Inclusion Criteria:  Age > 18 years old Primary complaint of neck pain Neck Disability Index > 10 points=20%  Exclusion Criteria:  Red flags noted in the patient's Neck Medical Screening Questionnaire (i.e., tumor, fracture, metabolic diseases, RA, osteoporosis, prolonged history of steroid use, symptoms of vertebrobasilar insufficiency, pregnancy, cervical spinal stenosis, bilateral upper extremity symptoms etc. Use of blood thinners History of whiplash injury within the past six weeks Evidence of central nervous system involvement, to include hyperreflexia, sensory disturbances in the hand, intrinsic muscle wasting of the hands, unsteadiness during walking, nystagmus, loss of visual acuity, impaired sensation of the face, altered taste, the presence of pathological reflexes (i.e., positive Hoffman's and/or Babinski reflexes), etc.  Two or more positive neurologic signs consistent with nerve root compression, including any two of the following:  Muscle weakness involving a major muscle group of the upper extremity Diminished upper extremity muscle stretch reflex (biceps brachii, brachioradialis, or triceps) Diminished or absent sensation to pinprick in any upper extremity dermatome Prior surgery to the neck or thoracic spine Workers' compensation or pending legal action regarding their neck pain Insufficient English language skills to complete all questionnaires Inability to comply with treatment and follow-up schedule