Springdale Mason Pediatrics

Neck Pain - Muscle Strain


  • Pain or discomfort in the back, side or front of the neck
  • Stiff neck (limited range of motion) is also common
  • Includes minor muscle strain from neck overuse

Call or Return If

  • Neck pain becomes severe
  • Pain starts to shoot into the arms, upper back or legs
  • Unexplained neck pain persists over 3 days
  • Pain lasts more than 2 weeks
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • In teens, new neck pain is mostly from strained neck muscles (muscle overuse).
  • The most common modern cause is working with the head down in a flexed position. Such head tilting occurs with texting or looking at smart devices.
  • Other 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 be causes.
  • At all ages, it can be from a swollen lymph node. That can cause spasm of the neck muscle it lies against.
  • Pain in the front of the neck often is from a sore throat. It can also be from a swollen lymph node.

Symptoms of Strained Neck Muscles

  • The head is often cocked to one side
  • Can't bend the head backward or put the chin to each shoulder. Usually bending it forward is not limited.
  • 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.

After Care Advice

  • Most new neck pain is from stretching and turning the neck muscles too much.
  • This causes strained muscles (also called muscle overuse).
  • Long periods of looking down is the most common cause of unexplained neck pain in back. Seen mainly with texting or using other mobile devices.
  • Looking up or to the side for too long is also a common trigger.
  • 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.
Cold Pack:
  • During the first 2 days, use a cold pack. You can also use 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 on the back or side, not the stomach. Sleeping face down puts the most stress on the neck muscles.
  • 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.
  • Do this for a few nights.
Stretching Exercises:
  • Protect the neck for 48 hours.
  • Then start a gentle stretching program.
  • Improve the tone of the neck muscles. Do 2 or 3 minutes per day of gentle neck stretches.
  • Touch the chin to each shoulder. Hold for 10 seconds.
  • Touch the ear to each shoulder. Hold for 10 seconds.
  • Move the head forward and backward.
  • Don't apply any resistance during these stretching exercises.
Prevention of Strained Neck Muscles:
  • Avoid triggers that overstress the neck muscles. Common triggers are listed below:
  • Keeping the neck turned or bent for a long period of time. The most common cause is bending forward to text or look at a mobile device. Another example is painting a ceiling.
  • The neck likes to keep the head in a neutral position because it is heavy (12 pounds or 5.4 kg).
  • Carrying heavy objects on the head
  • Carrying heavy objects with one arm (instead of both arms)
  • Standing on the head
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.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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