Recurring headache episodes for quite some time

Dear Ask The Doctor: Hi Doctor, I am a healthy 21 year old female. I have been suffering from headaches for quite some time now. There is no rhyme or reason for them and they don't come like there is a pattern, they are random and often. I can go several days with a headache then be headache free for a day or two then they are back. At other times I can go for a week without a single headache. It is frustrating because I have tried several OTC medications and nothing really works. At best, an OTC will take the edge off of the pain. I thought it was caffine withdrawl headaches so I tried to get some caffine when I felt a headache coming on and that didn't help. I also drink a lot of water so I doubt I am dehydrated. It can really make me irritable when I get headaches. I just don't know what else to try. Any advise would be much appreciated. Thank You, Jordan

Dear Jordan: Your description most likely correspond to a  tension headache, which is generally a diffuse, mild to moderate pain that's often described as feeling like a tight band around your head. A tension headache is the most common type of headache. Managing a tension headache is often a balance between fostering healthy habits, finding effective nondrug treatments and using medications appropriately. The exact cause is unknown, but sustained contraction of the muscles of neck, face and scalp may contribute to cause the pain. Potential triggers include the following: Stress, depression, anxiety, poor posture, jaw clenching, working in awkward position or holding the same position for a long time. The risk factors for tension headache: being a woman (90% of woman experience tension headaches during their lifetimes); also they are more common in middle age people. Sometimes, Rest, ice packs or a long, hot shower may be all you need to relieve a tension headache, but if these are not enough try some of these suggestions:  manage your stress level (relax techniques, meditation); Applying heat or ice to sore muscles may ease a tension headache. Which treatment to apply is a matter of personal preference. Good posture can help keep your muscles from tensing up. It places minimal strain on your muscles, ligaments, tendons and bones. Good posture supports and protects all parts of your body and allows you to move efficiently. When standing, hold your shoulders back and your head high. Pull in your abdomen and buttocks and tuck in your chin. When sitting, make sure your thighs are parallel to the ground and your head isn't slumped forward. Pain medications don't cure headaches; they just relieve the symptoms temporarily. Over time, painkillers and other medications may lose their effectiveness or they might even cause headaches. To avoid the development of medication overuse headaches, don't use over-the-counter pain relievers for more than nine days a month. In addition, all medications have side effects. If you take medications regularly, including products you buy over-the-counter, discuss the risks and benefits with your doctor. Also, remember that pain medications aren't a substitute for recognizing and dealing with the stressors that may be triggering your headaches. Using medications in conjunction with stress management techniques may be more effective than is either treatment alone in reducing your tension headaches. Additionally, living a healthy lifestyle , meaning  getting enough sleep, not smoking, exercising regularly and eating healthy foods , may help prevent tension headaches.