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    Neck Pain- Muscle Strain

    Updated at December 6th, 2022


    DisclaimerThis material is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it. It is not intended to provide medical advice, diagnosis or treatment, nor does it replace the advice or counsel of a doctor or health care professional. Reference to a specific commercial product or service does not imply endorsement or recommendation of that product or service by CPCMG.


    • 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

    Health Information


    • 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.

    Care Advice

    1. Overview:
      • 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.
    2. Pain Medicine:
      • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
    3. 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.
    4. 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.
    5. Sleep:
      • 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.
    6. 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.
    7. 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
    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.

    Call Your Doctor 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

    Author: Barton Schmitt MD, FAAP

    Copyright 2000-2020 Schmitt Pediatric Guidelines LLC