Pulsating Headache? Don’t Ignore It! Here’s What You Need to Know.

Headaches can be a nuisance, but pulsating headaches can be especially concerning. A pulsating headache is characterized by throbbing or pounding sensations in the head that may accompany other symptoms, such as light and sound sensitivity.

Pulsating headaches can range from mild to severe, but they typically last longer than regular headaches and may even become chronic if left untreated. There are different types of pulsating headaches. However, if you have a pulsating, pounding, or throbbing headache, it is almost always likely to be migraine (pulsating pain is part of the ICHD3 diagnostic criteria for migraine).

To treat them, you have to know the types and the common causes. Some causes and triggers of pulsating headaches are:

• Stress and Anxiety
• Sleep Deprivation or Disruption
• Medication Side Effects
• Hormonal Changes in Women
• Foods and food additives
• Weather/barometric changes
• High blood pressure

It’s essential to understand what type of headache you have so that you know how best to treat it. While many people try to ignore their pulsating headaches or take over-the-counter medication, this isn’t always enough.

Sometimes, the underlying cause needs medical attention for the pain to go away completely and decrease the frequency of the headaches. So, here’s everything you need to know about pulsating headaches, their types, common causes, and treatment. Read on!

Types of Pulsating Headaches

There are several types of pulsating headaches, including migraines, thunderclap headaches, high blood pressure (hypertension) headaches (hypertensive urgency or hypertensive emergency), and cluster headaches.

Migraines

Migraines are headaches that can cause throbbing pain and often come with nausea and light and sound sensitivity. Migraines are the most common cause of throbbing, pounding, and pulsating pain. They can last anywhere from a few hours to several days at a time. They can happen a few times per year to a few per month (episodic migraine) to once daily (chronic migraine).

It is important to contrast migraine pain and tension type headache pain, since they often get confused. Tension-type headaches are the most commonly experienced type of headache. They cause pain on both sides of the head and can be accompanied by neck stiffness or tenderness (although migraine can do this too).

The pain of tension type headache is described as an aching, tightness, or pressure. If there is any pulsating, throbbing, or pounding, this puts it into the migraine category, and moves it out of the tension-type category. By ICHD3 criteria, tension type headache can not have a pulsating, throbbing, or pounding character. Tension-type headaches typically last from 30 minutes to 7 days, with a frequency range of once every couple of weeks to several times a day.

Thunderclap Headaches

Thunderclap headaches are a rare but severe type characterized by sudden, intense pain that reaches maximum severity within seconds to minutes. They are called “thunderclap” headaches because the pain is often described as a sudden, explosive thunderclap in the head.

The pain is usually intense, severe, and abrupt. Sometimes it is described as an intense pulsating pounding pain. Patients often compain of it as the “worst headache of their life”. This type of headache requires emergent medical evaluation, especially the first time that it happens. Testing is necessary to exclude aneurysm rupture, bleeding (hemorragic) stroke, or some other concerning cause.

There are recurrent benign forms of this headache, but they must always have the proper evaluation with imaging of the brain and brain arteries before assuming one of these benign versions of the headache.

Thunderclap headaches typically last for a short period, usually several minutes to an hour, but may sometimes persist for several days. They may occur as a single episode or in clusters, with repeated attacks over the course of several days or weeks.

In addition to the sudden onset of severe pain, thunderclap headaches may accompany other symptoms such as nausea, vomiting, and sensitivity to light and sound. Some people may also experience changes in consciousness, confusion, or difficulty speaking or understanding language.

Hypertension Headaches (Hypertensive Urgency or Hypertensive Emergency)

High blood pressure (hypertension) can be a cause of pulsating headaches for some patients, called hypertension headaches. Hypertension is defined as blood pressure 140/90 or greater. A clue can sometimes be the pulsating headache in sync with your heartbeat. Hypertensive urgency and hypertensive emergency are situations where the blood pressure increases to unsafe levels.

If blood pressure is too high, additional symptoms can occur besides the headache such as blurred vision, confusion, and stroke-like symptoms. Strokes, brain bleeds (hemorrhagic stroke), or aneurysm development and rupture can also occur if not treated urgently to bring the blood pressure down.

Cluster Headaches

Cluster headaches are characterized by a sharp stabbing pain on one side of the head that most often occurs around the eye on one side and facial pressure or flushing. An ice pick pain through the eye area is often described.

Sometimes the pain is also described as having an intense pulsating, throbbing, or pounding component as well. However, it is most often severe stabbing, sharp, and very intense. They are associated with some autonomic features which can include redness and tearing of an eye, droopiness or puffiness of an eyelid, one sided nasal congestion or runny nose, or hearing complaints on the side of the pain. These types of headaches tend to occur in clusters and are usually more severe than other types of headaches.

These headaches typically last from 15 minutes to 3 hours and occur in clusters over periods lasting days, weeks, or months. They are usually more severe than other types of headaches and can recur multiple times per day during an active cycle. The frequency can range from once every couple of weeks to eight times a day.

Common Causes of Pulsating Headaches

Various factors, including physical or emotional stress, certain medications, and underlying medical conditions, can cause pulsating headaches.

Stress: Stress is one of the most common triggers for pulsating headaches. Stressful situations or emotions such as anger, fear, or anxiety can increase muscle tension, which may cause throbbing pain in the head.

Medications: Certain medications such as birth control pills, blood pressure medications, or migraine-specific medications can sometimes cause pulsatile headaches.

Underlying Medical Conditions: Various underlying medical conditions can also trigger pulsating headaches. These include sleep disorders such as insomnia, high blood pressure (hypertension), and certain infections. Other causes may include aneurysms, brain tumors, or stroke.

Dehydration: Dehydration can also lead to pulsating headaches called dehydration headaches. When the body is not adequately hydrated, it cannot function optimally, resulting in throbbing pain in the head. Dehydration is also one of the most common migraine triggers.

Lack of Sleep: Sleeping every night is essential for overall health and can also help reduce the frequency and severity of pulsatile headaches.

In some cases, the cause of pulsating headaches is unknown. Suppose your doctor suspects that you are experiencing pulsatile headaches. In that case, they will likely perform a thorough physical exam and order imaging tests such as a CT scan or MRI to diagnose the cause better.

Suppose your doctor can identify a cause for your pulsating headaches. In that case, they may recommend lifestyle modifications, medications, or other treatments, such as physical therapy, to help alleviate your symptoms. Additionally, they may suggest relaxation techniques or stress management strategies to help reduce the frequency and severity of future episodes.

Diagnosis and Treatment of Pulsating Headache

If you are experiencing frequent or severe pulsating headaches, it is essential to see your doctor to evaluate the cause and the best course of action. Your doctor may perform a physical exam and order imaging tests such as a CT scan or MRI to look for any underlying conditions causing your symptoms.

Depending on the cause of your pulsating headache, your doctor may recommend lifestyle modifications, medications, or other treatments, such as physical therapy, to help alleviate your symptoms. In some cases, relaxation techniques and stress management strategies may be recommended to help reduce the frequency and severity of future episodes.

Medications Used to Treat Pulsating Headaches

Medications used to treat pulsating headaches vary depending on the underlying cause. For example, medicines for migraine-specific headaches include triptans, ergotamines such as DHE, gepants or ditans. Other medications for high blood pressure (hypertension), such as beta-blockers, calcium channel blockers or angiotensin-converting enzyme (ACE) inhibitors, may be prescribed. Some of these blood pressure medicines are not only effective at treating blood pressure, but also preventing migraine.

Following your doctor’s instructions and taking medications as prescribed is essential, as this will help ensure the best possible outcome. Additionally, it is vital to keep a headache diary to track changes in symptoms and response to treatment. This can be helpful for both you and your doctor in determining the most effective treatment plan.

Lifestyle Modifications

Lifestyle modifications are vital to managing pulsating headaches and are usually recommended by doctors alongside medications and other treatments. Lifestyle modifications can involve diet, exercise, sleep habits, and stress management changes.

Diet plays a key role in maintaining good health, as certain foods can trigger increased pulsating headaches which are of the migraine type. It is important to ensure you eat a well-balanced diet that includes plenty of fruits and vegetables, whole grains, and lean proteins. Avoiding processed foods and added sugars and salts can also help reduce the frequency of pulsatile headaches.

Exercise is also an important component of managing pulsating headaches. Regular physical activity can help reduce stress, improve sleep quality, and boost overall health. It is essential to consult with your doctor before starting any new exercise routine to ensure it suits you.

Finally, getting enough sleep every night is extremely important for overall health and can also help reduce the frequency and severity of pulsatile headaches. Aim for at least eight hours of sleep each night, and avoid electronic devices and other distractions before bed.

Alternative Therapies for Pulsating Headache

Alternative therapies, such as acupuncture and massage therapy, may also be recommended to help reduce the frequency and severity of pulsatile headaches. There is evidence that these therapies may be effective in reducing symptoms for those with headaches caused by tension or stress and for people who experience migraine-type headaches. There are many other home and natural treatments for migraine and headache as well.

Speaking with your doctor before starting any alternative therapy is essential to ensure it is safe and appropriate. Additionally, it is important to note that alternative therapies are not a substitute for medical care and should always be used in conjunction with medications or other treatments prescribed by your doctor.

When to Seek Medical Attention?

It is important to seek medical attention if you experience persistent pulsating headaches that interfere with your daily activities or are accompanied by other symptoms such as nausea and vomiting. Any type of new headache should be evaluated by your doctor before you assume a benign cause of the headache. This is especially true if the headaches become more frequent or occur with high fever, vision changes, mental confusion, chest pain, or numbness in the extremities.

These symptoms may indicate a more serious underlying medical condition, so it is crucial to seek prompt medical attention if they are present. Additionally, if medications or lifestyle changes do not relieve pulsatile headaches, you must contact your doctor for further evaluation and treatment.

Prevention of Pulsating Headache

The best way to prevent pulsating headaches is to manage other underlying medical conditions, such as high blood pressure or diabetes. Additionally, avoiding common headache triggers, such as stress and lack of sleep, can help reduce the frequency of pulsatile headaches.

Finally, maintaining a healthy lifestyle with regular physical activity and a balanced diet can also help reduce the frequency and severity of pulsatile headaches.

Common preventive medications, especially for migraine, include anti-inflammatory drugs, beta-blockers, tricyclic antidepressants, anticonvulsants, calcium channel blockers, and serotonin-norepinephrine reuptake inhibitors (SNRIs), gepants, CGRP monoclonal antibodies, or Botox. These medications are typically prescribed by a doctor and should be taken according to the instructions on the label.

Alternative therapies, such as acupuncture and massage therapy, may also help reduce the frequency and intensity of pulsatile headaches. Speaking with your doctor before starting any alternative treatment is essential to ensure it is safe and appropriate.

Summing It All Up

Pulsatile headaches are a type of headache that is characterized by a throbbing or pulsating sensation. While the exact cause of pulsatile headaches is unknown, they may be triggered by certain medical conditions, such as high blood pressure or diabetes. Treating the underlying condition can often help reduce the frequency and severity of pulsatile headaches.

Additionally, lifestyle changes and preventive medications may also help manage symptoms. It is essential to seek medical attention if you experience persistent pulsatile headaches that interfere with your daily activities or are accompanied by other symptoms such as nausea and vomiting.

Alternative therapies, such as acupuncture and massage therapy, may also be recommended to help reduce the frequency and severity of pulsatile headaches. Ultimately, speaking with your doctor about the best treatment plan for you is essential.

If lifestyle changes and preventive medications do not relieve your pulsatile headaches, it is essential to contact a doctor for further evaluation and treatment. Your doctor can help you determine the best course of action and ensure that alternative therapies are safe and appropriate for your situation. Together, you can find the right solution to manage your pulsating headaches and help reduce their frequency and intensity.