Neck pain is an exceedingly common medical complaint. At any given time, 13% of adults have neck pain and 50% recall having a painful neck that limited function at some time in their lives (1). Among the treatments for sore and stiff neck, manual therapy is the oldest. Manual therapy is the use of hands to manipulate, mobilize, apply traction to, or massage the tissues. In manipulation, high-velocity, short-amplitude thrusts are used to move the joint passively beyond the point at which it could be moved actively by the patient; mobilization refers to passive movements of a joint within its normal range of motion by using nonthrusting, slowly applied pressure (2). The use of spinal manipulation was first described by Hippocrates and later by the Roman physician Galen; at approximately the same time, during the Han Dynasty in China, massage therapy was described in a textbook of medicine. Manual therapy techniques spread through the Middle East and Asia and became a standard part of medical practice during the 17th century. By the 19th century, the professions of chiropractic and osteopathy, which are based on manual therapy techniques, were established in the United States. Manual therapy is widely used in North America today by physical therapists; osteopaths; massage therapists; and, most notably, chiropractors.