What’s Causing Your Temple Headache?

Affecting people of all races, genders, and ages, headaches are among the most common medical issues. According to the World Health Organization (WHO), about 50%–75% of adults aged 18–64 have had at least one headache in the last year, with 30% or more reporting migraine.

There are many types of headache disorders, and a range of other health conditions can bring them on; in some cases, the pain is localized in the temples.

Sometimes accompanied by other symptoms, such as pressure and dizziness, temple headache can be a sign of a number of disorders and conditions, some of which require medical attention. This article provides a quick overview of the symptoms, causes, and treatments of this debilitating condition.

Symptoms of Temple Headaches

While many factors can cause temple headaches, they are most often the result of muscle tension, which causes tension headache, the most common type of headache. The associated temple pressure is often the result of eye strain, teeth clenching, and stress. This pressure may also be due to disruptions of blood flow to the area, caused by inflammation in the surrounding tissues.   

Since temple headaches can be the result of both primary headache disorders (headaches that occur independently and not brought on by another disorder), like migraine, and other health conditions, their symptoms can vary considerably. When the temples are affected, signs include:

• Pain and tenderness in one or both temples
• Feeling of pressure in one or both temples
• Headache pain that's dull and aching or intense and throbbing
• Dizziness
• Loss of vision
• Aching jaw

Temple Headache Causes

Temple headaches can be the result of both primary headache disorders or secondary headache disorders, occurring because of another health condition. Here’s a quick overview of the most common causes of these headaches.

Tension Headache

Tension headaches are the most common cause of pressure and pain in your temples. These headaches cause dull, non-throbbing pain, usually on both sides of the head. They can last anywhere from 30 minutes to a week.

Temple headaches can be caused by:

• Muscle tension in the neck and jaw
• Stress
• Skipping a meal
• Insufficient or irregular sleep

Migraine

Migraines are a common cause of pain and pressure in the temple, often causing severe and debilitating symptoms. Attacks recur and last anywhere from four to 72 hours and usually affect only one side of the head. The most common symptoms of this neurological disorder include:

• Moderate to severe headache pain that is unilateral (one-sided), stabbing, or pulsating
• Light and sound sensitivity
• Fatigue
• Visual disturbances (auras), such as flashing lights, zigzags, or loss of sight
• Restlessness, giddiness

There are many kinds of migraines, and the exact causes of this condition are unknown. However, migraines—like some other types of headaches—can be set off by triggers. These vary from person to person and can include:

• Certain foods and drinks
• Alcohol
• Changes in the weather
• Stress and anxiety
• Lack of sleep
• Hormone fluctuations
• Overuse of pain medications

Temporal Arteritis

Temporal arteritis is a condition that causes inflammation and swelling in one of the two temporal arteries on either side of your head. Also called “giant cell arteritis,” it disrupts blood circulation in the region, which can cause:

• Throbbing headache in the temple, side, or back of the head, usually only on one side
• Tenderness when touching the temple or scalp
• Jaw pain when talking or chewing
• Muscle aches and pains in the arm
• Stiffness and pain in the neck, shoulders, and hips
• Fatigue and weakness
• Fever
• Visual disturbances

Temporal arteritis requires medical attention.

Cervicogenic Headache

The result of nerve compression in the neck due to injury, malformation, or arthritis in the upper spine (or “cervical spine”), cervicogenic headaches cause symptoms on one side of the body. Along with pain in the temples, this can cause:

• Pain on the face or side of the head
• Pain around the eyes, neck, shoulder, and arm
• Nausea and vomiting
• Blurred vision
• Sensitivity to light and sound

If cervicogenic headaches aren’t treated they can become more severe and debilitating.

Temporomandibular Joint (TMJ) Disorders

The temporomandibular joint (TMJ) connects the upper and lower jaw. A range of conditions can cause dysfunction and pain here; these are called TMJ disorders. While their symptoms often last only a short while or resolve on their own, some cases lead to chronic problems. The signs of this condition include:

• Pain and stiffness in the jaw
• Pain spreading to the face, temple, and neck
• Popping or snapping in the jaw with or without pain when opening and closing
• Limited jaw mobility and difficulty chewing
• Ringing in the ears or hearing loss; dizziness
• Changes in tooth alignment

Infections

Bacterial, viral, fungal, or other kinds of infections affecting the brain, sinuses, and ears can also cause pressure and pain in the temples. Temple headaches are seen in:

• Meningitis: An inflammation of the tissue surrounding the brain and spine (the meninges), meningitis can become fatal if untreated. Arising due to bacterial, viral, fungal, or amoeba infections, among others, it may also be brought on by cancer or as a side effect of medication. Along with pain in the head and temples, patients experience neck stiffness and fever. Some cases cause nausea, light sensitivity, and confusion.
• Sinusitis: Bacterial or viral infections of the sinus passages running between the nostrils, mouth, and respiratory system can also be a source of significant pressure and pain. Often called sinusitis, sinus infection causes headaches, facial and temple pressure and pain, congested and/or runny nose, mucus in the throat, cough, and bad breath.    
• Ear infection: Ear infections, such as otitis media (an infection of the middle ear), can also cause temple headaches alongside other symptoms. Especially common in children, this causes fluid build-up and inflammation in the ear. This leads to pain and pressure in the ear or ears, headaches, fever, and irritability and/or restlessness, as well as problems with sleep.

Tumor

Though most headaches aren’t caused by cancer, temple pain and pressure can arise due to tumor growth. In these rare cases, other potentially very serious symptoms include:

• Seizures
• Nausea and vomiting
• Numbness
• Swelling in the eyes and vision problems
• Paralysis and weakness, often on one side of the body
• Speech problems
• Changes in personality
• Irritability

Brain tumors can also form without causing any pain or discomfort, as the brain cells may not register pain. The headaches and other symptoms arise once tumor growth impacts nerves and vessels in and around the temples.

Treatment

Treatment approaches to temple headaches depend on what’s causing them. When it arises due to another condition, such as an infection, the symptoms resolve when the health condition improves. There are several strategies to manage the pain and discomfort of most tension headaches, including:

• Over-the-counter (OTC) medications: OTC pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen) and Bayer (aspirin), and those that combine NSAIDs with caffeine, like Excedrin, can help manage acute headache pain.
• Prescribed medications: Combination drugs that mix opioids or other stronger pain medications with NSAIDs may also be considered, though there are concerns about side effects and physical dependency. Generally, the goal of therapy is to minimize or avoid using stronger drugs.
• Relaxation techniques: Since tension headaches often cause temple pain and pressure, developing methods of managing stress can help prevent and minimize symptoms. Yoga, mindfulness and meditation, and other activities can help you cope while promoting relaxation.
• Lifestyle changes: Getting enough exercise and sleeping enough and at consistent times can also help prevent attacks. Dehydration can set off headaches, so make sure you’re drinking enough water. Steer clear of alcohol and tobacco.
• Therapy: For difficult to manage cases, cognitive behavioral therapy (CBT) may be considered to help you develop means of coping with the pain. The therapist can also help you manage the emotional fallout and mental health burden of living with headaches.
• Alternative methods: There’s evidence that acupuncture may help some with headaches by stimulating certain nerves associated with pain. Massage and physical therapy can help ease tension or recover from injuries that may be at the root of the headaches.

Migraine Management

Migraines can be difficult to manage, and there’s no outright cure for the condition. In addition to standard approaches to headache problems, such as relaxation techniques and lifestyle changes, therapies include:

• Rescue medications: After a migraine has set on—and if OTC pain medications don’t work—doctors prescribe two classes of drugs: triptans and ergot alkaloids. Triptans, which are prescribed more often, include Imitrex (sumatriptan) and Zomig (zolmitriptan). These are available as injections, tablets, or nasal sprays (for faster onset).
• Preventive medications: Three kinds of drugs are taken regularly to prevent attacks: tricyclic antidepressants, anticonvulsants used to treat seizures, and antihypertensive drugs for blood pressure.
• Rest and relaxation: When a migraine has begun, go to a quiet, dark room and try to take a nap. Laying a warm towel over your forehead and face can help ease the pain.
• Biofeedback: Wearing devices that track your body’s signs of tension and stress, you learn to recognize the onset of a migraine. Eventually, you’ll be able to be proactive about managing them, easing their burden.
• Neurostimulation: In difficult to treat, chronic migraine cases (having 15 or more attacks a month), devices can be used to stimulate nerves in the head and neck. These emit low-level electrical or magnetic signals to scramble pain signaling at its source.

Temporal Arteritis Treatment

In addition to symptom management, temporal arteritis treatment focuses on reducing inflammation surrounding the temporal artery. Generally, oral corticosteroids, such as prednisone, are prescribed first, with another drug, Actemra (tocilizumab), added on.

This therapy is generally prolonged—taking one to two years—which can affect the health of your bones and make them more brittle. As such, you’ll need to take vitamin D supplements and bisphosphonates, quit smoking and reduce alcohol intake, and exercise.

When to See a Healthcare Provider

While most headaches don’t require hospitalization, it’s important to know the signs that you need help. Here’s when you should call 911:

• You black out or lose consciousness after hitting your head or jolting it
• Your headache sets on very rapidly
• The pain is more severe than it’s ever been
• The pain gets progressively heavier over a 24-hour period.

In addition, call your healthcare provider if your headache is accompanied by:

• Fever and neck stiffness
• Loss of muscle and limb coordination
• Loss of balance
• Difficulty remembering, slurred speech
• Pain and redness behind an eye or eyes
• Difficulty chewing or swallowing

Summary

Temple headaches are a common type of headache that can occur for a variety of reasons. They can be felt in one or both temples in the form of pain, pressure, dull achiness, or intense throbbing. The most common causes of temple headaches include tension in the head, neck, or back, migraines, TMJ disorders, and infections. They can also be caused by a tumor, but this is much rarer.

Treatments vary depending on the cause, but usually consist of various lifestyle changes, such as getting quality sleep, staying hydrated, exercising, and eating a healthy diet. Sometimes, headaches can be managed with rescue or preventive medicines, biofeedback, or neurostimulation.