Neck Pain

Kids get neck pain all the time. The vast majority of instances have to do with muscle injury or soreness. Oftentimes they wake up saying their neck hurts and not really remembering that tumble they took at recess yesterday. Neck soreness needs to be differentiated though from an inability to move one’s neck. 

If your kiddo is saying their neck hurts to the point that they cannot or refuse to move it, they should be seen by their pediatrician. Even then, most of the kids I see in clinic with sore necks are of the muscle-soreness variety and are easily managed with Tylenol/acetaminophen or Advil/Motrin/ibuprofen at home.

If a kiddo is complaining of immediate neck pain after a known injury, they should be seen in clinic to rule out fractures or other neck injuries. And if there is concern for a neck injury and there is numbness or tingling anywhere in the body, that is an immediate 911 call. Do not attempt to move the patient as movement to a damaged neck or spinal cord can worsen the initial injury. The neck needs to be stabilized by emergency personnel for transport for evaluation in the emergency room with imaging and neurology team evaluation.

However, if we have neck pain with a fever, we get concerned about meningitis. Meningitis is an infection/inflammation of the covering of the brain (the meninges). There are two main forms of meningitis: viral and bacterial. The bacterial version is the super scary one that we vaccinate against, and the kind that can make kids very sick, very fast with high fevers and changes in mentation and alertness. It is tough to miss and most parents with kids that look this sick will be in the emergency room lickety-split for evaluation and to start IV antibiotics.

Viral meningitis is much more common and less concerning than bacterial meningitis. Though it can be associated with a fever like bacterial meningitis, the symptoms are usually headache, light sensitivity, and a bit of a sore neck. We sometimes see it with certain viral illnesses such as influenza and enterovirus. We will see these kids in clinic to make sure it is not bacterial meningitis and discuss supportive care at home with rest, hydration, and Tylenol/acetaminophen or Advil/Motrin/ibuprofen to help with the headaches.