Consistent evidence was found to support the use of ' red flags ' to screen for serious pathologies , judicious use of imaging through clinical decision rule application and promotion of functional exercise coupled with advice and reassurance .
Neck pain and whiplash injuries are a common presentation to the ED , and a frequent cause of disability globally .
This rapid review investigated best practice for the assessment and management of musculoskeletal neck pain in the ED .
Early coping strategies do not influence the prognosis after whiplash injuries.
This is a 1-year prospect i ve study to investigate the prognostic value of coping strategies such as catastrophising for persistent pain after a whiplash injury . A consecutive series of 96 patients who were seen in the emergency room in the acute phase after the injury were followed prospect ively for 1 year . Age , gender and whether or not pain in the neck preceded the accident was recorded . Cases involving fractures or dislocations of the cervical spine , head trauma or pre-existing neurological disorders were not included . The mean interval between the accident and the initial examination was 3+/-2(S.D. ) days . Coping was measured using the  Coping Strategies Question naire ( CSQ ) . The outcome parameter was self-reported neck pain at 1 year after the motor vehicle accident . At 1 year , 34 % of the patients had neck pain . Women developed chronic neck pain more often than men ( 71 % versus 29 % ) ; they also had significantly higher coping activity , such as diverting attention , praying or hoping ( p<0.05 ) ,  catastrophising and increasing behavioural activities ( p<0.0001 ) . Women reported pain in the neck or shoulder more often before the accident and this was the only statistically significant predictor of chronic symptoms when analysed by logistic regression ( odds ratio 4.5 ) . To conclude , we found no evidence that the different coping patterns during the early phase after a whiplash injury influenced the prognosis
Consistent evidence was found to support the use of ' red flags ' to screen for serious pathologies , judicious use of imaging through clinical decision rule application and promotion of functional exercise coupled with advice and reassurance .
Neck pain and whiplash injuries are a common presentation to the ED , and a frequent cause of disability globally .
This rapid review investigated best practice for the assessment and management of musculoskeletal neck pain in the ED .