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Pain in the temples
The term "sleep pain" refers to a certain type of headache (see also headache back of the head), which occurs only in the temple region, i.e. occurs on the side of the head between the forehead and ear. Pain at the temples is a common phenomenon and can indicate various causes as there are many connections in the area. Accordingly, when treating these complaints, it is important to proceed in a differentiated manner and to pay attention to relationships.
Complaints and symptoms of sleep pain
Pain in the temple usually manifests itself in the form of an irregular pain or pulling in the area of the temples, which often radiates to the jaw, eyes or the back of the head. In other cases, it is more of a boring, deep-seated pain. The complaints can be felt on one or both sides or alternate between the sides.
It is possible that the pain in the temples may occasionally sting as soon as pressure is exerted on so-called “trigger points”. These are nodular hardenings in the muscle fibers, which are painful to pressure and associated with an inflammatory reaction and radiate to other parts of the body. For example, applying pressure to the chewing muscle while the patient grits his teeth can cause discomfort.
Causes of Sleep Pain
An acute, i.e. sudden and violent pain on the temple often occurs in connection with injuries such as a fracture or bruise of the temporal or zygomatic bone. If structural causes can be ruled out using imaging techniques, a number of other triggers can be considered: For example, a migraine can lead to pain attacks that are concentrated on one side of the head and in this case are perceived as sleeping pain.
It is possible that the symptoms occur in connection with other types of headache such as back headache, tension headache or the so-called "cluster headache".
Cause rheumatic diseases
Another cause - which is unfortunately only little known and is therefore often overlooked - is rheumatic diseases. The symptoms can be caused by temporal arteritis (also known as cranial artery, giant cell arteritis or Horton's disease), i.e. rheumatic inflammation of the temporal artery can be caused. This predominantly occurs in older women and is usually accompanied by other symptoms such as numbness or visual disturbances.
If such a disease can be diagnosed as a trigger for the pain in the temples, immediate treatment is urgently necessary. Because temporal arteritis, if left untreated, can lead to blindness or a stroke.
Malfunction of the temporomandibular joint
The complaints can be triggered by the so-called "Costen syndrome". This is a malfunction of the temporomandibular joint, which in turn e.g. is caused by an anomaly of the bite, poorly fitting prostheses, osteoarthritis or arthritis of the temporomandibular joint or teeth grinding due to psychological reasons. Since sleep pain, both on one side and on both sides, generally results from tense jaw muscles, this type of headache often occurs even after lengthy dental treatments. In most cases, the temporalis muscles, which are located directly on the temple, are particularly affected.
Causes of sleep pain from an osteopathic point of view
Osteopathy or craniosacral osteopathy assumes that the two central bones of the skull - the sphenoid bone and the temporal bone - under the temporal muscle have a connection to one another and to other bones. Accordingly, disturbances such as Unusual pressure or minimal shifts in these connections lead to sleep pain.
There is also the assumption that such disturbances can also affect the surrounding structures. For example, an artery running in this area (A. Meningea media) is conceivable, which could trigger migraines if there is abnormal tension.
Furthermore, in the context of the “trigger points” concept, osteopathy and other manual forms of treatment (e.g. manual massage or physiotherapy) assume that pain on the temple can also be triggered by nodular hardening in the muscle fibers (trigger points) of other parts of the body.
According to Dr. Janet G. Travell (1901-1997) and her colleague Prof. David G. Simons (1922-2010), a concept that is sensitive to pressure and often associated with an inflammatory reaction, can develop in the shoulder lifter muscle (M. Trapezius), which in turn causes pain in the Temporary area can trigger. The reasons for the hardening can be, for example, an overload (due to incorrect posture, high stress from a backpack, coat, bra, walking stick) or an oblique pelvis (sloping shoulders).
Treatment options for pain in the temple area
For fractures or breaks such as a broken zygomatic bone with a displacement of bone parts, an operation is essential. The bone is joined using special metal plates and then fixed in the correct position. In contrast, zygomatic fractures that are not displaced usually do not need to be treated surgically; instead, consistent physical protection is necessary.
In the case of bruises, it is advisable to cool the affected area immediately and apply pain-relieving ointment if necessary. A massage from the physiotherapist often helps here. With stubborn bruises, the pain can be relieved by the doctor if necessary by injecting narcotics and herbal and anti-inflammatory agents.
If the cause is a migraine, medication can be given during an attack (acute therapy) or prophylactically in the phases between the migraine attacks, whereby medications for inflammation, pain and nausea are particularly suitable. In the case of strong symptoms, so-called “triptans” are often used, which intervene in the metabolism of the messenger substance serotonin and help best if they are taken early. Danger: Triptans should never be used for coronary artery disease or other vascular diseases.
In the case of recurring and severe seizures, migraine prophylaxis with an active ingredient that is individually tailored by the doctor in combination with non-drug therapies is recommended to reduce the frequency of migraine attacks (see also under naturopathy).
If there is rheumatic inflammation of the temporal artery (temporal arteritis), immediate administration of high-dose cortisone preparations is necessary. These are needed to contain the inflammation and to cause the vascular wall to swell, thereby minimizing the risk of blindness or a stroke. Since time should not be wasted if there is sufficient suspicion of this rheumatic disease, experts are advised against waiting for a tissue examination from the temple first. In the meantime, it could already be too late for successful treatment and long-term damage.
To avoid this, the focus is on cortisone therapy. If this goes well, the pain gradually subsides and the dose can be gradually reduced after a few weeks. If treatment with cortisone does not work - which occurs in about 10 percent of cases - other medications such as Methotrexate used.
In the case of a "Costen syndrome", the therapeutic measures usually initially consist of orthodontic treatment or the possible adaptation of a so-called "bite guard", medicinal pain therapy and acupuncture. Further methods from the field of special pain therapy, which are used in so-called “pain clinics”, include therapeutic local anesthesia, in which local anesthetics are introduced into the body at certain points. There are also EMG biofeedback applications (registration and feedback of bioelectric muscle activity) and physiotherapy or relaxation procedures.
Naturopathy for pain at the temples
As an alternative to the "classic" therapeutic approaches, naturopathy offers a variety of treatment approaches to tackle painful temples. In osteopathy, for example, after a detailed anamnesis, blockages or movement restrictions are detected and released through the layered palpation of the tissue. Diagnosis and therapy take place here exclusively with the hands.
In many cases, help is also provided by trigger point treatment, which aims to eliminate the so-called "myofascial trigger points". In the case of sleep pain, this concept assumes that a myofascial trigger point in the shoulder lifter muscle (M. Trapezius) triggers or triggers the pain.
The treatment focuses on the prophylaxis of permanently shortened or misused muscles (e.g. due to poor posture, incorrect training) and on the other hand on the deactivation of the permanently contracted muscle fibers. Various methods are used, such as trigger point acupuncture (dry needeling). Treatment with special elastic tape bandages (“kinesio tape”) can cause a trigger point to come loose. Manual physiotherapy treatment techniques, acupressure or trigger shock wave therapy are often used.
Especially in the case of chronic complaints, relaxation courses are advisable, in which targeted mental exercises and imagination trips can be used to learn to accept and let go of the pain and thereby achieve a resolution or relief. Alternatively, techniques for stress relief such as progressive muscle relaxation, acupuncture and pain hypnosis or hypnotherapy are available.
If you are prone to migraines, endurance sports are highly recommended. A proven home remedy for migraines is silver willow tea, which is known in naturopathy for its analgesic and anti-inflammatory effects as "natural aspirin".Anti-headache tea with white willow
- Put a teaspoon of willow bark (from the pharmacy) in a saucepan
- Pour in a quarter liter of cold water
- Boil the mixture
- Take the pot off the hob
- After five minutes of infusion, the infusion is strained
- Drink two to four cups of the tea daily
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch
- Ingrid Gralow et al .: Interdisciplinary Pain Therapy: Pathophysiology - Diagnostics - Therapy, Schattauer, 2002
- Christian Lucae; Matthias Wischner: Entire drug teaching: All medicines Hahnemanns - The pure drug teaching - The chronic diseases and other publications. 3 vols, Karl F. Haug, 2007
- Wolf A. Lagrèze; M. Helmut Wilhelm; Hartmut Göbel: "Certified medical training: headache and eye", in: Deutsches Ärzteblatt, vol. 101, issue 49, 2004, Deutsches Ärzteblatt