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  • Neck Pain or Stiffness

    Definition

    • Pain or discomfort in the back, side or front of the neck
    • Minor muscle strain from overuse and neck injury are included
    • Pain in the front of the neck often is from a sore throat. It can also be from a swollen lymph node.

    FIRST AID for Suspected Spinal Cord Injury:

    • Don’t move your child until a spine board and neck brace are put on.

    Symptoms

    • Neck pains due to strained muscles cause these symptoms:
      • The head is often cocked to one side
      • Can’t bend the head backward or put the chin to each shoulder. Often, can still bend the neck forward (touch the chin to the chest).
      • The neck muscles are often sore to the touch

    Causes of Neck Pain

    • In teens, new neck pain is mostly from strained neck muscles (muscle overuse).
    • Triggers are sleeping in an awkward position or fixing something on the ceiling. Reading in bed or working on a computer for hours can also cause neck pain.
    • At all ages, it can be from a swollen lymph node. That can cause spasm of the neck muscle it lies against.

    Causes of Stiff Neck

    • A stiff neck means your child can’t touch the chin to the chest.
    • Meningitis is one of the serious causes of a stiff neck with fever. Suspected meningitis needs to be seen now.

    Pain Scale

    • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
    • Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
    • Severe: The pain is very bad. It keeps your child from doing all normal activities.

    When to Call Us for Neck Pain or Stiffness

    Call 911 Now (your child may need an ambulance) If:

    • Pain starts after a major injury such as with contact sports or car crash. See FIRST AID. Caution: Don’t move your child until a neck brace is put on.
    • You think your child has a life-threatening emergency

    Call Us Now (night or day) If:

    • Your child looks or acts very sick
    • Pain started after a minor injury
    • Stiff neck (can’t touch chin to chest) with fever
    • Can’t move neck normally with fever
    • Headache with fever
    • Numbness, tingling or pain in arms, upper back or legs
    • Muscles in the arms or legs are weak (loss of strength)
    • Pain is SEVERE
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen, but not urgently
    • Can’t move neck normally
    • Headache without fever
    • Fever lasts more than 24 hours
    • Age less than 5 years

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns
    • Cause of neck pain is not clear (no history of overuse)
    • Neck pain (from lots of turning) lasts more than 2 weeks
    • Neck pains are a frequent problem

    Parent Care at Home If:

    • Strained neck muscles (with history of overuse) present less than 2 weeks

    Care Advice for Strained Neck Muscles

    What You Should Know:

    • Most new neck pain is from stretching and turning the neck muscles too much. This causes strained muscles from muscle overuse.
    • Looking up or to the side for too long is a common trigger.
    • When muscle pain starts without reason, it’s often from sleeping in an awkward position.
    • Here is some care advice that should help.

    Pain Medicine:

    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.

    Cold Pack:

    • During the first 2 days, use a cold pack or ice wrapped in a wet cloth.
    • Put it on the sore muscles for 20 minutes.
    • Repeat 4 times on the first day, then as needed.
    • Reason: Reduces pain and any spasm.
    • Caution: Avoid frostbite.

    Heat Pack:

    • If pain lasts over 2 days, put heat on the sore muscles.
    • Use a heat pack, heating pad or warm wet washcloth.
    • Do this for 10 minutes, then as needed.
    • Caution: Avoid burns.

    Sleep:

    • Sleep on the back or side, not the stomach.
    • Sleep with a neck collar.
    • Use a foam neck collar (from a drug store). If don’t have one, wrap a small towel around the neck.
    • Reason: Keep the head from moving too much during sleep.

    Activity:

    • Protect the neck for 48 hours. Then start a gentle stretching program.
    • Avoid any sports or work that increase the pain.

    What to Expect:

    • New neck pain without a reason most often goes away in a few days.
    • Neck pain from muscle overuse (strained neck muscles) goes away in 1 to 2 weeks.

    Call Your Doctor If:

    • Neck pain becomes severe
    • Stiff neck occurs
    • Pain starts to shoot into the arms, upper back or legs
    • Pain lasts more than 2 weeks
    • Your child becomes worse

    Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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