Management

Historically, there has been controversy about how to manage simple neck sprain injury (i.e. injury to the neck where there has been no demonstrable bony injury or unstable ligamentous injury) and there have been few trials evaluating specific interventions.

A Cochrane review in 2007 [19] reviewed the evidence for conservative management of neck sprain injury (so-called ‘whiplash’). They found that there was insufficient evidence to support or refute the effectiveness of active versus passive treatments to relieve the symptoms of neck sprain injury. There were, however, a number of trials in this review which reported that cervical spine collars resulted in worse outcome than early mobilisation.

Although there are no randomised trials evaluating the use of analgesia in the management of neck sprain injury, it would be sensible to recommend analgesia to permit early mobilisation.

Patients who have a spinal cord injury should remain immobilised and immediately be discussed with the nearest Neurosurgeon or Spinal Surgeon on call by the trauma team leader or senior doctor in charge of the patients care.