disorders; diffuse idiopathic hyperostosis; inflammatory or destructive tissue changes of the cervical spine; infectious disease; substance abuse; cervical spine surgery; severe disabling health problems; pending or current litigation; having received any of the study treatments within 3 months; pregnancy or breastfeeding Diagnostics 2019, 9, 186 10 of 23 Table 2. List of the fifteen most recent clinical trials, by November 2018, about treatment efficacy in neck pain published in high impact journals. NP, neck pain; Clinical, number of authors belonging to clinical institutions; Non-Clinical, number of authors belonging to academic institutions; NDI, neck disability index; PT, physical therapy; VAS, visual analogue scale; SM, spinal manipulation; N/S, non-clearly specified. Study Authors’ Institutions Number of Citations PEDro Score Aim Participants Inclusion Criteria Exclusion Criteria Celenay et al., 2016 [51] Clinical: 0 Non-Clinical: 3 Citations: 13 6/10 Assess the effect of neck stabilization and scapulo-thoracic treatment with and without connective tissue massage in chronic NP N = 60 39 females 21 males 48 years Aged 18 to 65 years; NP > 3 months; baseline NDI ≥ 20% Stenosis; traumatic injury history; previous neck surgery; cancer; hypermobility; inflammatory rheumatologic diseases; severe psychological disorders; exercise or PT intervention in the last 3 months; pregnancy Celenay et al., 2016 [52] Clinical: 0 Non-Clinical: 3 Citations: 8 7/10 Compare the effect of stabilization exercises with or without manual therapy in patients with mechanical chronic NP N = 102 74 females 28 males 46 years Aged 18 to 65 years; NP > 3 months, with symptoms provoked by postures, movements, or palpation Inflammatory rheumatologic diseases, structural deformity, or malignity; previous cervical surgery; spinal stenosis; bilateral upper extremity symptoms; ≥ 2 positive radicular signs of nerve root compression; referred pain > than 7 on a 0-10 VAS in the related dermatome in the upper extremities; capsular pattern of arthritis; severe psychological disorder; pregnancy; any intervention including exercise or PT within 3 months Cerezo et al., 2016 [30] Clinical: 4 Non-Clinical: 4 Citations: 10 6/10 Assess the effect of deep dry needling of myofascial trigger points in chronic nonspecific NP N = 128 Sex distribution: N/S 50 years NP (with or without radiation) > 6 months, with no known pathological basis (neurological, trauma); having myofascial pain syndrome Major trauma; widespread pain; inflammatory, hormonal, or neurological disorders; upper limbs tendinopathy; severe psychiatric illness; inability to speak or write Spanish; use of muscle relaxant, analgesic, antidepressant, or anticoagulant medication in the last week; fibromyalgia; any contraindication to PT (infection, fever, hypothyroidism, wounds, metal allergy, cancer or systemic disease, fear of needles); or pregnancy De Araujo et al., 2018 [34] Clinical: 0 Non-Clinical: 5 Citations: 0 8/10 Assess the effectiveness of the Pilates method in chronic NP N = 64 14 females 50 males 49 years Aged 18 to 65 years; non-specific NP according to the Neck Pain Task Force; pain > 3 months; and pain intensity between 3–8 cm on a 0 to 10 cm rating scale Fibromyalgia; spine trauma, infection or inflammation; NP radiating to the upper limbs; having started or changed physical activity > 2/week within 3 months; visual impairments and no use of glasses; new or changed pain medication, or injections in the last 3 months; neurological diseases; musculoskeletal diseases hindering the practice of Pilates; pregnancy Diagnostics 2019, 9, 186 11 of 23 Table 2. Cont. Study Authors’ Institutions Number of Citations PEDro Score Aim Participants Inclusion Criteria Exclusion Criteria Essex et al., 2017 [37] Clinical: 1 Non-Clinical: 16 Citations: 0 4/10 Assess the cost-effectiveness of usual care vs. acupuncture and usual care vs. Alexander Technique and usual care for chronic NP N = 517 347 females 170 males 53 years NP > 3 months; score > 28% on the Northwick Park Neck Pain Questionnaire Current acupuncture treatment for NP or attended Alexander lessons in the last 2 years; litigation; serious underlying pathology; prior neck surgery; alcohol or drug dependency; involvement in other trial; history of psychosis, rheumatoid arthritis, osteoporosis, hemophilia, ankylosing spondylitis, cancer, HIV or hepatitis; inability to speak English; pregnancy Fernández-Carnero et al., 2018 [35] Clinical: 3 Non-Clinical: 2 Citations: 0 8/10 Assess the immediate effect of neural tension technique in chronic NP N = 54 41 females 13 males 21 years Aged 18 to 65 years; NP within the nuchal line and T1 spinous process > 12 weeks; no radicular symptoms to head, trunk, or upper limbs; ability to write and speak Spanish Systemic or degenerative diseases; headache and/or low back pain within 9 months; NP linked with whiplash; moderate or severe depression; red flags (metabolic diseases, tumor, fracture, rheumatoid arthritis, osteoporosis); fibromyalgia; neck surgery; cervical radiculopathy; disc herniation; neck or face pain within 6 months; NP with vertigo caused by vertebrobasilar insufficiency; non-cervicogenic headache after trauma within last year Griswold et al., 2018 [53] Clinical: 1 Non-Clinical: 4 Citations: 0 7/10 Compare the effect of concordant cervical and thoracic non-thrust vs. thrust SM for chronic mechanical NP N = 103 76 females 27 males 47 years Aged 18 to 70 years; having mechanical NP; NDI ≥ 20%; and NP > 2 on a 0 to 10 rating scale in the last 24 h Contraindications to manual therapy (fracture, malignancy, rheumatoid arthritis, myelopathy, osteoporosis); prior cervical or thoracic spine surgery; seeking litigation; nerve root compression (at least 2 or more neurological signs); receiving other nonsurgical care; inability to reproduce the concordant sign in the cervical or thoracic spine during testing Krøll et al., 2018 [54] Clinical: 4 Non-Clinical: 1 Citations: 1 5/10 Evaluate the efficacy of aerobic exercise in migraine and coexisting tension-type headache and chronic NP N = 70 62 females 8 males 37 years A minimum of 2 attacks of migraine; a minimum of 1 day with tension-type headache; a minimum of 1 day with NP per month Whiplash; significant neck trauma, (fracture,