How can I prevent frequent tension-type headaches?

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Diary

It may help to keep a diary if you have frequent headaches. Note when, where, how bad, and how long each headache lasts. Also note anything that may have caused it. A pattern may emerge and you may find a trigger to avoid. For example, hunger, eye strain, bad posture, stress, anger, etc.

Stress and depression

Stress is a common trigger for headaches. Avoid stressful situations whenever possible. Sometimes a stressful job or situation cannot be avoided. Learning to cope with stress and to relax may help. Breathing and relaxation exercises, or coping strategies, may ease anxiety in stressful situations and prevent a possible headache. There are books and tapes which can teach you how to relax. Sometimes a referral to a counsellor or psychologist may be advised. Depression can also cause frequent headaches. See a doctor if you feel that you are depressed.

Regular exercise

On average, tension-type headaches are more common in people who do not take much exercise compared to those who do. If you do not do much exercise, it may be worth trying some regular exercise like brisk walking, jogging, cycling, swimming, etc. (This will have other health benefits too apart from helping with headaches.) It is not clear how exercise helps. It may be that exercise helps to ease stress and tension which can have a knock-on effect of reducing headaches.

Medication

Amitriptyline is sometimes used to prevent frequent headaches. This is not a painkiller. It is an antidepressant medicine and you have to take it every day. (One effect of some antidepressants is to ease pain and prevent headaches even in people who are not depressed.) A low dose is started at first and may need to be increased over time. Once the headaches have been reduced for 4-6 months, the amitriptyline is stopped. Other medicines are sometimes tried if all else fails.