Purpose of study and background: It is generally accepted that a biopsychosocial model is required to explain the complex phenomenon of whiplash associated disorders, particularly in the development of chronic pain and disability. Because the factors leading to chronicity are present early in the course of the disorder, clinical guidelines and recommendations have stressed the need for appropriate information and advice for patients. Following the success of patient educational material, in the form of an evidence-based booklet, in the management of low back pain, a similar booklet has been produced for whiplash patients. The messages for the booklet were synthesised from a comprehensive review of the available scientific evidence; the resultant text was intended to challenge unhelpful beliefs about whiplash, promote positive attitudes, and stimulate an active approach to recovery.

Methods and results: Using samples of patients and non-patients, the booklet was evaluated for its ability to create a positive shift in beliefs, and for its ability to impart its intended messages about active management. The results showed that the booklet is considered easy to read, understandable, believable, and conveys its intended messages. Furthermore, it created a substantial and highly statistically significant positive shift in attitudes and beliefs about whiplash associated disorders, suggesting its suitability as patient educational material.

Conclusion: This booklet changes beliefs about whiplash, however only a randomised clinical trials will determine whether such a booklet can have an effect on clinical outcomes.

A review of scientific literature on whiplash associated disorders was conducted to inform appropriate messages for an evidenced based patient educational booklet, “The Whiplash Book.” The booklet is being developed for use as both a clinical tool and general health intervention.

A systematic literature search was conducted, using MEDLINE and psychINFO, together with hand searches, reference tracking, and the Internet. The Quebec Task Force report and the British Columbia Whiplash Initiative were taken as the starting point. The new evidence covered the period May 1994 through March 2001 (147 articles). All relevant articles were included, with a particular focus on management and treatment of whiplash associated disorders. The quantity, consistency and relevance of all retrieved articles was evaluated, and rated as *** for consistent findings in multiple reports, ** for consensus based on balance of various findings, or * for limited information (single report).

The main messages from the literature suggest: physical serious injury is rare, reassurance about good prognosis is important, over-medication is detrimental, fastest recovery occurs with early return to normal pre-accident activities, self-exercise/manual therapy and positive attitudes/beliefs are helpful to regain activities levels, collars/rest and negative attitudes/beliefs delay recovery and contribute to chronicity.