In order for the variations in the treatment of whiplash injuries to be studied a short postal questionnaire was sent to every Accident and Emergency department in the U. K. A literature search was then performed in order to determine how much this treatment is evidence based.

We present data from 186 Accident and Emergency units. The use of cervical collars in whiplash treatment is widespread. In the literature no study has shown a therapeutic benefit from collars. The majority of studies comparing early mobilization with immobilization in a collar show a prolongation of symptoms, an increase in pain and, decrease in movement from treatment in collars.

Physiotherapy is also provided by a number of units. There is certainly evidence that early mobilization is better than rest but, no evidence that physiotherapy is superior than self-mobilization after advice and prescribed exercise programs. Non steroidal anti-inflammatory drugs are also widely prescribed. There is no evidence these are superior to simple analgesia and they have significantly increased side effects.

A large proportion of Accident and Emergency units are providing treatment that is at best ineffective and, in some cases, detrimental to patients. This is at significant cost to the NHS and we suggest that treatment protocols be reviewed.