Should I Get an X-Ray for My 2-Year-Old's Neck Pain? - Orthopedics

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My two-year-old daughter has been experiencing neck pain for several days. Should we get an X-ray?


My lively and active daughter is 2 years and 3 months old.
For four consecutive days, she has been pointing to a protruding area on the back of her neck, saying it hurts! I suspect it might be due to playing horsey with her dad too roughly or a sports injury.
She can still turn her neck side to side and can tilt her head forward to touch her chin to her chest.
She has cold symptoms: a runny nose and a cough, but no fever.
The pediatrician at a nearby clinic suggested it might be muscle pain and prescribed pain medication along with cold medicine.
I'm very concerned that her cervical spine may have been injured.
Where should I take her for an examination? Should I go directly to a pediatric orthopedic clinic, a pain management clinic, or a traditional Chinese medicine practitioner for massage?

Xia Mami, 30~39 year old female. Ask Date: 2005/08/05

Dr. Li Wenlin reply Orthopedics


Hello: In response to your question, based on your description, it seems that your daughter’s cervical spine is likely not injured.
If there were an injury, her range of motion would be affected, and she would likely continue to cry persistently.
The pediatrician's assessment is quite plausible.
Moving forward, we should monitor any changes in her clinical presentation.
If it is muscle pain, rest and analgesics should help alleviate the symptoms gradually, so there is no need to worry too much.
However, if the symptoms persist, please have the pediatrician refer you to an orthopedic specialist for further evaluation.
I believe this will help your daughter recover soon!

Reply Date: 2005/08/05

More Info


When considering whether to get an X-ray for your 2-year-old daughter who is experiencing neck pain, it is essential to weigh the potential benefits against the risks associated with radiation exposure, especially in young children. Given her symptoms, including localized pain in the neck area, it is understandable that you are concerned about possible underlying issues, such as a muscle strain or even a more serious injury.

First, it is important to note that children are generally more sensitive to radiation than adults due to their developing bodies and longer life expectancy. Therefore, any decision to expose a child to X-rays should be made with caution. In your daughter's case, the pediatrician has already assessed her condition and suggested that the pain is likely muscular, which is a common cause of neck pain in active children. The prescribed pain relief and cold symptoms management indicate that the doctor believes the issue is not severe.

If your daughter can still move her neck without significant restriction and does not exhibit other alarming symptoms (such as severe pain, neurological symptoms like weakness or numbness, or fever), it may not be necessary to pursue imaging at this time. However, if her symptoms persist or worsen, or if you notice any new symptoms, it would be prudent to seek further evaluation.

In terms of where to go for further assessment, you have a few options:
1. Pediatric Orthopedic Specialist: If you are particularly concerned about her neck and want a thorough evaluation, a pediatric orthopedic specialist would be a good choice. They can assess her neck pain in detail and determine if imaging is necessary based on a physical examination.

2. Pediatric Pain Clinic: If the pain continues and you want to explore pain management options, a pediatric pain clinic could provide specialized care tailored to children's needs.

3. General Pediatrician: Returning to your child's pediatrician for a follow-up visit may also be beneficial. They can reassess her condition and decide if further imaging or referral is warranted.

4. Alternative Therapies: While some parents consider alternative therapies such as acupuncture or chiropractic care, it is crucial to consult with a healthcare professional before pursuing these options, especially for a young child.

In summary, while your concern for your daughter's neck pain is valid, it is essential to follow the guidance of healthcare professionals who have assessed her condition. If her symptoms do not improve with conservative management or if you have ongoing concerns, seeking a referral to a specialist would be the next appropriate step. Always prioritize open communication with your child's healthcare provider to ensure the best care and to address any worries you may have about her health.

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