In this issue, Bronfort and colleagues (13) report on their study of neck pain treatment. This pragmatic, randomized trial compared the commonly used therapies of spinal manipulation, medication, and home exercise for patients with acute and subacute neck pain. The therapies were not administered in isolation; providers could add other therapies of their choice, which more closely replicates the real-world experiences of people with neck pain who seek treatment. For example, participants in the manipulation group may have also received mobilization; advice to stay active; or other therapies, such as massage, assisted stretching, or hot or cold packs. Participants in the medication group could have received anti-inflammatories; analgesics, including narcotics; or muscle relaxants. The exercise group also received advice, including information about the basic anatomy of the cervical spine; postural instructions; and practical demonstrations of lifting, pushing, pulling, and other daily actions.