Effectiveness of specific neck exercise and manual therapy for chronic mechanical neck pain

Neck pain is an extremely common problem, affecting millions of people. When it becomes chronic — persisting for months without a traumatic cause such as a car accident — it can significantly limit daily activities and quality of life. Manual therapy (hands-on joint manipulation and mobilisation by a physiotherapist) and specific neck exercises are both used as treatments, but questions remain about which approach works best and for whom. This study is assessing the effectiveness of manual therapy and exercise for chronic mechanical neck pain, and importantly, trying to identify which characteristics of a patient predict who is most likely to benefit from these treatments. Participants receive a structured course of treatment and are followed over time to measure changes in pain and function. You may be eligible if your primary complaint is neck pain that came on gradually (not from an injury), and the pain clearly worsens or improves with certain positions or movements. People with pain radiating down the arm (radicular pain), whiplash injuries, signs of widespread pain sensitivity, or neck conditions requiring surgery are not eligible.