Manipulation, Exercise, and Self-care for Chronic Neck Pain   Sponsor     Health Research Services Administration (HRSA)   Principal Investigator     Gert Bronfort, DC, PhD, Northwestern Health Sciences University   Berman Center Co-Investigator     Richard Grimm, MD, MPH, PhD   Description     This study compares rehabilitative exercise, chiropractic spinal manipulation combined with rehabilitative exercise, and self-care education in reduction of patients’ self reports of neck pain after three and nine months of treatment. The study also compares the cost-effectiveness and cost utility of the treatments, evaluates changes in cervical spine function, examines associations between cervical function and patient-rated outcomes, and identifies predictors of outcome.   Role of the Berman Center     Berman Center investigators serve on the study’s Steering Committee and provide advice on recruitment and data management strategies.   Abstract     Neck pain is very common, afflicting 10% of the population at any given time. Despite its significant socioeconomic impact, neck pain has been poorly investigated. The broad, long term objective of this study is to identify effective therapies for neck pain and to increase our knowledge of this problematic condition. The trial will compare three treatment approaches for chronic neck pain in 270 participants:     • rehabilitative exercise     • chiropractic spinal manipulation combined with rehabilitative exercise     • self-care education (a minimal intervention control)     The study’s primary aim is to examine the relative efficacy of the three interventions in terms of patient-rated outcomes for chronic neck pain after 12 and 52 weeks. Secondary aims are to assess the relative cost-effectiveness and cost utility of the three treatments, evaluate changes in objective cervical spine function, assess if cervical function is associated with changes in patient-rated outcomes, identify predictors of outcome and finally, to describe patients’ interpretations of outcome measures used in clinical trials. Self-reported outcome measures will be collected at baseline and 4, 12, 26 and 52 weeks; objective outcome measures will be assessed by blinded examiners at baseline and 12 weeks.