We have all had headaches in the past. Headaches that reoccur or become a daily nuisance should be evaluated thoroughly. Organic headaches (brain tumor, a brain aneurysm, hematoma, meningitis, brain abscess, brain infection, cerebral hemorrhage, or encephalitis) need to be ruled out to first and foremost, these conditions can be fatal when left untreated. Headaches can also stem from a neuromusculoskeletal disorder. Cervical segments in the upper spine can have an impact on the base of the skull leading to headaches. Increased muscle tonicity in the sub-occipital and posterior cervical musculature can impinge on the vertebral artery and the sub-occipital nerve, which supplies nutrients and innervates the base of the skull, top of the head and over the ear. Once organic headaches have been ruled out treatment with manual therapy has been show to be effective in treating tension/migraine headaches.