Pulsating Pain in the Head and Ear: Possible Causes and Insights

Hello, doctor. Recently, I have started experiencing throbbing pain in my head and a pulsating pain in my ear?

Last year, it was similar around this time.
I’m not sure if it’s due to the cold weather, but I often start experiencing pain in the left occipital region (the area feels just above the greater occipital nerve).
The pain is not very intense, more like a mild throbbing, but by the next day, it extends to my left ear, where I also feel a throbbing pain.
This sharp pain feels like a needle piercing deeply and then being pulled out; sometimes it feels very deep, while other times it’s just a brief sharp pain.
When I touch the painful area on the left occipital region, I also feel discomfort.
Additionally, while sleeping, I experience this sharp pain, which wakes me up briefly before I fall back into a deep sleep with the same pain sensation.
It seems to correspond to a level 5 or 6 neuropathic pain, but it doesn’t feel like it exceeds my pain tolerance by much.
It’s uncomfortable but not unbearable, unless the sharp pain suddenly becomes very intense, lasting about 2 to 3 seconds.
This sharp pain can cause a rebound sensation in my body, and if I yawn or open my mouth too wide to swallow, it may trigger the sharp pain again.
I’m unsure what this condition might be.

Mr. Chen, 30~39 year old female. Ask Date: 2022/12/21

Dr. Peng Shiwei reply Neurology

Hello, since your symptoms seem to be related to ear discomfort and are associated with the opening and closing of the Eustachian tube (such as yawning or swallowing), it is recommended that you consult an otolaryngologist for an examination.
Thank you for your inquiry.

Reply Date: 2022/12/21

More Info

Pulsating pain in the head and ear can be a perplexing and distressing experience, and understanding its potential causes is crucial for effective management. Based on your description, it seems that you are experiencing a type of headache that is characterized by a throbbing or pulsating sensation, particularly localized to the left side of your head and extending to your ear. This type of pain can be associated with various conditions, and it is important to consider both neurological and otological factors.

One possible cause of your symptoms could be tension-type headaches. These headaches are often triggered by stress, poor posture, or prolonged periods of concentration, such as studying or working at a computer. The pain is typically described as a tight band around the head or a dull ache, but in some cases, it can present as a more pulsating sensation. The involvement of the occipital nerve (located at the back of the head) could also contribute to the pain radiating to the ear, as the nerves in this area can become irritated or inflamed.

Another potential cause is migraine, which can manifest as unilateral (one-sided) pulsating pain. Migraines are often accompanied by other symptoms such as sensitivity to light, sound, or nausea. The fact that your pain sometimes wakes you from sleep and can be triggered by yawning or swallowing suggests that it may have a vascular component, typical of migraine headaches. Migraines can also cause referred pain to the ear, leading to the sensation you described.

Additionally, ear-related issues such as ear infections or Eustachian tube dysfunction can cause referred pain to the head and may present with a pulsating sensation. If there is inflammation or pressure in the ear, it can lead to discomfort that feels like it is radiating to the surrounding areas, including the head.
Another consideration is cervicogenic headache, which arises from issues in the cervical spine or neck muscles. If you have been experiencing tension or strain in your neck, this could lead to referred pain in the head and ear. The occipital nerves can become compressed or irritated, leading to a pulsating pain that may be exacerbated by certain movements or positions.

Given the complexity of your symptoms, it is advisable to consult a healthcare professional, particularly a neurologist or an ear, nose, and throat (ENT) specialist. They can perform a thorough examination, which may include imaging studies such as MRI or CT scans, to rule out any serious underlying conditions like tumors or vascular issues.
In the meantime, managing stress through relaxation techniques, ensuring proper posture while working, and maintaining a regular sleep schedule may help alleviate some of your symptoms. Over-the-counter pain relief medications, such as NSAIDs, may also provide temporary relief, but it is essential to use them judiciously and not rely on them as a long-term solution.

In conclusion, while your symptoms may be indicative of tension-type headaches, migraines, or ear-related issues, a comprehensive evaluation by a healthcare professional is necessary to determine the exact cause and appropriate treatment. Keeping a headache diary to track the frequency, duration, and triggers of your headaches can also be beneficial for your healthcare provider in diagnosing your condition accurately.

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