Medical News Today: What can cause pain in the temple?

Pain in the temples is very common. While many factors can cause it, this pain most often stems from stress or tension. Temple pain can result from an underlying medical condition, though this is rare.

Over-the-counter pain medication and lifestyle changes can often relieve pain in the temples. If a person has additional symptoms or concerns, however, it may be a good idea to consult a healthcare provider.

In this article, we look at possible causes of temple pain. We also describe their symptoms, treatments, and when to see a doctor.

Tension headache

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A tension headache is a possible cause of temple pain.

A tension headache commonly causes vice-like pain in a band around the head. It can also cause tenderness in the head and neck muscles.

These headaches may last about 30 minutes, though a severe tension headache can last for up to 1 week.

Tension headaches usually cause mild or moderate pain. They do not get worse with physical activity, so people are often able to carry on with their routines.

While, unlike other types of headache, tension headaches do not cause nausea or vomiting, people may feel increased sensitivity to either noise or light.

Diagnosis

The doctor will review the person's medical history and symptoms.

There are no specific tests to diagnose tension headaches, and they can be difficult to distinguish from migraine headaches.

Treatment

If tension headaches are frequent and long lasting, and therefore chronic, a doctor may recommend preventive treatment. This may involve an antidepressant called amitriptyline as well as massage and relaxation therapy.

If tension headaches occur infrequently, and are therefore acute, a person may benefit from taking over-the-counter medication for pain relief, such as acetaminophen or an anti-inflammatory drug.

Migraine

Migraine headaches usually start on one side of the head. They can also move from the back of the head to the front, behind the eye.

A migraine headache can start as a dull ache that develops into a pulsing pain. Some people feel pain or pressure in their temples.

A migraine episode may have the following four stages, distinguished by changes in symptoms:

Prodrome: This stage can include sensitivity to light and sound, tiredness, mood changes, neck pain, and nausea.

Aura: A migraine aura is a sensory disturbance. An aura may be visual, involving lights, lines, or spots in the field of vision. Or, the aura may be physical, causing a pins-and-needles sensation. Auras affect one-third of people with migraine.

Headache: A migraine headache causes pain that gets worse with movement. A person may also have nausea, vomiting, and sensitivity to sound, smells, light, or a combination.

Postdrome: The final stage of a migraine episode can involve tiredness, trouble concentrating, weakness, and dizziness.

Diagnosis

There is no test to diagnose migraine.

A doctor will ask for detailed descriptions of the intensity and frequency of migraine headaches and the extent to which symptoms interfere with everyday life.

Keeping a record of symptoms and any medications can help the doctor recommend the best course of treatment. Meanwhile, an MRI or CAT scan can rule out other causes of head pain.

Treatment

When a person is experiencing a migraine episode, the following treatments can help:

• Sleep: This may put an end to a mild episode.
• Analgesics and antiemetics: Examples include metoclopramide and the combination medications Fioricet and Fiorinal.
• Triptans: Examples include naratriptan, zolmitriptan, rizatriptan, and sumatriptan.

However, people should not use triptans if they have, or have a risk of, cardiac ischemia.

Also, Botox injections can help relieve migraines. A healthcare professional can inject Botox around the head, neck, and shoulders to block muscle contraction.

The following medications may help prevent migraine episodes:

• tricyclics, such as amitriptyline, nortriptyline, or dosulepin
• propranolol, a beta-blocker
• anticonvulsants, such as topiramate, if the two options above are not effective
• fremanezumab-vfrm or erenumab

Cervicogenic headache

A cervicogenic headache can result from a disorder of the cervical spine, injuries to the neck, or arthritis of the upper spine.

Symptoms of a cervicogenic headache can include:

• pain on one side of the head, possibly in the temple
• a stiff neck
• nausea
• blurred vision
• a sensitivity to light and sound
• a reduced range of motion of the neck
• a headache that gets worse with certain movements of the neck

Diagnosis

A doctor diagnoses a cervicogenic headache after considering the person's medical history and symptoms.

Treatment

Treatment for cervicogenic headaches involves:

• medication, including nerve blocks
• exercise
• physical therapy

Giant cell arteritis

Giant cell arteritis (GCA) causes inflammation of blood vessels. This results in pain that is intense, burning, and pulsating. The pain tends to occur in the temples, though it can extend throughout the head.

Common symptoms include:

• tiredness
• tenderness in the scalp or temples
• pain in the jaw when chewing
• a fever
• a loss of appetite
• weight loss

Rarely, GCA can also cause blurring, double vision, or loss of vision if it affects the blood supply of the eyes. To prevent this, it is important to obtain a swift diagnosis and immediate treatment.

Doctors do not know what causes GCA.

Diagnosis

The doctor will do a blood test and a biopsy to confirm a diagnosis. The person will then begin treatment immediately.

Treatment

A high dosage of steroids, such as prednisone, can help with GCA. This treatment will continue for 1 month until symptoms go away. Then, the doctor will gradually lower the dosage. Overall, the treatment tends to last about 1 year to prevent recurrence.

Side effects of steroids can include:

• weight gain
• an increased risk of infection
• muscle weakness
• bone loss
• elevated blood sugar levels

Vitamin D and calcium supplements may help prevent bone loss.

Tocilizumab is another treatment for GCA, and a healthcare provider administers this as a series of injections.

If GCA causes vision loss, it is usually irreversible.

Mild traumatic brain injury

A mild traumatic brain injury (TBI) is caused by an impact to the head.

About 85% of headaches that result from a TBI are tension headaches. A person may feel this pain anywhere in the head, including the temples.

Diagnosis

After a mild TBI, doctors may use MRI or CAT scans to detect any blood clots or bruising to the brain.

If memory problems, dizziness, visual disturbances, or persistent headaches occur, the person may need to see a neurologist.

Treatment

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Rest may help a person recover from a TBI.

After a TBI, it is important for the person to follow their healthcare provider's instructions.

These may involve:

• rest
• exercise
• relaxation
• a reduced caffeine intake

Physical therapy may also help with tension headaches that result from a mild TBI.

Cerebral aneurysm

A cerebral aneurysm is a weak, bulging area in the wall of an artery in the brain. If it bursts, this causes a sudden, excruciating headache. An aneurysm can develop in any artery in the brain.

Symptoms can include:

• drowsiness
• ïsensitivity to light
• eye pain
• a stiff neck
• nausea
• vomiting
• a sudden, severe headache, if the aneurysm ruptures

Diagnosis

Doctors use the following tests to diagnose an aneurysm:

• Digital subtraction angiography: This produces an image of the blood vessels of the brain.
• CT scan: This shows a more detailed image to help detect irregularities.
• MRI: This can show small changes in brain tissue.
• Magnetic resonance angiography: This involves using intravenous dye to make the blood vessels more visible on the scans.

Treatment

The primary treatment for an aneurysm is surgery, of which there are two types:

• open craniotomy, which involves using a metal clip to prevent blood flow to the aneurysm
• endovascular coiling, which involves inserting soft coils through a catheter to prevent the aneurysm from rupturing

Brain tumor

A brain tumor is an abnormal mass of cells in the brain. Symptoms can include:

• headaches
• dizziness
• nausea
• confusion
• seizures
• paralysis

Diagnosis

To diagnose brain tumors, doctors can use various forms of imaging, including CT, PET, and MRI scans.

To confirm the diagnosis, the doctor may recommend a biopsy. However, this is a risky procedure.

Treatment

Doctors usually treat brain tumors with:

• Surgery: The neurosurgeon will remove as much of the tumor as possible without damaging the surrounding brain tissue.
• Radiation: This can shrink the tumor by killing cancerous cells.
• Chemotherapy: This damages the cancerous cells.

When to see a doctor

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A person should talk to their doctor if head pain interferes with their daily life.

It is important to seek medical attention for head pain when it:

• increases in frequency and severity or does not stop
• interferes with daily life
• is accompanied by symptoms such as confusion, dizziness, a fever, or vomiting
• occurs as a result of a head injury

Seek immediate medical help if a person experiences:

• a sudden, excruciating headache
• a headache accompanied by vision loss, a loss of consciousness, or vomiting

Summary

The cause of pain in the temples is often stress or tension.

However, it is important to recognize when head pain or accompanying symptoms are not manageable at home.

If the pain becomes more frequent or intense, or if symptoms such as confusion, dizziness, a fever, or vomiting occur, see a doctor.