Throbbing Headache

Throbbing headaches cause a rhythmic pulsating or pounding sensation over the whole head or one part of the head. They range in intensity from mild to severe. Usually, they stem from a primary headache disorder like migraine or a secondary headache disorder like caffeine withdrawal or giant cell arteritis (an inflammatory blood vessel disease).

Rarely, a throbbing headache may be a sign of a potentially life-threatening condition, such as a stroke (a blocked blood vessel or bleeding in the brain) or blood vessel tear in the neck.

This article focuses on the common symptoms, causes, and treatment of a throbbing headache. It also provides insight into when to seek medical attention for your headache.

Throbbing Headache From Caffeine Withdrawal

AndreyPopov / Getty Images

Symptoms of a Throbbing Headache

The symptoms that may accompany a throbbing headache depend on the cause of the headache.

Examples of such possible symptoms include:

  • Nausea and/or vomiting
  • Sensitivity to light, sound, or smell
  • Restlessness
  • Cranial autonomic symptoms (e.g., facial flushing, eye redness and tearing, and stuffy nose)
  • Mood or thinking disturbances (e.g., anxiety or problems concentrating)
  • Scalp tenderness
  • Jaw claudication (pain when chewing)

Causes of a Throbbing Headache

Primary headache disorders exist on their own, whereas secondary headaches are caused by an underlying health-related issue, such as illness or drug withdrawal.

Primary headache disorders that may cause throbbing head pain include:

  • Migraine headaches usually occur on one side of the head, are often aggravated by movement, and may be preceded by an aura (reversible visual or sensory disturbances).
  • Cluster headaches are less likely than migraines to cause throbbing pain. If they do, the pain is typically severe and is centered in or around the eye or temple on one side of the head.

Tension-Type Headaches

Tension-type headaches are common primary headaches that cause dull, non-throbbing pain on both sides of the head.

Several secondary headache disorders may cause throbbing head pain.

Three common examples are:

  • Caffeine withdrawal headaches usually occur on both sides of the head and develop within 24 hours after regular consumption of caffeine (around two cups of coffee per day for more than two weeks).
  • Hangover headaches tend to occur on both sides of the head, especially on the forehead and/or the temples. They can develop within 12 hours of consuming alcohol.
  • Giant cell arteritis (GCA) is a form of vasculitis (blood vessel inflammation) that affects large and medium-sized arteries in the head and neck. It's typically only seen in adults over the age of 50. The throbbing headache of GCA is classically felt over both temples.

How to Treat a Throbbing Headache

The treatment of a throbbing headache depends on the underlying diagnosis.

Primary Headaches

A mild migraine headache can usually be eased with a nonsteroidal anti-inflammatory drug (NSAID) like Aleve (naproxen sodium) or Advil or Motrin (ibuprofen). More severe or persistent migraine headaches may require a triptan.

What Is a Triptan?

Triptans are prescription medications that abort migraines by binding to specific serotonin (a brain chemical) docking sites. They are available in unique formulations, including pills, tablets that dissolve on your tongue, nasal sprays, and injections.

Lifestyle behaviors play an important role in migraine management. Notably, avoiding triggers (e.g., strong smells, too much or not enough sleep, and hunger) is paramount to most patients' migraine treatment plans.

Cluster headaches are treated by either inhaling oxygen or injecting or inhaling a triptan like Imitrex (sumatriptan). Smoking cessation and avoiding heavy alcohol intake are also usually advised.

Secondary Headaches

Hangover headaches resolve on their own within 72 hours. In the meantime, they can be soothed with a combination of ibuprofen, rest, and drinking lots of fluids.

Avoid Tylenol

It's important to avoid taking Tylenol (acetaminophen) while or after drinking alcohol to prevent harm to your liver.

A caffeine withdrawal headache will also resolve on its own, but it can take up to a week of not taking in caffeine.

If you think you may be experiencing a caffeine withdrawal headache, it's probably best to go ahead and drink a cup of coffee (or something else that is equivalent to around 100 milligrams of caffeine). This should relieve your headache within an hour.

Giant cell arteritis is treated with high doses of corticosteroids, which are strong anti-inflammatory medications.

Complications Associated With a Throbbing Headache

Complications are health problems that can arise as a result of a headache disorder.

As an example, migraine is associated with the following rare complications:

Are There Tests to Diagnose the Cause of a Throbbing Headache?

Most migraine headaches are diagnosed with a medical history and neurological exam. Imaging or other diagnostic tests are not typically needed.

If your exam is abnormal or your healthcare provider suspects a cluster headache, magnetic resonance imaging (MRI) of the brain will be performed.

The diagnosis of a hangover headache or caffeine withdrawal headache usually only requires a careful medical history.

The diagnosis of giant cell arteritis typically involves the following tests:

  • Erythrocyte sedimentation rate (sed rate): This blood test is for a marker of inflammation.
  • Temporal artery biopsy: A tiny tissue sample of the artery in your temple is removed and examined under a microscope

When to See a Healthcare Provider

Most throbbing headaches are not worrisome. However, sometimes, a throbbing headache is the only or first sign of something serious going on.

Be sure to see a healthcare provider in the following situations:

  • Your headache pattern is changing (e.g., headaches occur more often).
  • You have a headache and are pregnant, just gave birth, or have a history of cancer or a weakened immune system.
  • You are 65 years old or older and are experiencing a headache that feels different from prior headaches.
  • Your headache is triggered by sneezing, coughing, or exercising.
  • You are experiencing rebound headaches from taking painkillers regularly.

Seek Emergency Medical Attention

Go to your emergency room or call 911 right away if:

  • You have a sudden headache that becomes severe within a few seconds or minutes.
  • You have a headache and a fever/stiff neck, painful red eye, seizure, fainting, or symptoms of a stroke.
  • You develop a headache after a blow or injury to your head.

Summary

A throbbing headache feels like a pulsating sensation within your brain and has many potential causes, including a migraine, hangover, or caffeine withdrawal. A blood vessel inflammatory disease called giant cell arteritis may cause a throbbing headache in older individuals.

Treatment of a throbbing headache depends on the underlying diagnosis and usually involves a combination of medication and lifestyle strategies.

A Word From Verywell

If you are experiencing throbbing headaches, cannot pinpoint the underlying culprit or trigger, or are having trouble getting control of them, make an appointment with your healthcare provider or a headache specialist.

Obtaining the correct diagnosis is key to devising a headache treatment and prevention plan that is uniquely effective and safe for you.

Frequently Asked Questions

  • Is throbbing headache a sign of COVID-19?

    Some people infected with COVID-19 report a throbbing headache. The headache is typically moderate to severe in intensity and is felt on both sides of the head, near the temples, forehead, or around the eyes.

  • How long does a throbbing headache last?

    The duration of a throbbing headache depends on its cause, and whether it's treated or not. As an example, an untreated migraine or hangover headache can last up to 72 hours. In the absence of caffeine, a caffeine withdrawal headache may last up to a week.

  • How do I treat a throbbing headache?

    The treatment of a throbbing headache depends on the underlying diagnosis. For instance, migraine headaches are often treated with an NSAID, like ibuprofen, or a prescription drug called a triptan.

    A throbbing headache from caffeine withdrawal can be eased by consuming 100 milligrams of caffeine, which is equivalent to one cup of coffee.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.