Children's Hospital Colorado

Neck Pain or Stiffness

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

  • 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.

Causes of Neck Pain

  • Strained Neck Muscles. In teens, new neck pain is mostly from stretched neck muscles (muscle overuse). The most common modern cause is working with the head flexed down. Such head bending occurs with texting or looking at smartphones and mobile devices. Reading lying in bed or working on a computer for hours can trigger neck pain. The neck likes to keep the head in a neutral position. This is because the head is heavy (12 pounds or 5.4 kilograms). Other triggers are sleeping in an awkward position or fixing something on the ceiling.
  • Infected Lymph Node. At all ages, it can be from a swollen lymph node. That can irritate and cause spasm of the neck muscle it lies against.
  • Whiplash Injury. Caused by sudden movement of the head and neck. The head snaps back and forth. Neck muscles, nerves and ligaments are stretched. Can occur with a rear-end auto collision. Can also be from a sports injury. Needs to be examined.
  • Major Neck Injury (Serious). The neck protects the spinal cord. A fracture or other injury of the neck can damage the cord. Therefore, all neck injuries need to on a spine board until they are cleared.
  • Meningitis (Very Serious). A bacterial infection of the membrane that covers the spinal cord and brain. The main symptoms are a stiff neck, headache, confusion and fever. A stiff neck means your child can't touch the chin to the chest. Younger children are lethargic or so irritable that they can't be consoled. If not treated early, child can suffer brain damage.

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

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.

Call 911 Now

  • Pain starts after a major injury such as with contact sports or car crash
  • Not moving or too weak to stand
  • You think your child has a life-threatening emergency

Go to ER Now

  • Stiff neck (can't touch chin to chest) 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)

Call Doctor Now or Go to ER

  • Pain started after a minor injury
  • Can't move neck normally with fever
  • Severe pain
  • Not alert when awake ("out of it")
  • Acts or talks confused
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

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

Call Doctor During Office Hours

  • 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
  • You have other questions or concerns

Self Care at Home

  • Strained neck muscles (from turning or overuse) present less than 2 weeks

Care Advice for Strained Neck Muscles

  1. What You Should Know About Neck Pain:
    • Most new neck pain is from stretching and turning the neck muscles too much. Muscle overuse causes strained neck muscles.
    • Long periods of looking down is a common cause of neck pain. Seen mainly with texting or looking down at other mobile devices.
    • When muscle pain starts without reason, it can be from sleeping in an awkward position.
    • Here is some care advice that should help.
  2. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  3. Cold Pack for Pain:
    • 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.
  4. Use Heat After 48 Hours:
    • If pain lasts over 2 days, put heat on the sore muscle.
    • Use a heat pack, heating pad or warm wet washcloth.
    • Do this for 10 minutes, then as needed.
    • Reason: Increase blood flow and improve healing.
    • Caution: Avoid burns.
  5. Sleep Position:
    • Sleep on the back or side, not the stomach.
    • Sleeping with a neck collar helps some people.
    • 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.
  6. Activity:
    • Protect the neck. Avoid any activity that increases the pain.
    • Avoid any sports or work that increase the pain.
    • After 48 hours, start a gentle stretching program.
  7. Stretching Exercises:
    • Do 3 minutes of gentle stretching exercises each day. Reason: improve the tone of the neck muscles.
    • Touch the chin to each shoulder. Touch the ear to each shoulder. Move the head forward and backward.
    • Don't apply any resistance during these stretching exercises.
  8. 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.
  9. 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
    • You think your child needs to be seen
    • Your child becomes worse

Disclaimer

The information contained in these topics is not intended nor implied to 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.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

And when in doubt, call your child's doctor NOW or go to the closest emergency department.

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