Pain when pressing on the side of the head, especially around the ear and temple, often involves the temporal bone. Discomfort in this region can stem from various underlying issues, and understanding these can help determine when medical evaluation is needed.
Understanding the Temporal Bone
The temporal bone is a paired bone that forms a large part of the skull’s sides and base. It protects the brain’s temporal lobe and contains several sections, including the squamous, mastoid, petrous, and tympanic parts.
It primarily protects the ear’s structures, including those for hearing and balance. The temporal bone also forms part of the temporomandibular joint (TMJ), connecting the lower jaw to the skull for chewing and speaking. Many cranial nerves and blood vessels pass through this bone.
Common Reasons for Pain
Pain in the temporal bone area often stems from temporomandibular joint (TMJ) issues. This joint, located in front of the ear, can develop disorders (TMDs) causing pain or tenderness in the jaw, ear, and temple. Symptoms may include clicking or popping sounds, difficulty chewing, or jaw locking. TMDs can result from teeth grinding (bruxism), jaw injury, or displacement of the joint’s cartilage disk.
Muscle tension and headaches frequently contribute to temporal bone pain. Tension headaches can cause a constant, band-like pressure on both sides of the head, including the temporal areas. The temporalis muscle, a chewing muscle over the temporal bone, can become inflamed or overworked, leading to pain that may spread to the ears, shoulders, and neck. Bruxism can also strain these muscles, causing discomfort in the temporal region.
Ear infections can cause pain around the temporal bone. Mastoiditis, an infection of the mastoid process (a part of the temporal bone behind the ear), causes throbbing pain, swelling, and redness. This condition often develops when middle ear infections spread to the bone. Otitis media can also cause ear pain that radiates to the adjacent bone.
Sinus inflammation (sinusitis) can cause referred pain in the temporal region. This happens as pressure builds within inflamed sinus cavities, which are connected to nasal passages and can affect surrounding bone. Dental problems, such as severe toothaches or abscesses, can also lead to referred pain in the temporal area due to the head and face’s nerve network.
Nerve irritation is a common source of temporal bone pain. Trigeminal neuralgia causes intense, sharp, electric shock-like pain affecting the trigeminal nerve, which supplies sensation to the face, including areas near the temporal bone. This pain is often triggered by light touch, chewing, or a breeze. Occipital neuralgia causes pain that typically starts at the base of the head and can radiate to the scalp, temples, and behind the eye.
Head trauma or injury can directly affect the temporal bone. A direct impact or blunt force can cause temporal bone fractures. Such injuries can damage ear structures, nerves, or blood vessels passing through the bone, potentially causing hearing loss, balance issues, or facial paralysis, in addition to pain.
Recognizing When to Seek Medical Attention
Certain symptoms indicate a need for medical evaluation. Persistent pain that does not improve with self-care or over-the-counter remedies needs attention. Pain accompanied by fever, swelling, or redness around the temporal area can suggest an infection or inflammatory process.
Other signs include changes in vision, new or worsening hearing loss, or weakness or paralysis on one side of the face. If the pain is severe, sudden, or accompanied by dizziness or confusion, seek prompt medical attention. These indicators can suggest more serious conditions.
Diagnosis and Treatment Approaches
A healthcare professional diagnoses temporal bone pain by taking a medical history and performing a physical examination. This often includes assessing jaw movement, checking for tenderness in muscles and joints around the temporal bone, and evaluating ear and nerve function. This information helps narrow down potential causes.
Imaging studies are used to visualize the temporal bone and surrounding areas. Computed tomography (CT) scans evaluate bone structures, detecting fractures or degenerative changes in the TMJ. Magnetic resonance imaging (MRI) assesses soft tissues, including the TMJ disc, muscles, and nerves, providing insights into conditions like nerve irritation or muscle inflammation.
Treatment varies depending on the underlying cause. For muscle-related issues or TMJ disorders, conservative measures often include pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. Lifestyle modifications such as eating soft foods, avoiding excessive jaw movements, and stress reduction techniques are also beneficial. Physical therapy, including specific jaw exercises, may help improve jaw function and reduce pain.
For infections like mastoiditis, antibiotics are prescribed, sometimes intravenously for serious cases. If an infection leads to an abscess or doesn’t respond to antibiotics, surgical drainage or removal of infected tissue is necessary. For nerve-related pain, specific medications or nerve blocks manage symptoms. Temporal bone trauma may require observation or surgical intervention depending on the injury’s extent and complications.