From the Research
Temporal headaches are most commonly caused by tension-type headaches, which typically produce a band-like pressure or tightness around both temples. According to the most recent and highest quality study available, tension-type headache (TTH) is the most common primary headache disorder, with a worldwide lifetime prevalence of 46% to 78% 1. TTH causes greater disability and accounts for more missed work days than migraine. The etiology of TTH is thought to be multifactorial, involving genetic and environmental factors.
Key Characteristics of Tension-Type Headaches
- Tension-type headaches typically describe headache pain as pressing, dull, and with the sensation of a tight band around the head 1
- Nonprescription analgesics are indicated for management of episodic TTH 1
- Prophylaxis should be considered for patients with chronic TTH, with very frequent episodic TTH, at risk of medication overuse headache, and who are unable to tolerate effective doses of first-line drugs 1
- Amitriptyline is recommended as a first-line drug for prophylaxis 1
Other Causes of Temporal Headaches
- Migraines often cause throbbing pain that may be more intense on one side of the head, including the temporal region
- Temporal arteritis (giant cell arteritis) specifically affects the temporal arteries and causes severe, burning pain in the temples, often accompanied by scalp tenderness, jaw pain when chewing, and systemic symptoms like fever and weight loss
- Cluster headaches can also cause temporal pain, characterized by excruciating pain around one eye that may radiate to the temple
- Sinus headaches may cause pressure in the temples due to congestion in the sinuses
- Other causes include cervicogenic headaches from neck issues and temporomandibular joint (TMJ) disorders, which can refer pain to the temples due to jaw muscle tension and inflammation
It's worth noting that while other studies support the use of NSAIDs and acetaminophen for short-term pain relief in patients with TTH 2, and the effectiveness of amitriptyline for prophylactic treatment of chronic TTH 3, 4, the most recent and highest quality study available 1 provides the most relevant and up-to-date information on the topic.