Headaches are a common condition reaching greater than 30 billion dollars each year in health care costs. The majority of headaches are multifactorial in nature but can commonly be broken down into tension/myofascial headache, migraine, cluster, and cervicogenic headaches. This finally category of headache includes pain referred to the head by the upper neck joints just beneath the skull. Cervicogenic headaches are found in close to 20% of patients with severe headaches and over half of all headaches in patients recovering from whiplash injuries or neck pain. Spinal manipulation by Physical Therapists have been shown to be very effective treatment for patients suffering from this type of headache. When combined with exercise patients can expect significant long term benefits in pain and disability. A recent review of the medical evidence documents the impact of spinal manipulation on patients with cervicogenic headache.