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Dr. Andrew Rynne

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Suggest treatment for pain in the temple region

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Dr. Riddhi Shah

ENT Specialist

Practicing since :2008

Answered : 507 Questions

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Posted on Thu, 2 Mar 2017 in Ear, Nose and Throat Problems
Question: Hi i have a very bad head ache in my eyebrows , my temples, in between my brows and on top of my head more on the left side and i feel pressure in my ear. For a week now. Tried sinus tablets , panadol and amoxillin for sinus. My xrays showed a swollen nose up the too between my brows but still so sore. The light makes it worse.
Please help !
doctor
Answered by Dr. Riddhi Shah 2 hours later
Brief Answer:
Please see the answer.

Detailed Answer:
Hi,thank you for posting your query on health care magic.

Looking at your symptoms,there can be following possibilities:

1.)Sinusitis-Inflammation in your sinuses.
It is associated with symptoms like Nasal blockage,Nasal discharge,Heaviness in the face along with headache.You might be feeling pressure in your ear due to nasal blockage/congestion.
In such a case you might find relief by taking following medicines:
Antihistaminic like Levocetrizine,
Analgesic and Anti-inflammatory like Ibuprofen with Antacid like Rantac,
Oral Decongestant like Phenyephrine and Nasal Decongestant drops like Xylometazoline(take decongestant only if you are not suffering from high blood pressure,heart disease,kidney disease,or high pressure in the eyes-glaucoma) and
Mucolytic like Ambroxol.
You need to take Antibiotics if your symptoms are suggestive of bacterial infection like high grade fever(more than 101 degree fahrenheit,pus discharge from nose,severe headache,no relief of symptoms after 3-4 days of medication,etc).
You have already taken antibiotic-Amoxycillin ,Sinus medicines(most of them contain combination of antihistaminic and decongestant), and Panadol(it contains Acetaminophan-which is helpful in case of fever and mild headache).
Also do steam inhalation,drink lots of fluids(warm) as they help in break down and drainage of collected mucus secretions in the sinuses.Avoid cold and very sweet food as they increase mucus production.Avoid dust,smoke and other pollutants.

2.)Migraine-
Typical symptoms of migraine include the following:
Throbbing or pulsatile headache, with moderate to severe pain that intensifies with movement or physical activity,
Unilateral and localized pain in the frontotemporal and ocular area, but the pain may be felt anywhere around the head or neck,
Pain builds up over a period of 1-2 hours, progressing posteriorly and becoming diffuse,
Headache lasts 4-72 hours,
Nausea and vomiting, including anorexia and food intolerance, and light-headedness may be associated and
Sensitivity to light and sound.

Treatment of migraine may include the following:
Reduction of migraine triggers (e.g- lack of sleep, fatigue, stress, certain foods).
Reduction of pain from headache by taking Analgesic like Ibuprofen along with Antacid like Rantac.
If attack occurs repeatedly, then you may need prophylactic medicines like Beta blockers, tricyclic antidepressants,etc.

3.)Tension headache-
Pain onset in tension-type headache is usually more gradual than onset in migraines. Compared with migraines, tension-type headaches are less severe.
For tension-type headaches, the following characteristics might be present:
Pressing or tightening (nonpulsatile quality),Frontal-occipital location
Bilateral - Mild/moderate intensity,Not aggravated by physical activity
Duration of 30 minutes to 7 days,No nausea or vomiting
Photophobia and/or phonophobia (sensitivity to light or sound may be present)

May occur under emotional distress or intense worry,reduced sleep
Muscular tightness or stiffness in neck, occipital, and frontal regions may be present.
In case of attack of tension headache,Analgesic like Ibuprofen help in reducing the pain.If it is frequent,then medicines like Amitriptylline may be needed for prophylaxis.

So,considering the above probabilities, it would be advisable to consult an Otolaryngologist doctor to rule out sinusitis,migraine or tension headache.

Hope this answers your query.I would be happy to answer if you have any follow-up questions.Get well soon.


Above answer was peer-reviewed by : Dr. Kampana
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Follow up: Dr. Riddhi Shah 4 days later
I have really bad ear pressure pain with my head aches around my ears and jaw , down the side of my face(next to ears) , temple pain , back of head pain and there is now a post natal drip down my theoat. The ear pain has been there for about 2 months and headache preasure about 2 weeks. Ive had a ct scan and thats clear and a blood test and that is clear. Any ideas ? Ive had 2 x course of amoxillon but it did nothing. On my way for an MRI in an hour also
doctor
Answered by Dr. Riddhi Shah 10 hours later
Brief Answer:
Probably suffering from Sinusitis

Detailed Answer:
Hi,thank you for your follow up question.

Looking at your symptoms,it is probably suggestive of Sinusitis.You mentioned in one of your question that your X ray showed polyps in the ?MT sinus.
The complains of posterior nasal drip and ear pressure might be a result of sinusitis.
Eustachian tube connects Middle ear with the nose and is responsible for equalization of middle ear pressure with the outer atmospheric pressure..In case of sinus infection,this tube may get blocked resulting in negative middle ear pressure with the feeling of pressure in the ear.You may follow the treatment measures which I have mentioned before in the answer.

It is good that you are going for MRI,to rule out any pathology in the brain.

Hope this answers your question.Take care.


Above answer was peer-reviewed by : Dr. Remy Koshy
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Follow up: Dr. Riddhi Shah 9 minutes later
Thanks alot. The dr today said there was no sign of sinus but polyps. But they said polyps can be normal. My head is in so mich pain right now i cant even explain. They now think its a jaw disfunction of me clenching so hard that i have now losged my jaw whuch is causing the ear, face and jaw pressure. As for my head aches still no clue ! MRI clear. Temples are killing me top of head killing me as if its going to explode with heat and pressure
doctor
Answered by Dr. Riddhi Shah 5 hours later
Brief Answer:
Please see the answer

Detailed Answer:
Hi,thank you for your follow-up question.

I am happy to learn from you that you MRI brain has come normal.

In addition to the cause which might be jaw dysfunction,there might be an another possibility for the cause of your symptoms,which needs to be ruled out.

It is Cluster headache(CH).CH involves a grouping of headaches, usually over a period of several weeks.It has the following characteristics:
The patient experiences attacks of severe or very severe, strictly unilateral pain (orbital, supraorbital, or temporal pain) that last 15-180 minutes and occur from once every other day to 8 times a day.
The attacks are associated with 1 or more of the following (all ipsilateral): conjunctival injection(redness in conjuctiva), lacrimation(watering from eyes), nasal congestion, rhinorrhea(nasal discharge), forehead and facial sweating, constriction of pupil(miosis), ptosis(drooping of eyelid), or eyelid edema.
Treatment is symptomatic (eg, oxygen and medicines like triptans, ergot alkaloids,) and
Preventive/prophylactic (eg, medicines like calcium channel blockers, mood stabilizers, and anticonvulsants).

Take care.Wish you a speedy recovery.
Above answer was peer-reviewed by : Dr. Prasad
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