Ponytail headache: What is it, causes, and treatments

Dec 22, 2023

A headache from a ponytail likely occurs due to compression against the head. When someone ties their hair up, it can pull at the scalp. Research suggests headaches from a ponytail may be more common in people with migraine.

Headaches are a common symptom that people will experience from time to time. Some possible causes, such as wearing hair in a ponytail, may be preventable.

This article overviews a ponytail headache, why it occurs, who is at risk, diagnosis, preventions, treatments, and frequently asked questions.

Sex and gender exist on spectrums. This article will use the terms "male," "female," or both to refer to sex assigned at birth. Click here to learn more.

People may choose to style their hair in a ponytail, where a tie draws the hair to the back of the head, and it hangs down the neck or back, depending on the length of the hair. Parents or caregivers may also style a child's hair in this way.

This hairstyle may trigger headaches without an individual realizing that the ponytail is the likely cause. People who often wear their hair in a ponytail for work, to play sports, or as a personal choice may be more aware of this cause and remedy. Therefore, they tend not to seek medical attention when this type of headache occurs.

Despite its frequent occurrence, the official medical literature does not extensively document the experience of headaches from a ponytail.

However, a study from 2020 found a prevalence of 40% among participants.

Existing research refers to this type of headache in the following medical terms:

Anecdotal evidence suggests doctors may refer to ponytail headaches as a type of allodynia, in which a person feels unexpected pain from supposedly nonpainful stimuli, such as wearing hair in a ponytail.

Research from 2004 demonstrated that 50 out of 93 female participants experienced headaches from wearing their hair in a ponytail.

The pain occurred in the following areas:

Males with long hair likely have similar experiences in the same locations. However, research has yet to explore this area.

Additional research details the pain as worse at the site of compression, usually resolving within an hour of removing the source of the pain.

This type of headache occurs due to sustained compression or traction against the head, such as wearing hair in a tight ponytail that pulls on the scalp.

The 2004 study refers to this as an extracranial headache occurring due to a person experiencing traction, or tension, in their head. "Extracranial" means it occurs outside the skull.

Further research from 2018 suggests that headaches may occur due to irritation of extracranial sensory fibers in the scalp, such as in the muscles, fascia, the membrane of blood vessels known as the periosteum, or the nerves themselves due to:

Research from 2020 suggests the incidence of external compression headaches increased during the COVID-19 pandemic. This was likely due to the protective measures among healthcare workers and the general population, including wearing personal protective equipment and face masks.

Objects with tight bands or straps around the head may provoke external compression headaches. This may be relevant to people wearing their up in a ponytail or using certain equipment or accessories, such as:

The 2020 study details how experts have incorporated headaches due to external compression into the international classification system as an external-pressure headache.

Research from 2015 also suggested that females experienced bilateral headaches caused or worsened by wearing a hijab or headscarf. Removing the headscarf or making minimal modifications in style, where possible, alleviated pain.

Not everyone will be affected by wearing hair in a ponytail. There may be a connection to migraine or other types of headaches. Research suggests individuals at more risk of migraine or tension headaches are likelier to experience ponytail headaches.

On a similar note, research from 2020 suggests those with a history of migraine among participants who wore a ponytail for 60 minutes experienced headaches that met the diagnostic criteria for migraine. This may indicate that wearing hair in a ponytail triggered migraine episodes.

The researchers concluded that external factors, such as the mechanical pulling of the hair, led to the onset of migraine-like symptoms.

Find out more about headaches vs. migraine.

A lack of sleep or emotional stress may increase the likelihood of a ponytail headache.

Anecdotal evidence suggests people with thicker and heavier hair may also be more at risk of experiencing a headache when wearing it in a ponytail.

People may easily treat a ponytail headache by loosening their hair. This may relieve the pain immediately or within an hour.

Current treatment guidelines for external compression headaches recommend frequently and temporarily removing the traction that causes the pressure, such as a ponytail, and suggest that the headache usually disappears when a person removes the pressure caused by the band.

People may wish to try different hairstyles or accessories to find a comfortable alternative to prevent a ponytail headache.

They may benefit from pain relief medication or soft head massages to relieve headaches caused by ponytails.

There are other possible causes of a headache, which may coincide with when a person is wearing hair in a ponytail.

These triggers include:

People can speak with a doctor if their headache is not easing with home remedies or appears to occur at other times of the day with no apparent cause.

Find out when to consult a doctor about a headache.

Below are answers to some common questions about ponytail headaches.

A person may relieve a ponytail headache by removing the hair from the tie or loosening the ponytail.

When a person removes the pressure from the band or tie, the headache will likely resolve within an hour.

A ponytail may cause a headache in some people due to the compression force against the head. This hairstyle tends to pull on the scalp, which results in an aching sensation.

This type of headache causes a heavy feeling and pain at the site of the compression. It may create the sensation that there is something on the head. People may also experience pain in other areas of the head or neck.

Ponytails can pull on the scalp, creating tension in the head and pain. A ponytail headache occurs due to compression against the head when hair is tied up.

People tend to be aware of this as a possible cause of headaches and know to remedy them by removing or loosening the ponytail temporarily or frequently.

Other remedies may include trying different hairstyles or taking pain relievers, depending on the frequency of the headaches.

There are other possible triggers of headaches, such as posture or eating certain foods, that can be avoidable in some cases. A doctor can best recommend the likely cause and suitable line of treatment for a person's headache.