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I had a patient who came to the clinic one day very worried, and asked me the same question "I feel throbbing and pulsing in my thigh!" I knew this patient for a few years he was a healthy young adult with no significant past medical history.

I examined the patient; the first thing I wanted to know is what was causing the throbbing sensation, a vessel or a muscle.

Even though you might think the pulsation must come from a vessel, sometimes muscle twitches can mimic this sensation.

My patient's vibrations were from a vascular origin, and that's why I am going to start with some useful info about this kind of throbbing sensation before talking about muscle twitching.

Throbbing from vascular origin

A vein can produce this sensation because of the increased blood flow to a particular area due to physical activity - this can happened when you jog in the morning or after bodybuilding exercise or any other physical activity. When somebody tackles you during a football game and traumatizes your leg, the swelling can push on the vessels and this can produce a throbbing sensation. A trauma can also produce an abnormal communication between an artery and vein - this is called AV fistula.

Usually throbbing from vascular origin is not a reason to worry. You may visit a general practitioner who will probably examine the blood flow and may even order a test to look at your vessels.

Rarely the cause of throbbing is aneurism which produces a wide pulsatile area - aneurisms are often treated surgically.

  • It is useful to know that common conditions such as deep vein thrombosis, blood clots or peripheral artery disease usually do NOT present with throbbing sensation but usually present with pain and swelling.
Throbbing caused by muscle twitching

Turn off the lights, sit on a chair and use a direct light from a lamp and try to make the light beam horizontal so you can see the throbbing area clearly.

If you see tiny twitches you should know that your throbbing sensation is produced by your muscles.

Conditions causing muscle twitching

Although muscle twitches are often idiopathic or as a result of muscle hyperactivity or hyperexcitability because you had too much coffee or you had a heavy exercise earlier, muscle twitches can be a symptom of a serious medical conditions.

B12 deficiency. This is found especially in alcoholics or vegetarians. Muscle twitching is not an early symptom, usually B12 deficiency presents with anemia and decreased or altered sensation.

Multiple Sclerosis. Usually presents with pain behind one eye. Muscle twitching is a common symptom.

Herpes infection and Amyotophic Lateral Sclerosis also known to cause muscle twitches. It is advisable to see a neurologist for further evaluation, the neurologist is most likely to order MRI and blood tests.

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