Pulsating Headaches: Causes and When to Seek Help

Head pressure and tightness pain?

Hello, doctor.
I have been experiencing occasional headaches over the past two weeks.
During these episodes, the upper half of my head feels tight and somewhat swollen, but the pain is mild and does not last long, nor does it significantly affect my daily life.
I would like to know what might be causing this and which specialist I should see.
Thank you!

Yang Yang, 20~29 year old female. Ask Date: 2023/03/01

Dr. Jiang Junyi reply Neurology

Dear Miss Yang,
You mentioned that "the upper half of my head feels like it's tightening and has a bit of a throbbing pain, the symptoms are mild...
and they don't last very long." Your symptoms may suggest tension-type headache, which is caused by muscle tightness in the head.
Common manifestations include tight, constricting pain in the forehead and temples, similar to wearing a tight headband.
Since this is caused by muscle fatigue, it typically begins in the afternoon and peaks in the evening or at night.
Taking a hot shower, getting a massage, or sleeping may provide relief.
Lack of sleep, stress, or anxiety can exacerbate the severity of the headache.

In summary, tension-type headaches may arise from stress, anxiety, or poor posture leading to excessive muscle tension.
For treatment, identifying and addressing the sources of stress, engaging in muscle relaxation exercises such as yoga, or being mindful of your posture can be beneficial.
Medication treatment usually involves muscle relaxants, anxiolytics, and mild analgesics.
If your symptoms persist or worsen, it is advisable to seek medical attention.
A consultation with a neurologist for further evaluation is recommended.
Thank you for your inquiry, and feel free to discuss any related questions!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Hospital

Reply Date: 2023/03/01

More Info

Pulsating headaches, often described as a throbbing or pounding sensation, can be caused by a variety of factors. Given your description of the symptoms occurring intermittently over the past two weeks, it is essential to consider several potential causes and when to seek medical help.

Possible Causes of Pulsating Headaches
1. Tension-Type Headaches: These are the most common type of headaches and can manifest as a tight band-like sensation around the head. They are often triggered by stress, anxiety, poor posture, or prolonged periods of screen time. While they may not be pulsating in nature, they can sometimes present with a feeling of pressure.

2. Migraine: Migraines are characterized by intense, throbbing pain, often on one side of the head. They can be accompanied by nausea, sensitivity to light and sound, and sometimes aura symptoms (visual disturbances). Although your symptoms are mild and not affecting your daily life significantly, it’s worth considering if they fit the migraine profile.

3. Cluster Headaches: These are less common but can cause severe, unilateral pain that is often described as a burning or piercing sensation. They occur in cyclical patterns or clusters, hence the name. However, given your description of mild symptoms, this may be less likely.

4. Sinus Headaches: If you have accompanying symptoms such as nasal congestion or facial pressure, sinus headaches could be a possibility. These headaches are often related to sinus infections or inflammation.

5. Cervicogenic Headaches: These originate from issues in the neck, such as muscle tension or cervical spine disorders. If you spend long hours in front of a computer, this could contribute to tension in the neck and lead to headaches.

6. Medication Overuse Headaches: If you have been taking over-the-counter pain medications frequently, this could lead to rebound headaches, which can be pulsating in nature.

When to Seek Help
While your symptoms are currently mild and not significantly impacting your daily life, it is essential to monitor them closely. You should consider seeking medical attention if:
- The headaches become more frequent or severe.

- You experience additional symptoms such as visual disturbances, confusion, weakness, or numbness.

- There is a sudden change in the pattern of your headaches or if they start to interfere with your daily activities.

- You have a history of head trauma, as this could necessitate further evaluation to rule out any serious underlying conditions.

Which Specialist to See
For headaches, the best course of action is to consult a neurologist. They specialize in disorders of the nervous system, including headaches, and can provide a comprehensive evaluation. They may perform a physical examination, take a detailed medical history, and possibly recommend imaging studies (like an MRI or CT scan) if they suspect any underlying issues.

Conclusion
In summary, while your pulsating headaches may not currently be a cause for alarm, it is crucial to remain vigilant about any changes in your symptoms. Keeping a headache diary can help track the frequency, duration, and intensity of your headaches, as well as any potential triggers. This information can be invaluable when discussing your condition with a healthcare provider. If your symptoms persist or worsen, do not hesitate to seek medical advice to ensure proper diagnosis and management.

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