Ariana Grande gives me a headache, and not because of her complicated relationships and ability to sing really high notes — I'm talking about her iconic tight ponytail. Anyone who's worn a tight hairstyle over an extended period of time has probably experienced a "ponytail headache," mild pain or tenderness around the head. But for people with migraines, myself included, tight hairstyles can actually trigger an attack. So, while Ariana's crazy tight, super long, probably heavy hairstyle is NBD to her, I see a recipe for a headache.
A "ponytail headache" might sound dramatic, but it is technically a thing. Some people with migraines also experience something called "allodynia" during an attack, which is pain or discomfort to a stimulus that's normally not painful, says David Dodick, MD, neurologist at Mayo Clinic and chair of the American Migraine Foundation. "With migraine, people may experience allodynia over the head," he says. Any light touch, like having glasses on your nose, wearing a hair clip or ponytail, or brushing your hair, may become painful, he says.
The reason why the scalp is particularly sensitive for people with migraines has to do with the trigeminal nerve, which is a large cranial nerve responsible for transmitting sensations in the head, face, and neck, Dr. Dodick says. While doctors and researchers don't know what exactly causes migraines, they know that the trigeminal nerve is somewhat involved, he says. When this nerve is activated, like during a migraine, it makes the head and neck muscles tender or even painful, he says.
Usually allodynia goes away a migraine ends, but some people experience it even between migraine attacks, Dr. Dodick says. For people with frequent migraines (one or more a week) who also have allodynia, it's possible that hats, headbands, ponytails, or braids could trigger an attack, he says.
For everyone else who doesn't get migraines, tight ponytails can still cause a headache. In the International Classification of Headache Disorders (ICHD), the manual that neurologists use to diagnose headache disorders, there's something called an "external traction headache," which is a headache resulting from sustained traction on the scalp. This type of headache is usually no big deal, and will go away about an hour after the hairstyle (aka "traction") is taken out or released, according to the ICHD.