SUMMARY. The success of physical therapies in the management of headache relies in the first instance on an accurate differential diagnosis of a cervical musculoskeletal origin to the headache. Examination should identify a symptomatic pattern of headache characteristic of neck dysfunction and these symptoms must be associated with relevant physical impairments in the cervical articular and muscle systems. Dysfunction in the upper three cervical joints, poor activation levels and endurance capacity of the deep and postural supporting muscles of the neck, shoulder girdle region and deficits in kinesthesia have been identified in the cervical headache patient. Treatment needs to be precise and comprehensive to address each aspect of this interrelated dysfunction if long-term success of treatment is to be achieved. Copyright 1997 Harcourt Publishers Ltd.