Eighteen adults with chronic idiopathic neck pain were randomized to receive either assisted plus active cranio-cervical flexion (exercise group) or passive mobilisation plus assisted cranio-cervical flexion (mobilisation group). The purpose of the study was to determine which treatment was more efficacious with respect to performance on the cranio-cervical flexion test (CCFT), pain at rest, and pressure pain threshold. Immediately following intervention, both groups demonstrated improvements in pain and pain thresholds, but the exercise group experienced significantly greater improvements. Additionally, electromyographic amplitude of the sternocleidomastoid and anterior scalene muscle activities, measured during the CCFT, were significantly reduced with exercise group exclusively, indicating improved cervical spine muscle control.