Headaches are often multifactorial in nature, but three types (migraine, tension type, and cervicogenic) are commonly treated in our Boulder Physical Therapy practice. Cervicogenic headaches include headache symptoms driven by the joints in the upper neck and respond best to upper cervical joint mobilization and manipulation, as well as, neck and shoulder strengthening exercises. Tension type headaches are driven in part by tightness in the muscles of the neck and head including the suboccipitals, levator scapulae, upper trapezius, and sternocleidomastoid. This type is best treated with soft tissue interventions including trigger point dry needling and neck and shoulder strengthening exercises. A recent review of the research highlights the impact of dry needling for these headache types.