IntroductionNeck sprain has usually been associated with car accidents. Widespread attention has been paid to neck sprain because of the enormous increase in the whiplash-associated disorders (WAD) due to car accidents, especially over the last decades [1,6,9,19,34,41]. However, neck sprain is not only caused by car accidents.The diagnostic rubric "sprains and strains of the neck" from the International Classification of Diseases (ICD-9 CM) from the World Health Organization is used by the majority of hospital-based trauma registries. Whiplash is a component of this diagnostic rubric and, according to Penning [26], the primary mechanism of whiplash trauma is a hypertranslation of the head. In contrast to the enormous bulk of whiplash literature, as far as we know, only a few studies have focused on neck sprain. Going back to 1970, we retrieved 19 studies from Medline [21] about neck sprain, of which 9 were about neck sprain due to car accidents [3,7,11,13,14,32,38,40,42] and 3 were about neck sprain due to sports injuries [5,18,35]. The remaining seven studies, in which the aetiology is unclear, describe treatment and research methods [4,12,15,20,23,37,39]. Research results from 1970 were based on data from hospital registries in which no distinction was made between inpatients and outpatients. As far as we know there are no studies analysing trends in neck sprain Abstract During the 25-year period 1970-1994, 680 patients were diagnosed with neck sprain due to causes other than car accidents at the Emergency Room of the University Hospital Groningen. The purpose of the present study was to analyse the prevalence, groups at risk and trends in patients with neck sprain. We defined the population as patients diagnosed with neck sprain that was not due to a car accident (NCA). The binominal test was used to obtain measures of statistical significance, ∆ x was used to obtain both the total increase in the number of neck sprain victims over the whole period and the relative contribution of successive 5-year periods. Over the 25-year period a steady increase in the number of patients was observed from 55 in 1970-1974 to 241 in 1990-1994. The highest