From the Publishers of the New England Journal of Medicine

The usual treatments for whiplash probably make things worse, an expert panel recently charged. Physicians often mistreat whiplash, partly because they get little training on how to treat it and partly because the science behind these treatments is lacking, said the international panel of spine and neck experts. After four years of study, they concluded that common treatments such as immobilizing the neck with a soft collar "probably prolong disability." They also called a host of other treatments, ranging from cervical pillows and ultrasound to acupuncture and injections, unproven and likely ineffective.

"Most whiplash injuries heal on their own in a fairly short period of time," said panel director Dr. Walter O. Spitzer. Improper treatments, generally those that prevent the neck muscles from moving or bearing weight, may actually turn a simple injury into a more serious one that can last for months.

In a press conference last month marking the publication of its report in the scientific journal Spine, the panel sharply criticized physicians for the way they study and treat whiplash injuries. Of 10,382 scientific papers published on this subject, the panelists found that only 62 were relevant and scientifically acceptable.

The panel, convened in 1991 by the Automobile Insurance Society of Quebec, made these recommendations:

• If you have minor whiplash, return to work and normal activity as soon as possible. Serious whiplash may require a short period of restricted movement, with an escalating level of daily activity.

• Question the need for X-rays—physicians can generally diagnose whiplash by talking to a patient and doing a physical examination.

• Make sure that chiropractic and other "manipulative treatments," which can alleviate whiplash pain and symptoms, are done by trained providers with the goal of improving mobility and normal activity.

• Adjust the headrest in your car or truck so it supports the back of the head, not the neck.