Clinical Reference Systems: Pediatric Advisor 10.0
Spanish version

DESCRIPTION

• Your child complains of pain in the back of the neck or upper back. (Pain in the front of the neck usually is due to a sore throat or swollen lymph node.)
• Your child's head is often cocked to one side.
• The neck muscles may be tender to touch.

CAUSE

Acute neck pain is usually caused by strain. A strained neck may result from sleeping in an awkward posture, painting a ceiling, reading in bed, prolonged typing, and so forth.

A stiff neck (your child can't bend forward and touch his chin to the chest) can be an early symptom of meningitis. In this case your child will also have a fever.

Serious spinal cord injury can result from diving injuries, trampoline injuries, or other accidents involving the neck. Children who have suffered such an accident should not be moved until a neck brace or spine board has been applied by a rescue squad.

EXPECTED COURSE

A strained neck isn't serious and usually lasts 1 to 2 weeks.

HOME CARE

1. Pain-relief medicines

   Give acetaminophen or ibuprofen four times a day until your child has gone 24 hours without any pain. This is the most important part of treatment because neck pain causes muscle spasm and thus more pain, and these medicines can stop this cycle.

2. Local heat

   A heating pad, hot water bottle, or hot shower spray applied to the most painful area for 20 minutes helps to relieve muscle spasm. Do this whenever the pain flares up.

3. Sleeping position

   Instead of a pillow at night, your child may prefer a folded towel wrapped around the neck. This collar will keep the head from moving too much during sleep. (A foam collar can be obtained at a pharmacy.)

4. Exercises

   Your child should avoid any neck exercises until he is completely well.

5. Prevention

   If your child has had more than one neck ache, usually he has an activity or habit that overstresses the neck muscles or bones. Such activities are working with the neck turned or bent backward, carrying heavy objects on the head, carrying heavy objects with one arm (instead of both arms), standing on the head, contact sports, or even friendly wrestling. Avoid these causes.

   Also, improve the tone of the neck muscles with 2 or 3 minutes of neck stretching exercises per day. Helpful stretching exercises are touching the chin to each shoulder, touching the ear to the shoulder, and moving the head forward and backward. Don't apply any resistance (counterforce) during the stretching exercises.

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

• The pain becomes severe AND persists more than 2 hours after taking a pain medicine.
• Numbness or tingling occurs in the arms or upper back.
• A fever (over 100 degrees F, or 37.8 degrees C) occurs.
• Your child starts acting very sick.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

• The pain is unexplained (not from muscle strain) AND persists more than 24 hours even though your child has taken pain medicine.
• The pain is no better after 3 days of treatment.
• The pain is still present after 2 weeks.
• You have other concerns or questions.