Chiropractic Manual Therapy and Neck Pain

Inclusion Criteria: * Male or Female * 21 to 60 years of age * Chronic neck pain * Neck pain duration greater than 6 weeks * Numeric Rating Scale greater than 30, less than 65 * Pain distribution between nuchal ridge and spine of the scapula * Pain aggravated by local provocation maneuvers at single motion segment * Antero-posterior glide * Paraspinal tenderness * Negative provocative maneuvers at adjacent segment * Able to tolerate neck movement to 50 percent normal in all directions Exclusion Criteria: * Worker's compensation or other medico-legal claim * Cervical spine surgery or fracture or dislocation * Uncontrolled hypertension (Blood Pressure over 140 over 90) * Stroke or Transient Ischemic Attack * Upper respiratory infection within 4 weeks * Severe degenerative disease of the cervical spine * New or significantly altered pattern of headache complaint * Connective tissue disease * Primary fibromyalgia * Metabolic or metaplastic bone disease * Whiplash injury within 12 months * High cholesterol levels not well-managed medically * Cardiovascular surgery in the past 6 months or planned * Use of narcotic analgesic, prescription anti-inflammatory, or muscle relaxants, anti-convulsants * Angina pectoris * Dizziness * Tinnitus * Blurred vision, vertigo, undiagnosed sensory and motor disturbances * Radicular symptoms and signs * Current use of anticoagulant therapy * Upper respiratory infection * Neck pain on provocation greater than 7 out of 10 * Provocation of radicular pain or sensory disturbance * Hypermobility of multiple peripheral joints, * Physical or mental impairment precluding following instructions or participating -in supine recumbent postures