The hijab is a type of headscarf worn by many Muslin girls and women beyond puberty in the presence of people outside their immediate families in conforming to a moral standard of modesty and privacy.

The headscarf can be made from several different kinds of fabrics and is usually secured by a pin under the chin. Long hair may be tied back in a bun or ponytail underneath the hijab.

In 2004 a study described a headache syndrome triggered from wearing hair in a ponytail. The ponytail headache occurred when the hair was tied too tightly. Relief usually came within minutes to an hour after loosening the hair.

A new study sought to determine whether wearing the hijab was associated with headache, what the headaches were like, and their similarity to ponytail headaches.

Five females with an age range of 20-63 years were asked if they had ever had headaches in association with wearing the hijab.

All 5 women said headaches had occurred while wearing the hijab, with 4 never having experienced headaches prior to wearing the hijab and the fifth saying she had “tension-type” headaches of greater severity and frequency after she wore one.

None of the headaches were associated with migrainous symptoms. The fifth patient who had previously had headaches took a 2-year respite from wearing the hijab. She noticed decreased frequency and severity of her symptoms.

All 5 women said they had headache symptoms 30 minutes to 4 hours after putting on the headscarf.

Hijab headache is apparently well know to women who wear it, but it has not been reported in the medical literature. A possible explanation for this kind of headache may be similar to that of ponytail headache, extracranial in nature, associated with the relation of the headscarf to extracranial tissues and friction against the hair.

The authors of the study believe that a lack of description regarding hijab headache in the medical literature is due to the ease of remedy without medical intervention and perceived cultural importance of wearing the headscarf.The hijab often becomes an essential part of a Muslim women’s identity, and no longer wearing it is not considered to be an option, even though it may bring on discomfort.

The authors point out that it is important to recognize that wearing the headscarf may bring on an extracranial headache and improving symptoms can be brought about by adjusting it.

Headache The Journal of Head and Face Pain
March 2015

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