Conditions

Neck Problems

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What are neck problems?

Neck problems affect the upper part of your child’s spine, called the cervical spine. This part of the spine is made up of 7 neck bones (vertebrae) stacked in a column. and muscles connect the bones to each other. Many other important structures pass through this area, including the , nerves that branch off of the spinal cord and vessels that carry blood to and from the brain.

Like adults, children and teens can get bothersome but mild neck problems from time to time, like sore or stiff muscles from sleeping “wrong” or holding their head in 1 position too long. Usually, these problems are not serious, and they will get better on their own. However, the neck can also be injured, and neck problems are sometimes part of a broader or condition.

When is neck pain or stiffness an emergency?

Call 911 or take your child to our Emergency Department if any 1 of these is true:

Neck pain or stiffness starts after your child has a major injury, like from sports or a car crash
They are not moving or feeling a part of their body that they typically can
They became unable to stand
You think they might have a life-threatening condition

Learn more about when to call a doctor for neck pain or stiffness.

Types of Neck Problems

Neck problems that could be more serious and are likely to need care from a doctor include:

Cervical instability

Often, cervical instability means ligaments in the neck are loose or weak. As a result, the bones do not stay aligned or the joints do not move in the usual ways.

Instability can happen after a very forceful injury that causes a broken bone (fracture) in the neck. More commonly, cervical instability is a part of another condition, including those with loose ligaments or bones that aren’t the usual shape, like , , disorders (such as Marfan syndrome), 22q11.2 deletion syndrome, skeletal dysplasia, or .
Basilar invagination

In this condition, the top of the spine presses up into the bottom of the skull. It may cause pressure on the or top of the spinal cord. This might happen in children whose skull or spine did not form in the typical way or who have a craniofacial condition, a soft-bone disease (like ), Chiari malformation or another condition that affects their bones.
Tumors in the spine

Tumors in the spine may be benign (not cancer), like or , or they may be complex, cancerous tumors that can grow into nearby tissues and spread to other parts of the body, including bone tumors, soft tissue tumors and spinal cord tumors.
Neck trauma

Falls and car accidents are common causes of forceful neck injuries, or neck trauma. Injuries like this can stretch or tear soft tissues, like ligaments, and break vertebrae or move bones out of their usual place.
Cervical kyphosis and cervical stenosis

Cervical kyphosis is a forward curve of the neck. Usually, the upper back curves forward and the neck curves backward.

Cervical stenosis means the is narrower than usual. A bone or a disc between the vertebrae might be pushing on the spinal cord.

Neck Problem Care at Seattle Children's

The Spine Program at Seattle Children's is the largest pediatric spine center in the Pacific Northwest and offers the most comprehensive care for your child, no matter how complex their condition is.

What are the symptoms of neck problems?

Sometimes children have no symptoms at all, even though they have a condition that affects their neck, like loose ligaments or bones that are not the typical shape.

If a neck problem causes pressure on nerves in or around the neck or on the or , your child may have:

New balance issues
Very stiff neck after a minor fall
New bladder or bowel control issues
Headache when laughing, coughing, sneezing or jumping
Pain in the neck, scalp, face, shoulder or arm
Numbness, tingling, burning or “pins and needles” feeling
Muscle spasms, tightness or stiffness
Weakness in the neck, arms or legs
Trouble moving the neck, arms or legs

Other symptoms of neck problems may include:

Feeling that the neck is not stable or it’s not moving in the usual way.
Not being able to do typical neck motions smoothly or fully.
Getting tired of holding the head up or feeling like the head is oddly heavy.
Trouble with fine , like using buttons or zippers.
Neck or head that is not in the typical position. For example, in torticollis, the neck is tilted or twisted.

Some types of neck problems may cause pressure on blood vessels and reduce blood flow to parts of the brain. This may lead to symptoms, like problems with balance, movement, coordination, swallowing, hearing or vision; confusion; or fainting.

How are neck problems diagnosed?

When your child comes to our clinic, they will see a , or doctor. These team members are specially trained in children’s neck and spine care. We will examine your child’s neck and ask about their condition to find out what is wrong.

We will check your child’s and their reflexes and may do other tests. We may ask that your child have .

After reviewing the X-rays, the exam results and your child’s symptoms, we may ask for more tests, including:

How are neck problems treated?

Treatment for neck problems depends on your child’s symptoms and the cause. At Seattle Children’s, we use both surgical and nonsurgical treatments based on your child’s needs.

Nonsurgical treatments for neck problems

We can help many children with neck problems using:

Changes in their activities to relieve symptoms, let an injury heal and reduce the risk of a new injury
Medicines that reduce pain and swelling (anti-inflammatories)
Bracing to keep the neck still
Physical therapy to strengthen, stretch or balance neck muscles and help with stability and movement

Surgery for neck problems

Seattle Children’s plan and perform neck surgeries. For cervical spinal fusion (joining the neck bones), they work side by side with our . We recommend surgery only when we believe it will give your child the best results.

Your child’s treatment plan will be custom-made for them. In many cases, the goals of surgery are to:

Make your child’s neck stable
Decrease the risk for further neck problems or related conditions later

Often, surgery involves changing the position of the bones, making them stable and relieving any pressure on the nerves, spinal cord, brainstem or blood vessels. Typically, this means making the bones grow together using screws, rods or a so they stay in place (spinal fusion). The surgeon may also need to take out part of a bone () along with soft tissues that are pressing on nerves.

Before surgery, we sometimes use halo-gravity traction. This is a way to apply a slow and safe stretch to your child’s spine. It uses a metal ring that surrounds the head (called a halo). A surgeon puts the halo on your child’s head under general anesthesia. The halo is attached to a pulley system 24 hours a day for several weeks. Weights are added to the pulley system to slowly pull the head upward. This can help correct curves in the spine or basilar invagination (top of the spine pressing up into the bottom of the skull).

In the case of tumors, surgeons will take out the tumor and perform any other steps needed to give your child the best use of their neck, such as spinal fusion.

Often, nonsurgical treatments, like bracing and physical therapy, are part of a child’s plan for healing after surgery and getting back to their usual activities.

Why choose Seattle Children’s for neck treatment?

The Spine Program at Seattle Children’s treats all types of cervical spine conditions in babies, children, teens and young adults. Ours is the largest pediatric spine center in the Pacific Northwest. We offer the most comprehensive care for your child, no matter how complex their condition is. It’s why other hospitals in the region refer their most complex pediatric patients to us.

We have a special clinic for children with neck problems. While some children’s hospitals don’t treat cervical spine conditions, we have the expertise to treat the spine all the way from the skull to the tailbone.

“Being at Seattle Children’s brought us a sense of comfort. I felt like they cared about us, not just as patients, but as people.”

– Magi, whose son Ryder had spine surgery at Seattle Children’s for a rare type of kyphosis that affects the neck

The spine experts you need are here
- The Spine Program team includes doctors, surgeons, and from Orthopedics and Sports Medicine. For neck problems that may require joining bones (spinal fusion), this team works with experts from Neurosurgery. An orthopedic surgeon and a neurosurgeon do the procedure together so your child gets their combined skills. The surgeons will see your child together in shared clinic visits.
- We can successfully treat neck problems in most children with methods other than surgery. Nonsurgical treatment often means changing activities, wearing a brace or doing physical therapy. We have onsite orthotists to build and fit braces for our young patients. We also have the largest team of physical therapists in the Pacific Northwest who specialize in the care of babies, children, teens and young adults.
- If your child needs surgery, our spine surgeons are leaders in their field. They have more training and experience with children’s complex spine conditions than anyone else in the area. Spine surgery for children is all they do. Each is .
- We offer your child the support of an entire medical center and connect you with any expert your child may need. Based on your child’s condition, we involve specialists from across Seattle Children’s, such as the Craniofacial Center, the Heart Center, Neurosurgery, Pulmonary Medicine and Rehabilitation Medicine.
Our approach to surgery increases comfort and reduces stress
- Our new state-of-the-art operating rooms reduce stress and increase comfort for your child. The design lets you stay by your child’s side until they gently go to sleep before any spine surgery.
- Before we recommend surgery, we look at your child as a whole person. Your child’s team will take many factors into account. These include the degree of their neck problem, the effects on their health and how much more they will grow. We also consider what results you can expect from treatment.
- We have the technology and skills to use 3D imaging to guide your child’s surgery. This helps us place hardware, such as screws, with precision. It also lets us see in real time the changes we make to your child’s spine. Based on your child’s needs, we may use regular , low-dose 3D X-rays, or .
- helps us prevent a spinal cord injury during surgery. Our surgical spinal cord monitoring team leads the country in new ways to make spine surgery safer.
Care from birth through young adulthood
- We specialize in caring for kids. This means our experts have the knowledge, training and skills to treat the youngest patients, from babies with cervical spine conditions through young adults.
- Babies, children and teens are still developing. When we evaluate your child’s neck, plan their treatment and provide their care, we carefully consider their growth. We think about how growth may affect your child’s spine over time. We also consider how their spine may affect the rest of their development and health.
- If your child needs imaging that uses radiation, we use the lowest amount possible (PDF) to make the best image. We have a low-dose radiation X-ray machine, called the EOS. It makes safer full-body images. We can also get 3D images in the operating room with lower-dose instead of , which uses more radiation. We have the largest group of pediatric radiologists in the Northwest.
Support for your whole family
- We know it can be stressful to have a child with a spinal condition and to find the treatment they need. Everyone at Seattle Children’s works to make your experience here as easy as we can on your whole family.
- Your child’s team does more than plan and provide care for your child. We also make sure you and your child understand your child’s condition and treatment options.
- Care is easier for you because your child’s team members from the Spine Program work closely with each other — and with other programs and clinics your child may need at Seattle Children’s.
- Seattle Children’s supports your family with a range of resources. Our Child Life specialists, Family Resource Center and Guest Services are here to help.
Research and advances to improve care
- Members of the Spine Program team are leaders in research. We are always tracking the results of our patients’ care so we can be sure we are choosing the best treatment for each child. Your child’s care team may ask if you want to be involved in research. For example, we may ask to include data about your child’s condition and treatment in our studies.
- Our spine experts are part of national and international research groups. These groups study the latest treatment approaches and technologies. Together, we work to find the best and safest ways to care for children. We are part of the Pediatric Spine Study Group, Harms Study Group and Fox Congenital Spine Study Group.
- Researchers at Seattle Children’s study topics like these:
  - How the cervical spine may be different in children with skeletal dysplasia
  - If doctors should do X-rays to check for neck problems in children with Down syndrome who do not have symptoms and, if so, how often
  - How to check for tumor growth in the spines of children with multiple hereditary exostoses, a rare condition that causes tumors (osteochondromas) that could grow into the
  - How children do after nonsurgical or surgical treatment for
- Our “Spine at Risk” program keeps kids’ spines and spinal cords safe when they are under anesthesia. It has helped protect our patients for over 10 years. A recent grant supports our research to keep improving and sharing our methods so more children benefit. Learn more.
- Learn more about current orthopedics research at Seattle Children’s.