140 patients experiencing shoulder pain were included in this study to determine if the addition of cervicothoracic manual therapy to exercise therapy resulted in a greater reduction in disability and pain. Patients were randomized to manual therapy plus exercise or exercise alone. Outcomes measures were assessed over a 6-month period including the Shoulder Pain and Disability Index (SPADI), QuickDASH score, a numeric pain rating scale, and additional measures of patient perceived improvement. There were no significant differences in disability and pain measures at any time point over the 6 months. At certain times, the manual therapy group had greater perceived improvement, but these differences were not of clinical relevance.