria. There are anti-viral medications that a doctor may prescribe.
The best prevention is an annual flu shot.
Top Symptoms: fatigue, headache, loss of appetite, cough, muscle aches
Symptoms that never occur with influenza: headache resulting from a head injury
Urgency: Phone call or in-person visit
Brain tumor or mass
In medical terms, "mass" and "tumor" mean the same thing: the unexplained, out-of-place growth of tissue anywhere in the body, including the brain.
The cause of any sort of brain tumor is unknown. Some originate in the brain, while others spread from cancers growing in other parts of the body.
Symptoms may include increasing headaches; nausea and vomiting; blurred or double vision; loss of sensation in an arm or leg; loss of balance; confusion; speech difficulties; or seizures.
If symptoms persist, it is important to see a medical provider so that any treatment can begin as soon as possible.
Diagnosis is made through neurological examination, CT scan, and/or MRI.
If the mass or tumor is found to be benign, that means it is not cancer and not harmful. It may or may not be treated.
If it is malignant, that means it is cancer and must be treated. This will involve some combination of surgery, radiation therapy, and chemotherapy, followed by specialized therapy to help with recovery.
Top Symptoms: fatigue, headache, nausea, loss of appetite, irritability
Symptoms that always occur with brain tumor or mass: focal neurological symptoms
Urgency: In-person visit
Concussion not needing imaging
A traumatic brain injury (TBI), or concussion, happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that people must go to the hospital, and the worst injuries can lead to permanent brain damage or death.
Top Symptoms: dizziness, irritability, depressed mood, difficulty concentrating, trouble sleeping
Symptoms that always occur with concussion not needing imaging: head or face injury
Symptoms that never occur with concussion not needing imaging: recent fall from 6 feet or higher, severe vomiting, posttraumatic amnesia over 30 minutes, slurred speech, fainting, moderate vomiting
Urgency: Primary care doctor
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Treatment and relief
Seek immediate throbbing headache treatment in the emergency room or call 911 if:
- The headache is severe and is accompanied by loss of use of part or all of one side of the body.
Schedule an appointment for:
- Discussion of specific medications:
- Migraines are sometimes helped by Botox injections.
- Other throbbing headaches may be helped by medications that constrict the blood vessels.
- Steroids are sometimes useful for especially difficult cases.
- Discussion of ways to regain hormonal balance, especially in women.
Throbbing headache remedies that you can try at home:
- Try over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
- Use caffeine and alcohol only in moderation.
- If you do get a caffeine headache, try consuming some caffeine right away as well as drinking extra water.
- When using caffeine, try consuming about the same amount at about the same times throughout the day.
- For a headache caused by the aftereffects of drinking alcohol (hangover) drink extra water. Much of the pain of this headache is caused by dehydration from the alcohol.
- Use ice packs or cold packs on the head, especially while lying down in a darkened room.
- Take steps to improve diet, sleep, and exercise, to improve overall health.
- Take steps to decrease daily stress and learn stress management.
Here are some frequently asked questions about throbbing headache.
Why do I have a sudden throbbing headache?
A sudden throbbing headache can be the symptom of many different disorders. The most common type of headache is a tension headache, which can involve a throbbing sensation across both sides of the head or in the middle of the head. It is often caused by stress, lack of sleep, food, or water, or any number of other stressors including excess sunlight or allergies. Other headaches that can occur suddenly include migraine headaches, which while not immediate, may become painful enough to rise to an individual's attention suddenly. You should be concerned if the headache is severe or if you experience any changes in physical sensation (e.g. touch, taste, smell, hearing, sight, motion, balance) in concert with the headache.
Can stress cause a throbbing headache?
Yes, psychological stress can cause a headache commonly known as a tension headache. Often, excessive worry and a lack of rest because of this worry can contribute to the frequency of these headaches. However, throbbing headaches can also be migraine headaches, strokes, or aneurysms. Accordingly, if you experience any changes in sensation, any weakness or fatigue, or any loss if vision, hearing, or facial droop you should seek medical care immediately.
Why do I have consistent throbbing headaches?
Consistent throbbing headaches lasting longer than a few hours may be migraine headaches, which can last as long as a week in severe cases. Migraine headaches are made better in some cases by medications, and in other cases by darkness, silence, rest, and hydration. If you are experiencing a migraine, resting in a quiet, dark place is often the best treatment for symptoms. It is best, if possible, to take an anti-inflammatory or migraine medication just as a migraine begins and to remain well-rested and hydrated to prevent migraines. Of course, migraines are not the only reason, and you should seek medical evaluation if the headaches continue or become worse.
How do you know if a throbbing headache is a sign of something more?
There is no way to know if a throbbing headache is a sign of something more severe short of medical evaluation. It is best to speak with a medical professional who knows your medical history, has access to your medical records, or tools for proper medical evaluation. It is likely that a more serious process is taking place if you are experiencing numbness, tingling, loss of ability to move one or more body parts, facial drooping, or loss of sense of sight, smell, taste, or hearing.
Why do I wake up with a headache everyday?
Waking up with a headache may be a sign of lack of proper amount of sleep, may occur following sleep apnea (a condition in which you are not able to breathe reliably during sleep) or may be a sign of increased pressure within the skull, possibly from a mass (especially if accompanied by vomiting). You should seek evaluation from a physician if you are experiencing headaches upon waking every morning.
Questions your doctor may ask about throbbing headache
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Any fever today or during the last week?
- Have you experienced any nausea?
- Do you have a cough?
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