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Neck Pain In Children: Causes, Symptoms, Remedies, And Treatment

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Neck pain is the most common form of spinal pain in children and may be a symptom of physical injuries or medical conditions. Neck pain in children may also occur without any underlying systemic disease and is referred to as musculoskeletal neck pain.

Neck pain can originate in several places from the skull base to the shoulders, including the intervertebral discs, muscles, ligaments, dura, facet joints, and nerve roots. However, severe neck pain in children may disrupt their day-to-day activities (1) (2) (3).

Read this post to learn about the possible causes, symptoms, complications, diagnosis, and treatment of neck pain in children.

Causes Of Neck Pain In Children

A physical strain or spasm of the neck muscles or inflammation of the neck joints is caused due to various activities, including (1) (4):

  • Bending the head while watching TV/laptop/mobiles or reading
  • Incorrect sleeping or sitting position
  • Muscle strain
  • Spending too much time resting the forehead on the upright fist or arm (thinker’s pose)
  • Stress
  • Upper body exercises

A child may experience sudden (acute) neck pain due to a minor injury sustained as a result of (1):

  • Tripping
  • A short distance fall
  • Excessive twisting of the spine

Severe neck pain in children may result from major injuries or conditions (1) (4).

  • Infected lymph node: A swollen lymph node can irritate and cause spasms of the neck muscle.
  • Whiplash injury: A sudden movement of the head and neck, such as in a rear-end auto crash or during sports, can cause this injury. Such injuries force the head to bounce back and forth, stretching the neck muscles, nerves, and ligaments, causing neck pain.
  • Fracture or dislocation of the spine: It may damage the spinal cord and cause severe pain in the neck.
  • A torn or ruptured disc: This may cause the jelly-like material inside the disc to leak out (herniate) and press against a nerve or the spinal cord (central disc herniation), causing severe neck pain.
  • Underlying medical conditions: There are certain medical conditions, including meningitis, childhood arthritis, torticollis, and cancer, which may cause severe neck pain (5).

Signs And Symptoms Of Neck Pain In Children

Some of the common symptoms of neck pain in children are (4) (6):

  • Head is often tilted to one side
  • Holding the head too stiffly
  • Limited neck movement, i.e., a child may not bend the head back and forth.
  • Feels sore neck muscles when touched
  • Pain in the front of the neck if your child has a sore throat or swollen glands
  • Pain in the back of the neck and around the shoulder blades
  • Headache

Complications Of Neck Pain In Children

Neck pain is mostly mild and temporary in children, but, if left untreated, results in chronic pain in the neck and other complications, including (2):

  • Cervical spine degeneration: It is caused due to repeated stress on the cervical spine, such as the “text neck syndrome.”
  • Developmental complications: Various developmental disorders, including eye symptoms (vision problem or eye strain), are associated with musculoskeletal neck pain in children due to increased near-work activities, such as using digital screens (7).
  • Psychological complications: Various studies have shown a correlation of neck pain in children with psychological and emotional problems, such as depression, anxiety, irritability, and stress (8).
  • Social complications: A persistent neck pain in your child may also bring changes in your child’s daily life and habits, such as changes in behavior, poor communication skills, and decreased academic performance.
  • Persistent neck pain in children or adolescents also increases the risk of developing chronic neck pain in adulthood.

If a child is experiencing severe neck pain, the complications may vary depending on the type of trauma and the extent of the damage. It may include (9) (10):

  • Chronic pain
  • Stiffness or weakness in the neck, shoulder, or arm
  • Shooting pain that spreads down the arm into the hand and fingers
  • Paralysis (partial or complete)
  • Limited neck movement
  • Permanent disability

Diagnosis Of Neck Pain In Children

To diagnose neck pain, your child’s doctor will perform (5):

  • A comprehensive physical examination
  • A detailed history including the duration of neck pain, details of your child’s normal activities, history of trauma or any previous injuries and how the injury occurred, measurement of the neck’s range of motion, neck muscle strength, and reflexes, and check for any point of tenderness (11).
  • Various imaging tests, including X-ray, magnetic resonance imaging (MRI), or computed tomography (CT), help detect specific medical conditions, injuries, and other abnormalities in the bones and surrounding tissues in the neck (11).
  • Additional tests, such as electromyography, nerve conduction studies, myelogram, and nerve root block, may be considered if a child has severe neck pain. These procedures examine the discs in the spine, the spine itself, the function of nerves and muscle reaction, and the source of the pain.

Signs To See A Doctor

Neck pain is common in children and adolescents; however, if it interferes and disrupts your child’s daily activities, seek medical care. Call a physician if your child (5):

  • Experiences persistent pain in the neck or radiating pain that goes down the arms and legs
  • Develops neck pain after an accident (sports, motor vehicle collision, etc.)
  • Loses movement or feels numbness and tingling (1)
  • Has difficulty controlling the muscles of the arms or legs (1)
  • Experiences loss of bowel or bladder control (1)
  • Has pain that lasts more than two weeks (4)
  • Has neck pain with fever or headache (4)
  • Does not respond to over-the-counter analgesics (10)
  • Neck pain is worsened despite the conservative management (10)
  • Neck pain does not improve or worsens when resting (10)

Home Remedies For Neck Pain In Children

Some home remedies and care advice for neck pain in children are (12):

  • Wearing a soft neck collar for a short term (11)
  • Applying cold pack or ice wrapped in a cloth on the sore neck muscles
  • Applying heat on sore muscles using a heat pack, heating pad, or warm wet washcloth
  • Improving sleep positions of your child and using a neck collar while sleeping
  • Doing stretching exercises, including touching the chin and ears to shoulders, moving the head back and forth, at least three minutes daily.
  • Preventing your child from doing any activity that may increase the pain
  • Taking over-the-counter pain medicines, such as acetaminophen (Tylenol), Ibuprofen (Advil), if necessary

Treatment For Neck Pain In Children

For neck pain due to an accident, first-aid measures, physical therapy, manipulative therapy (such as chiropractic or osteopathic care), medicine, and, in some cases, surgery could be the treatment options. The treatment is tailored to the underlying cause, injury location, and severity to relieve pain and improve function. The age of the child, health condition, and daily activities also play a role in managing neck pain in children (1).

For severe musculoskeletal neck pain caused by neck sprains and without underlying systemic disease, the symptoms of neck pain improve with time (usually four to six weeks) and with proper treatment.

Some of the current evidence-based treatment options for musculoskeletal neck pain in children include (3) (13):

  1. Pharmacological treatments include pain medicines and muscle relaxants, such as nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and anti-depressants for improving neck pain and stiff neck; however, the intake and uptake of these medications should be reviewed pro-actively.
  1. Physical therapy, including supervised stretching and strengthening exercises.
  1. Conventional and alternative medicine (CAM), including acupuncture, and yoga.
  1. Spinal manipulative therapies, including chiropractic and osteopathic care
  1. Soft tissue therapy, including massage, and trigger point therapy.
  1. Passive modalities, including interferential current or transcutaneous electrical nerve stimulation (TENS)
  1. Intermittent traction
  1. Lifestyle counseling, including a balanced diet, sleep hygiene, appropriate weight management, regular physical activity, and staying active

Neck pains are one of the most common spinal pains in children. Mostly, they are mild and temporary but can lead to various complications and persistent chronic neck pain if left untreated. Diagnosis of neck pain in children includes a physical examination, a thorough history, and imaging tests. Applying cold and heat compresses, stretching exercises, OTC pain medicines, etc., can help treat the pain; and in case your child has developed neck pain after accident/injury or has chronic severe pain, seek medical advice.

References:

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  1. Neck Problems and Injuries.
    https://www.mottchildren.org/health-library/necpn
  2. Fares J Fares MY Fares Y. Musculoskeletal neck pain in children and adolescents: Risk factors and complications.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445652/
  3. Cox J Davidian C Mior S. Neck pain in children: a retrospective case series.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039770/
  4. Neck Pain or Stiffness.
    https://www.seattlechildrens.org/conditions/a-z/neck-pain-or-stiffness/
  5. Neck pain.
    https://my.clevelandclinic.org/health/symptoms/21179-neck-pain
  6. Neck Pain or Stiffness.
    https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/symptoms/neck-pain-or-stiffness/
  7. Thorud HS Aurjord R Falkenberg HK. Headache and musculoskeletal pain in school children are associated with uncorrected vision problems and need for glasses: a case-control study.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7822909/
  8. Rees CS Smith AJ O\’Sullivan PB Kendall GE Straker LM. Back and neck pain are related to mental health problems in adolescence.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3123209/
  9. Neck Problems and Injuries.
    https://www.uofmhealth.org/health-library/necpn
  10. Rubel D Brahma B. Neuro spine care for kids.
    https://www.choa.org/-/media/Files/Childrens/medical-professionals/physician-resources/neurosciences-referrals/neurospinecareforkids.pdf
  11. Neck Sprain.
    https://orthoinfo.aaos.org/en/diseases–conditions/neck-sprain/
  12. Neck Pain or Stiffness.
    https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Neck%20Pain%20or%20Stiffness
  13. Caes L Fisher E Clinch J Eccleston C. Current Evidence-Based Interdisciplinary Treatment Options for Pediatric Musculoskeletal Pain.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096755/
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Reshmi Das

Reshmi Das has over three years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction. She writes health and wellness articles for children and pregnant and lactating women. Reshmi has completed her Master’s degree in Biotechnology. She is currently pursuing an Executive... more