Headaches Are Where Most Clinicians Get Stuck

Headache patients walk into your clinic having already seen three other providers. They have a folder of imaging, a list of medications that didn't work, and a story about how their last PT "did some neck stretches" before discharging them. The diagnosis is rarely written cleanly on the referral, and the differential matters. Cervicogenic headache responds to the upper cervical work you can do today, tension-type headache lives in a territory that requires something more than feel-good treatments, migraine needs a different conversation entirely, and missing a vertebral artery dissection is the kind of mistake that ends a career. This course is built around the headache types that fill an orthopedic caseload and the clinical reasoning that separates effective treatment from passive care. You'll work through the ICHD-3 framework so you can confidently classify what's in front of you, learn to screen for cervical arterial dissection by recognizing both the ischemic signs and the local presentations that come first, and build out the upper cervical examination — flexion-rotation test, segmental assessment, deep neck flexor endurance — that actually informs what you do next. The intervention evidence is here in full: the Jull trial, both Dunning RCTs, the Jung network meta-analysis, plus the manual therapy literature for tension-type headache and the aerobic exercise research that should be part of every long-term plan. The course closes with a complete six-visit episode of care that shows how the skills, reasoning, and patient education sequence across an actual course of treatment, including how to handle the real-world moments when your plan and your patient's expectations don't line up.