Attached is a recent RCT in patients with neck pain assessing the benefits of manual therapy in addition to advice and exercise. The results generally showed no additional improvement over advice and exercise with manual therapy, although patients receiving manual therapy demonstrated higher satisfaction. These data conflict with several recent trials, the Hoving study in 2002 in particular. Perhaps the classification issue has raised its head once again. The authors reported a basic subgroup analysis, but it’s quite preliminary given the few number of predictors they considered.