Pain in the temples (the sides of the head) is one of the most common locations for many different types of headaches. The cause of headache at temples and temple pain is not unique to any single cause—it can stem from primary headache disorders, lifestyle factors, or underlying concerning medical conditions (secondary headache disorders). Determining the most likely cause requires a detailed discussion of your medical history, a physical examination, and analysis of the headache’s pattern, character, location, associated symptoms, age, and other factors. While most temple headaches are not life-threatening, they can significantly impact daily life. This guide covers the most common causes, differentiation strategies (one-sided vs. double-sided), and critical red-flag conditions requiring urgent evaluation.
This content is for educational purposes only and is not a substitute for professional medical advice. You can also use the free headache symptom checker tool developed by a headache specialist to generate a list of possible headache types to discuss with your doctor. Always consult a healthcare provider for personalized evaluation.
Most Common Causes of Temple Headaches
So what causes temple headaches? Temple headaches are frequently reported across many headache types. This guide focuses on the top common causes and a few that warrant urgent medical attention. A helpful way to differentiate them is by laterality: one-sided temple pain versus pain affecting both sides simultaneously.
One-Sided (Unilateral) Temple Headaches
Migraine
Migraine headaches are very common, affecting about 1 in 5 women (20%) and 1 in 16 men. They are classically one-sided (only one side of your head) and often involve the temple region, though they can occur on both sides and do not have to be strictly unilateral. The pain is typically throbbing, pulsating, or pounding. Associated symptoms often include nausea, sensitivity to light (photophobia), sensitivity to sound (phonophobia), and worsening with physical activity. Many patients seek relief in a dark, quiet room. There are numerous migraine triggers, including stress, sleep changes, hormonal fluctuations, and dietary factors.
Trigeminal Autonomic Cephalalgia (TAC)
Cluster headaches are 1 of 4 varieties of trigeminal autonomic cephalalgia (TAC) syndromes. They occur strictly on one side of the head, frequently involving the temple, but often the area around the eye and forehead as well. They do not occur on both sides. They are considered among the most severe headaches—sometimes referred to as “suicide headaches” due to their intensity. Cluster headache pain is often described as severe, ice-pick-like stabbing. Attacks occur in “clusters,” with multiple episodes per day (often at similar times, such as overnight), lasting 15 minutes to 3 hours. Cycles can persist for weeks to months. They commonly align with seasonal changes (e.g., fall or spring) but can happen anytime. Autonomic features on the affected side may include a droopy, puffy, red, or tearing eye, and/or a congested or runny nose.
The 3 additional less common TAC syndromes that can present with strictly one-sided temple pain and autonomic features include hemicrania continua, paroxysmal hemicrania, and SUNCT/SUNA. These headache types are differentiated from cluster headache and from one another by headache duration and frequency of attacks.
Double-Sided (Bilateral) Temple Headaches
Tension-Type Headache
Tension-type headaches are by far the most common cause of bilateral temple headaches. Tension headaches are the most common type of headache type worldwide. They typically affect the temples and forehead symmetrically, often described as a dull aching pressure or a tight band around the head that may extend to the back of the head. Neck muscle tension and aching frequently accompany them. Common triggers include lack of sleep, sleep apnea, and stress.
Temporomandibular Joint (TMJ) Dysfunction
Temporomandibular Joint (TMJ) Dysfunction involves problems in the jaw joint that cause jaw pain. This pain can radiate to the areas in front of and around the ears and often extends into the temples. It frequently occurs bilaterally but can be unilateral. Teeth grinding (bruxism) is commonly associated with TMJ disorders.
Hypertension
Hypertension (high blood pressure, technically 140/90 or higher) is a very common condition that can cause headaches in the temple areas, usually bilaterally. Hypertension headaches may feel pulsating (though migraines can also cause this sensation), like pressure, aching, or dull discomfort. Other symptoms can include fatigue, dizziness, and shortness of breath. If you have hypertension, work with your healthcare provider to manage blood pressure and reduce long-term risks beyond headaches.
Other Notable But Less Common Causes of Temple Headaches
Sinus Headaches / Sinusitis-Related Pain
True sinus headaches caused by acute or chronic rhinosinusitis (infection) are relatively uncommon compared to popular belief. Many people with self-diagnosed “sinus headaches” actually have migraine attacks that activate the trigeminal nerve, producing nasal congestion, runny nose, and facial pressure. When true sinus-related pain occurs, it often involves the areas around the eyes, the forehead areas over the frontal sinuses, or below the eyes in the cheeks over the maxillary sinuses. However, the temples can sometimes be involved due to referred pain from the frontal, maxillary, or ethmoid sinuses. Sinus headaches from a sinus infection can be worse with bending forward, and are usually associated with postnasal drip, nasty colored nasal discharge, and fever. It can be unilateral if one sinus is primarily affected.
Idiopathic Intracranial Hypertension or IIH (Pseudotumor Cerebri):
IIH is typically bilateral and can involve the temples, but can also be variable throughout the head, or include the whole head. IIH is caused by an elevated pressure of the cerebrospinal fluid. Additional symptoms can include pulsatile tinnitus (whooshing in the ears), visual disturbances such as black outs of vision with straining, coughing, bending forward (transient visual obscurations) lasting a few seconds, and papilledema (swelling of the optic nerves). This is more common in overweight women of childbearing age, but can be seen in anyone.
Low CSF Pressure Headache (CSF leak; Intracranial Hypotension)
A leak of the cerebrospinal fluid (CSF) causes a characteristic positional headache which worsens upon standing, and improves when lying down. It is usually a bilateral headache. It can involve the temples, but often is felt throughout the whole head including the back of the head and neck.
Less Common But Emergent Types Of Temple Headaches
These conditions can involve the temples (unilaterally or bilaterally) and are considered “red flag” headaches requiring prompt medical evaluation. They are secondary headaches, meaning the pain results from an underlying problem.
Giant Cell Arteritis (Temporal Arteritis)
Giant Cell Arteritis (GCA) is an inflammatory condition that affects the temporal arteries in the temple regions and is less common but important to recognize. It more often causes bilateral pain but can be unilateral. Associated symptoms include jaw cramping (claudication), blurry vision, scalp sensitivity or soreness, and tender, hardened arteries in the temples when touched. It predominantly affects people over age 50. Untreated, it risks vision loss or blindness; prompt steroid treatment is critical. Patients over 50 with new temple pain should be screened with ESR and CRP blood tests. A biopsy of the temporal artery is often done to help confirm diagnosis.
Brain Aneurysm
A brain aneurysm is a weakened, bulging area in an artery wall. Unruptured aneurysms usually do not cause headaches, but rupture produces a sudden, intense “thunderclap headache” (often described as the “worst headache of your life”), along with nausea, vomiting, stiff neck, confusion, loss of consciousness, vision problems, or other neurological symptoms. Risk factors include older age, high blood pressure, diabetes, genetic conditions, smoking, and atherosclerosis. This is a medical emergency—call 911 immediately, as time is critical.
Brain Tumor
Brain tumors involve abnormal cell growth in the brain. Associated headaches often worsen gradually over time and may accompany persistent neurological symptoms such as vision changes, double vision, numbness, tingling, weakness, imbalance, or cognitive changes. While rare as a headache cause, any new or changing headache pattern should prompt discussion with your doctor for timely evaluation.
Meningitis
Meningitis is an infection of the spinal fluid affecting the meninges (protective layers around the brain) and potentially the brain itself. It typically causes a symmetric (bilateral) headache that may involve the temples or the entire head. Common accompanying symptoms include severe neck pain and stiffness, fever, chills, confusion, disorientation, drowsiness, or other neurological issues. This requires immediate medical attention.
Comparison of Common Temple Headache Causes
- Migraine: Often one-sided (but can be both sides), throbbing, with nausea/photophobia/phonophobia.
- Cluster: Strictly one-sided, extreme stabbing pain with autonomic features.
- Tension-Type: Bilateral, band-like pressure, often with neck tension.
- TMJ: Often bilateral (can be unilateral), linked to jaw pain/teeth grinding.
- Hypertension: Bilateral, pulsating/pressure with systemic symptoms.
Red-flag conditions (GCA, aneurysm, tumor, meningitis) require urgent care and often have additional warning signs.
Conclusion
So when you ask yourself, “why do I have a headache in my temples”, and are wondering what causes temple headaches, there are some important points to keep in mind. Temple headaches have many possible meanings and causes—most are benign (such as tension-type or migraine), but some can be serious or life-threatening and require emergency care. There are many other headaches which can cause temple pain and temporal headache, including head injury. Any new, changing, or concerning headache should be evaluated by a doctor. Early diagnosis leads to better management and peace of mind.
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