Prevalence of Headache, Neck Pain and Its Association with Its Risk Factors in Young Girls Wearing Modern Hijab and High Ponytails

Abstract

Background: Headache and neck pain are prevalent complaints among young women and may be influenced by external mechanical factors such as tight hairstyles and head coverings. Modern hijab styles and high, tight ponytails involve prolonged traction and compression forces on the scalp and cervical musculature, potentially contributing to headache and neck pain syndromes. However, there is limited comparative research evaluating these associations in culturally relevant populations. Objective: To determine the prevalence and severity of headache and neck pain among young women wearing modern hijabs and high, tight ponytails compared to a control group, and to evaluate associations with age, duration, and frequency of wear. Methods: This cross-sectional observational study recruited 210 female participants aged 16–26 years from two educational institutions. Participants were categorized into three groups: hijab wearers, ponytail wearers, and controls. Headache and neck pain were assessed using the Headache Impact Test (HIT-6) and Numeric Pain Rating Scale (NPRS), respectively. Statistical analyses included ANOVA and Pearson’s chi-square test, with significance set at p<0.05. Results: The mean HIT-6 score was significantly higher in the ponytail (57.1 ± 9.1) and hijab (54.9 ± 7.8) groups compared to controls (51.1 ± 5.7; p<0.001). Neck pain was more prevalent in the ponytail (72.9%) and hijab (62.9%) groups than controls (41.4%). Headache was significantly associated with neck pain and age, but not with hours or years of wear. Conclusion: Modern hijab and high, tight ponytail use are associated with greater prevalence and severity of headache and neck pain in young women. These hairstyling practices represent modifiable risk factors warranting clinical attention and culturally sensitive preventive strategies.