Chiropractic and Exercise for Seniors With Neck Pain

Inclusion Criteria: * Chronic neck pain (Defined as current episode more than 12 weeks duration.) * Quebec Task Force classifications 1, 2, 3 and 4. This includes patients with neck pain, stiffness or tenderness, with or without musculoskeletal and neurological signs. * 65 years of age and older * Independent ambulation * Community dwelling (residency outside nursing home) * Score of 20 or more on Folstein Mini-Mental State Examination * Stable prescription medication plan (no changes in prescription medications that affect musculoskeletal pain in previous month) Exclusion Criteria: * Referred neck pain from local joint lesions of the upper extremities or from visceral diseases * Significant infectious disease * Ongoing treatment for neck pain by other health care providers * Mean neck pain score of less than 20 percentage points * Contraindications to exercise Determined by history or by referral to supplementary diagnostic tests (i.e., uncontrolled arrhythmias, third degree heart block, recent ECG changes, unstable angina, acute myocardial infarction, acute congestive heart failure, cardiomyopathy, valvular heart disease, poorly controlled blood pressure, uncontrolled metabolic disease) * Contraindications to spinal manipulation (i.e. Progressive neurological deficits, blood clotting disorders, severe osteoporosis, infectious and non-infectious inflammatory or destructive tissue changes of the spine)