Are Migraines Throbbing?
Yes, migraines are characteristically throbbing or pulsatile in nature, and this is one of the key diagnostic features used to distinguish them from other headache types.
Diagnostic Criteria
According to the International Headache Society classification system, throbbing character is one of the four cardinal features used to diagnose migraine, where at least two of these features must be present 1:
- Unilateral location
- Throbbing character
- Worsening pain with routine activity
- Moderate to severe intensity
The throbbing quality helps differentiate migraine from tension-type headaches, which are described as having a "pressing, tightening, or nonpulsatile character" 1.
Clinical Presentation
Migraine is consistently described as a "throbbing headache" in the medical literature, with this pulsatile quality being a defining characteristic 2, 3, 4, 5. The throbbing nature is typically:
- Unilateral (one-sided), though it can be bilateral 1
- Moderate to severe in intensity 1
- Exacerbated by physical activity 2
- Associated with nausea, vomiting, photophobia, and phonophobia 1, 2
Important Clinical Caveat
While throbbing is a classic feature, not every migraine attack will present with throbbing pain. The diagnostic criteria require only two of the four cardinal features, meaning a patient can have migraine without throbbing if other criteria are met (such as unilateral location plus moderate-to-severe intensity) 1. However, the throbbing quality remains one of the most reliable distinguishing features when present.