suspect temporal arterities- should i go to the ER or can i wait and see a doc on Mondayc

for a while I have had a tender area on my head above the eye in the the temple area. and in the past some ice pick type headaches.

last night the area was more tender and painful to the touch than in the past.  I do not really have a headache, (some sinus type pressure) or any another systems only an imflammed area  that hurts if you bump it or apply pressure that seems to be to directly on a blood vessel/artery

I suspect this to be temporal arterites,

i just got home from cruise and drove 10 hours home so i have had lots of achohol and caffine and wonder if that may have inflammed a pre existing condition.

i have 3 questions for anyone who might help

1   I am posting this one sunday do i need to drop every thing and run the ER and wait for 4 hrs or can i wait to see
a doctor on monday

2  what kind of doctor should i see

3   i see steriods is the course of treatment   I have a topical steroid fluocinonide   can this be used on the area and will it affectly soak in or is that useless

thank you

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

There are many causes and type of headaches. If you are older than the age of 55, one potential causes is called giant cell arteritis or temporal arteritis. This is due to an inflammation in the temporal artery and other arteries in the body. Symptoms include one sided headache pain in the temple and jaw that may be triggered by chewing. This condition can be diagnosed by a blood test called an ESR and a biopsy of the artery. It is very important to rule this diagnosis out as it is highly treatable and if left untreated it can lead to vision loss. It is exceedingly rare in people younger than 55, and is more common in even older age groups.

Another potential cause of temple pain is inflammation or arthritis of the temporo-mandiublar joint, commonly called the TMJ. This can sometimes occur due to bruxism, biting down at night or during the day, and other stresses to the joint. This is best diagnosed/managed by an orthodontist or an ENT, and treatment includes braces and other dental fixtures and sometimes muscle relaxants, depending on the exact cause.

I am not sure if you have a prior history of temporal arteritis, but you should follow up with your family doctor to be evaluated.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.