Headache in Temples: Causes, When to Worry, Treatment

Headache in the Temples — Causes, When to Worry and Treatment

What usually causes pain in the temples, the warning signs that need urgent care, and what helps. Explained by a Sydney neurologist.

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When a Headache in the Temples Needs Urgent Care

Most headaches in the temples are not dangerous. A few patterns need care straight away, so they come first.

Call 000 — or go to an emergency department — if

a headache comes on suddenly and severely and reaches its worst within a minute (the worst headache of your life), even if it then eases
the headache comes with fever and a stiff neck, a rash that does not fade when pressed, confusion or unusual drowsiness
you are over 50 with a new headache and you notice blurring, double vision, or sight that dims or goes dark in one eye, even if it lasts only a few minutes
an eye becomes painful and red, especially with blurred vision, halos (coloured rings) around lights, or nausea and vomiting
the headache comes with sudden loss of vision (even if brief), double vision, a new drooping eyelid or one pupil larger than the other, slurred speech, sudden severe dizziness or unsteadiness, or numbness or weakness of the face, an arm or a leg
the headache started after a head injury and is getting worse, comes with vomiting, drowsiness or confusion, or you take blood-thinning medicine
the headache comes with a seizure

A sudden, explosive headache, wherever it is felt, can mean bleeding around the brain (a subarachnoid haemorrhage). In someone over 50, a new headache with a change in vision can mean giant cell arteritis is cutting off the blood supply to the eye (see below): treated the same day, sight can usually be saved, but sight that is lost rarely comes back. A painful red eye with blurred vision and halos can mean a sudden rise in the pressure inside the eye (acute angle-closure glaucoma), which can permanently damage sight if it is not treated quickly. Weakness, trouble speaking or a sudden loss of vision can mean a stroke. A new drooping eyelid or a change in the size of one pupil can mean pressure on a nerve from a bulging blood vessel (an aneurysm) or a tear in the wall of an artery in the neck (a dissection). After a blow to the side of the head, bleeding inside the skull can build up over hours, sometimes after a spell of feeling well. Fever with a stiff neck can mean meningitis. A seizure with a headache needs urgent checks for a cause in the brain. All need urgent treatment. If you already know you have cluster headache, a red, watering eye, a drooping eyelid or a smaller pupil on that side during your usual attacks are part of it and settle afterwards; a first attack, an attack that is different, blurred vision or halos, or eye signs that stay after the attack still need urgent care. If you have migraine with aura, your usual aura (shimmering or zigzag lines that spread slowly over several minutes and clear within an hour) is part of your migraine; a first aura after 50, an aura that is different from your usual one, or sight that goes dark in one eye needs urgent care. Remember FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 000.

See your GP the same day if

it is a new headache and you are over 50, especially if it is at the temples or comes with a tender scalp, a tender or thickened artery at the temple, pain in the jaw when you chew that eases when you stop, aching shoulders, or feeling generally unwell; with any change in your vision, see the list above
a rash of small blisters appears on one side of the forehead, temple or scalp, often after 2 or 3 days of burning or tingling pain there
the headache is getting steadily worse over days or weeks, or is worst on waking or when lying down, with vomiting or blurred vision
the headache is brought on by coughing, sneezing, laughing or straining, or comes with a whooshing sound in the ears in time with your heartbeat
you have a fever with the headache
you have cancer or a weakened immune system
you are pregnant or have had a baby in the last few weeks; with blurred vision or sudden swelling of the face or hands, contact your maternity unit or go to hospital now

Fever can mean an infection. Cancer, a weakened immune system, and pregnancy or a recent birth each make some serious causes more likely, such as high blood pressure of pregnancy (pre-eclampsia), so the bar for checking is lower. The other items are explained further down this page. If you cannot see your GP that day, go to an emergency department. If something matches both lists, follow the 000 list.

Where most people sit

These patterns are uncommon. Most headaches in the temples are tension-type headache or migraine, or come from the jaw: common conditions that do not damage the brain and can be treated. Giant cell arteritis is the one to keep in mind after 50: it almost never starts before then, it is uncommon even after 50, and it is treatable when it is caught early. If you are worried about a brain tumour: in a large UK study of family-doctor records, fewer than 1 in 1,000 people who saw their GP with a headache were later found to have one, and tumours usually cause other symptoms too, such as weakness, seizures, a change in personality, or a headache that gets steadily worse over weeks.

Why Do My Temples Hurt?

When a headache throbs in your temples, it is easy to picture a swollen blood vessel under the skin, pulsing with every heartbeat. For a long time, doctors thought much the same: that migraine pain came from arteries widening outside the skull. Then researchers in Denmark scanned the arteries of 19 women during migraine attacks. The artery at the temple showed no real widening, and the arteries inside the skull had widened only slightly. So if a swollen blood vessel is not the cause, why do the temples throb?

The answer lies in the nerves. The skin of the temple is supplied by branches of the trigeminal nerve, the main nerve of the face. One of them, the auriculotemporal nerve, also carries feeling from the jaw joint, part of the ear, and part of the coverings of the brain. In migraine, the problem starts in the brain's own pain pathways. The brain tissue itself cannot feel pain, but the pathways that carry and process pain signals from the head become oversensitive, so even ordinary signals are felt as pain, and moving makes it worse. It is a little like sunburnt skin: the skin looks the same, but even a light touch hurts.

The temple is also a crossroads. Under the skin sit one of the main chewing muscles (the temporalis, which tightens when you clench your teeth), an artery you can feel pulsing just in front of the ear (the superficial temporal artery) and, just below, the jaw joint. So pain in the temples can come from tense muscles in a tension-type headache, from the brain's own pain system in migraine, from a strained jaw or, more rarely, from an inflamed artery. Each leaves its own clues, and the rest of this page is about reading them.

Where most people sit

A headache in the temples is felt through the muscles, nerves and blood vessels of the head, not in the brain tissue itself. Most are tension-type headache, migraine or jaw strain. They can be painful and they can keep coming back, but they do not damage the brain, and most improve once the cause is clear.

The Common Causes of a Headache in the Temples

Each of these has a typical pattern. No single feature proves one, but together they point to it.

Tension-type headache. The most common headache of all: in different studies, between 30% and 78% of people have had one. It feels as if something is pressing on your head or tightening around it, like a weight or a tight band, usually on both sides and often spread across the head, including both temples. It is mild to moderate, does not throb, and you can usually carry on with your day. Stress, tiredness, poor sleep and long hours at a desk make it more likely. The muscles of the head, including those at the temples, are often tender, and pressing on tender spots in the temple muscle can bring on the familiar pain. Read more about tension headache.
Migraine. In a study at a US headache centre of nearly 1,300 people with migraine, 58% felt the pain in the temples, second only to around the eyes (67%). It is often on one side, though it can switch sides or affect both. It is usually throbbing, moderate to severe and worse with activity, lasts 4 to 72 hours, and comes with nausea or a dislike of light and noise. Stress, missed meals and poor sleep are among its most common triggers. Some people see flashing lights or zigzag lines before the headache: see migraine aura.
The jaw (temporomandibular disorder, or TMD). Problems with the jaw joint and the chewing muscles affect about 6 to 9 in 100 adults, and after toothache they are the most common cause of pain in the face. The headache is usually in the temples, on one or both sides, often with an ache in front of the ear or in the cheek. It is worse when you chew, talk a lot, yawn, or clench or grind your teeth (some people do this in their sleep without knowing), and pressing on the muscle at the temple, or moving the jaw, can bring it on. The jaw may click, pop or grate, feel stiff, or not open fully.
Medication-overuse headache. Pain relief taken on too many days a month can itself keep headaches going, and can turn occasional headaches into near-daily ones. See medication overuse headache.
Pressure on the temples. A tight hat, helmet or headband, or the strap or rim of swimming or diving goggles, can cause a headache where it presses. It starts within an hour of putting it on, is worst at that spot, and settles within an hour of taking it off.

Tension-Type Headache, Migraine, Jaw Pain, Cluster Headache or Giant Cell Arteritis?

These features help tell the five apart.

Swipe the table sideways to compare all five →

Feature	Tension-type headache	Migraine	The jaw (TMD)	Cluster headache	Giant cell arteritis
Where it hurts	Both sides, often spread across the head, including both temples; like something pressing on the head or tightening around it	Often one side, but it can switch sides or affect both; the temples are the second most common place, after around the eyes	The temples, on one or both sides; often in front of the ear or in the cheek too	Always one side: in, around or behind one eye, or in the temple; usually the same side throughout a bout	One or both temples, or elsewhere on the head; the scalp is often tender to touch
Feels like	Pressing or tightening, mild to moderate	Throbbing, moderate to severe, worse with activity	An ache that is worse when you use the jaw	Very severe; often described as a hot poker in or behind the eye	A new headache that does not go away; its feel varies
How long	30 minutes to 7 days	4 to 72 hours	Comes and goes with jaw use; can last for months	15 minutes to 3 hours, from once every other day to 8 times a day, in bouts lasting weeks or months	Usually present most of the time, for days or weeks, until it is treated
Brought on by	Stress, tiredness, poor sleep, long hours at a desk	Stress, missed meals, poor sleep, hormonal changes, weather changes, alcohol	Chewing, talking, yawning, clenching or grinding the teeth	During a bout, alcohol can set off an attack	Nothing in particular; chewing can make the jaw ache
Other symptoms	Usually none; no more than mild nausea	Nausea, a dislike of light and noise; sometimes aura	Clicking or grating of the jaw, a stiff jaw, an ache in front of the ear	On the same side: a red, watering eye, a blocked or runny nostril, a drooping or swollen eyelid; restlessness, pacing	Age over 50; a tender scalp, jaw pain when chewing, aching shoulders, feeling unwell; changes in vision

Headaches every day? A headache on 15 or more days a month is often called chronic daily headache. The usual causes are frequent tension-type headache, migraine that has become chronic, and taking pain relief on too many days, which can itself keep headaches going; often more than one is present, and a strained jaw, clenching or grinding can add to them. If you have caffeine every day, stopping or delaying it can bring on a headache within a day that settles within a week. Daily headaches are common, and treatable once the causes are sorted out. A daily headache that is new after 50, or that keeps getting worse, needs your GP the same day.

Where most people sit

The table is a guide, not a diagnosis. The features overlap: jaw pain and tension-type headache often go together, and many people have more than one kind of headache. Cluster headache affects about 1 in 1,000 people, and giant cell arteritis is uncommon and almost never starts before 50. Sorting out which headache, or headaches, you have is the main job of the consultation.

Giant Cell Arteritis: Why a New Headache After 50 Matters

Giant cell arteritis (also called temporal arteritis) is an inflammation of the walls of arteries, especially the arteries at the temples. It is uncommon and treatable, but of all the causes of a headache in the temples, it is the one that most needs to be found quickly, because it can affect the eyesight.

Who gets it. Almost only people over 50: on average, people are in their late 70s when it is found, and about 7 in 10 are women. Each year about 1 in 10,000 people over 50 develop it.
The headache. A new headache that does not go away, often at one or both temples, though it can be anywhere on the head. Its feel varies, and for some people it is the only symptom at first.
The clues. A tender scalp, so that brushing your hair or resting your head on a pillow hurts (the scalp can also feel tender during a migraine attack; in giant cell arteritis the tenderness is new and does not go away); pain in the jaw muscles when you chew that eases when you stop, one of the strongest clues; an artery at the temple that is thickened, tender or has lost its pulse; aching and stiffness in the shoulders or neck, worst in the morning; and feeling generally unwell, with tiredness, fever, sweats or weight loss.
Why it is urgent. The inflammation can cut off the blood supply to the nerve at the back of the eye. Blurring, double vision, or sight that dims or goes dark for a few minutes can come first: if this happens, go to an emergency department now. Sight that is lost rarely comes back, and the other eye can follow, usually within a week. In a Swedish study of 840 people with giant cell arteritis, about 1 in 10 had a problem with their sight. Prompt treatment protects the sight, which is why it is started without delay, often before all the test results are back.
How it is found. Blood tests for inflammation, then either an ultrasound scan of the arteries at the temples or a small sample of the artery, taken with the skin numbed (a biopsy). An ordinary brain scan is not the test for it, so a normal brain scan does not rule it out.

Where most people sit

Giant cell arteritis is uncommon, and most people over 50 with a headache in the temples have tension-type headache, migraine or a jaw problem. The same-day visit is not because the worst is likely: it is because a blood test is a simple first step, and treatment, when it is needed, protects the sight. If your GP thinks it is possible, international guidelines advise that you see a specialist within 24 hours.

The Less Common Causes Doctors Look For

A few other conditions can cause pain in the temples. Each is uncommon, and each usually has a pattern that gives it away.

Cluster headache. Much less common than migraine, and very severe: pain in, around or behind one eye or in the temple, always on one side and usually on the same side throughout a bout, lasting 15 minutes to 3 hours, from once every other day to 8 times a day, in bouts that last weeks or months. On the same side the eye usually turns red and waters, the nostril blocks or runs, and the eyelid can droop or swell. People pace or rock rather than lie still. It affects about 1 in 1,000 people, is three times more common in men, and usually starts between 20 and 40. During a bout, alcohol can set off an attack. The eye signs settle after each attack; a first attack like this, or one that is different from your usual attacks, needs same-day assessment in an emergency department. Read more about cluster headache.
Shingles. Burning or tingling pain on one side of the forehead, temple or scalp, followed after 2 or 3 days by a rash of small blisters there. Treatment works best when it is started early, so see your GP the same day. If the rash reaches the tip of the nose, or the eye becomes red, painful or blurred, go to an emergency department the same day, because shingles can affect the eye.
A tooth problem. An infected tooth or gum, or an inflamed gum around a partly grown lower wisdom tooth, usually causes toothache or pain in the face, but can spread pain to the head on the same side. Pressing or tapping on the tooth usually makes it worse. See a dentist; with a swollen face or a fever, go the same day.
Raised pressure inside the head. A headache that is worse lying down or first thing in the morning, sometimes with vomiting or blurred vision, and that gets steadily worse, can mean pressure is building up, for example from a blockage of the fluid pathways or, rarely, a tumour. Raised pressure of the fluid around the brain without a tumour (idiopathic intracranial hypertension) can also cause a whooshing sound in the ears in time with the heartbeat, and is most common in women of child-bearing age. All need prompt assessment, because some can affect sight.

A headache set off within a second or two of coughing, sneezing, laughing or straining is a different condition (cough headache). It peaks almost at once and usually fades over seconds to minutes. About 4 in 10 cough headaches have an underlying cause, most often a Chiari malformation, where the lowest part of the brain sits lower than usual and crowds the top of the spinal canal. So a cough headache is always worth having checked, usually with an MRI scan. Headaches that come on with hard exercise or during sex are assessed with the same care: see headache after exercise.

Where most people sit

These causes are uncommon, and they usually announce themselves: one-sided attacks with a red, watering eye, a rash, a tender tooth, a headache that changes with lying down or coughing, or one that worsens week by week. A careful history and examination usually tell the doctor whether any of them is possible, and the right test, when one is needed (a scan, blood tests, an eye check or a dental check), usually settles the question.

How Is the Cause Found?

Most of the time the cause is found from your story and an examination. Tests are for when the pattern raises a question.

Your story. Where the pain is and whether it is on one side, what it feels like, how long it lasts, what brings it on (stress, short sleep, chewing, clenching, goggles or a tight hat), whether your jaw clicks or aches, how often you take pain relief, how much caffeine you have, and any other symptoms, including any change in your vision.
The examination. A full neurological examination, including the back of the eyes and your blood pressure, and a check of the arteries at the temples, the scalp, the jaw joints and chewing muscles, and the neck.
Blood tests, when you are over 50. Tests for inflammation are the first step when giant cell arteritis is possible, followed by an ultrasound scan of the arteries at the temples or a biopsy.
A scan, when it will change what happens next. An MRI scan is the usual test when the pattern points away from the common causes, for example one-sided attacks with a red, watering eye, a headache that is worse lying down, or one set off by coughing. Most people with tension-type headache, migraine or jaw pain do not need one.
An eye check or a dental check, when they fit. An eye check measures the pressure inside the eye and looks at the nerve at the back of it; a dentist can check the teeth and the jaw joint.

A few weeks of a headache diary (when the pain came, where it was, what you were doing, what you took) often makes the pattern clear.

How to Get Rid of a Headache in the Temples

The right treatment depends on the cause, which is why the diagnosis comes first. These help most people.

For the headache today. Rest, a drink of water, something to eat if you have missed a meal, loosening anything tight on your head, and simple pain relief from the pharmacy can ease a tension-type headache.
Keep pain relief to two or three days a week at most. Taking it on too many days (15 or more days a month for simple pain relievers, 10 or more for some others) can itself keep headaches going: see medication overuse headache.
Rest the jaw. If your jaw is involved: softer food for a while, no chewing gum, no very wide yawns, and noticing when you clench so you can let the jaw relax.
Jaw exercises and hands-on therapy. For jaw pain that has lasted 3 months or more, an international guideline recommends jaw exercises and stretching, hands-on therapy and posture exercises guided by a physiotherapist, and psychological therapy for pain, such as cognitive behavioural therapy.
Loosen what presses. A looser hat, helmet strap or goggles usually stops that kind of headache.
Sleep, meals, water and stress. Regular sleep, regular meals, enough water, regular exercise and ways to manage stress, such as relaxation training or psychological therapy, reduce how often headaches come. In a trial in people with recurrent headaches, drinking more water helped them feel better, though it did not reduce the number of headache days.
Keep caffeine steady. If you have caffeine every day, stopping suddenly can bring on a headache within a day that lasts up to a week. If you want to cut down, do it gradually.
Cluster headache has its own treatments, both for the attacks and to prevent them during a bout, so it needs a doctor's diagnosis: see cluster headache.
Giant cell arteritis is treated as soon as it is suspected, usually by a rheumatologist (a specialist in inflammation of the joints and blood vessels) together with your GP, and the treatment then continues for many months.
Medicine, when headaches are frequent. Preventive medicines can reduce how often headaches occur. Your doctor can advise whether they suit you.
Treat the migraine, if migraine is present. Migraine treatment and prevention help the headache wherever it is felt.

Where most people sit

Most people improve once the cause is clear and the treatment matches it, often with simple changes to sleep, caffeine, jaw habits and how pain relief is used. For those who need more, there are preventive treatments that help many people.

When to See a Neurologist About Headaches in the Temples

Headaches in the temples keep coming back, or are becoming more frequent
Headaches on most days, or you are taking pain relief on many days a month
You are not sure whether it is tension-type headache, migraine, your jaw or something else
One-sided attacks with a red, watering eye or a blocked or runny nostril
A constant headache on one side that never fully goes away
A new headache after 50 (see your GP the same day first)
You want a clear diagnosis and a plan

A consultation involves a detailed history, a neurological examination and a plan: working out which headache, or headaches, you have, arranging tests when the result will change what happens next, and coordinating with your GP and, when needed, a dentist, a physiotherapist, an eye specialist or a rheumatologist. Dr Ron Granot trained at Prince of Wales Hospital, Sydney, and sees patients in Bondi Junction. For the wider picture, read our migraine overview.

Frequently Asked Questions

What causes a headache in the temples? +

Most often tension-type headache, which feels like pressure or a tight band on both sides of the head, or migraine, which usually throbs, is often on one side and comes with nausea or a dislike of light and noise. Strain in the jaw joint and chewing muscles, pressure from tight goggles or a hat, and taking pain relief on too many days are other common causes. Less often it is cluster headache, a tooth problem, shingles or, after 50, giant cell arteritis, which needs your GP the same day, or an emergency department straight away if your sight changes. A sudden, severe headache that peaks within a minute is different: call 000.

Why do I get a headache in my temples every day? +

The usual reasons are frequent tension-type headache, migraine that has become chronic, and taking pain relief on too many days, which can itself keep headaches going; often more than one is present. Clenching or grinding your teeth, poor sleep and caffeine wearing off can add to it. Daily headaches are treatable once the causes are sorted out. A daily headache that is new after 50, or that is getting steadily worse, needs your GP the same day.

Why is the pain only in one temple? +

Migraine is often one-sided, though it can switch sides. Jaw problems often affect one side more than the other. Cluster headache is always one-sided, lasts 15 minutes to 3 hours, and usually comes with a red, watering eye or a blocked or runny nostril on that side. Giant cell arteritis can affect one or both temples. A one-sided headache that comes on suddenly and severely, reaching its worst within a minute, or that comes with weakness, numbness, trouble speaking or a sudden loss of vision, needs 000. Your usual migraine aura or cluster attacks do not need 000; a first attack, or one that is different, needs urgent care. Read more about headaches on one side of the head.

Why do my temples and eyes hurt? +

Migraine is a common reason: in a large study at a US headache centre, about 2 in 3 people with migraine felt the pain around the eyes and more than half in the temples. Tension-type headache can do it too, and so can eye strain after long spells of reading or screen work, though eye strain is a less common cause than most people think. Cluster headache causes severe pain around one eye and temple. A painful red eye with blurred vision or halos around lights needs an emergency department straight away, and so does any change in vision with a new headache after 50.

Can a sore jaw or grinding my teeth cause a headache in the temples? +

Yes. The muscle at the temple is one of the main chewing muscles, so clenching or grinding the teeth, by day or in your sleep, and problems with the jaw joint can cause a headache in the temples, usually with an ache in front of the ear that is worse when you chew. The jaw may click or feel stiff. Jaw exercises and stretching, hands-on therapy from a physiotherapist, and learning to keep the jaw relaxed often help. Pain in the jaw when chewing that starts after 50, with a new headache, is different: see your GP the same day, because it can be giant cell arteritis.

How do I get rid of a headache in my temples? +

It depends on the cause. For a tension-type headache, rest, a drink of water, something to eat if you have missed a meal, loosening a tight hat or goggles, and simple pain relief help. If your jaw is involved, rest it with softer food, avoid chewing gum and try not to clench. To prevent headaches, sleep regularly, eat regular meals, keep caffeine steady, exercise and manage stress. Keep pain relief to two or three days a week at most, because using it more often can keep headaches going. If headaches are frequent, preventive medicines can help.

When should I worry about a headache in my temples? +

Call 000 or go to an emergency department if it comes on suddenly and reaches its worst within a minute; if it comes with fever and a stiff neck, confusion, weakness, loss of vision, double vision, a new drooping eyelid, slurred speech, sudden unsteadiness or a seizure; if an eye becomes painful and red with blurred vision or halos; if you are over 50 with a new headache and any blurring, double vision or dimming of sight; or if it started after a head injury and is getting worse or comes with vomiting or drowsiness, or after any head injury if you take blood-thinning medicine. See your GP the same day if it is new after 50, especially with a tender scalp or pain in the jaw when chewing, keeps getting worse, is worst on waking or when lying down with vomiting or blurred vision, is brought on by coughing or straining, or comes with a blistering rash or a fever.

Could a headache in my temples be a brain tumour or a stroke? +

Very unlikely. In a large UK study of family-doctor records, fewer than 1 in 1,000 people who saw their GP with a headache were later found to have a brain tumour. Tumours usually cause other symptoms as well, such as weakness, seizures, a change in personality, or a headache that gets steadily worse over weeks, with vomiting. A stroke usually causes sudden weakness, numbness, trouble speaking or loss of vision, with or without a headache: call 000 straight away. A headache with a seizure needs 000 too, and one that gets steadily worse over weeks, or comes with a change in personality, needs your GP the same day.

Important: This page is general health information for adults living in Australia and is not a substitute for individual medical advice. If you have a sudden, severe headache that peaks within a minute, a headache with a stiff neck and fever, a headache with weakness, sudden loss of vision, double vision, slurred speech or sudden unsteadiness, a painful red eye with blurred vision, or, if you are over 50, a new headache with blurring, double vision or dimming of sight, or any other warning sign listed at the top of this page, call 000 or go to an emergency department. Diagnosis and treatment decisions are made on an individual basis with your treating doctor.

Headaches in Your Temples?

Book a consultation with Dr Ron Granot — neurologist with a special interest in headache, Bondi Junction. Ask your GP for a referral, then get in touch.

Book a Consultation

Call Us02 9388 0615

LocationSuite 301, Bondi Junction

Emailreception@eastneurology.com.au

Last reviewed: 17 October 2026 by Dr Ron Granot, FRACP — Consultant Neurologist, East Neurology, Bondi Junction.