Why Do I Have Neck Pain from Sleeping?

Why Your Neck Hurts When You Wake Up...And What To Do About It

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You’ve been sleeping pretty much every night since, oh, your entire life (minus a few all-nighters in college, we’re guessing). Don’t you just hate it when you wake up with back or neck pain? You might think, “How did I mess up laying down, closing my eyes and doing nothing?”

Don’t worry, you didn’t do anything wrong. You can wake up with a stiff neck after sleeping for a few reasons. What’s most encouraging is that there are a few simple fixes that can prevent you from getting neck pain from sleeping, and some actions you can take to relieve any pain you do have.

What’s (Probably) Going On Here?

The spine is more than the sum of its parts. It’s strong because it has to be—it keeps you upright and moving and it fights gravity and other forces acting upon it pretty much 24/7. But its individual parts can be surprisingly delicate, especially in the neck, aka the cervical spine.

The cervical spine has an important job: holding up your head all day. The human head weighs about 10 to 12 lbs—as much as a bowling ball—and that’s with perfect posture. According to a 2014 study published in Surgical Technology International, the head’s effective weight can increase to up to 60 lbs. with a 60-degree tilt!

All that weight means the muscles that support your head and neck need to work overtime, and all that works makes for tired muscles. That’s one piece of the puzzle. Then add misalignment while you’re supposed to be resting and you’ve got yourself some torticollis.

Torticollis, also known as wry neck, is a condition where your neck is twisted or tilted at a funny angle. Some babies are born with it (congenital torticollis), and some people pick it up from a variety of sources. It can be ongoing (chronic) or temporary and caused by a single event (acute).

Torticollis isn’t a condition in and of itself like, say, ankylosing spondylitis is. It’s more like a symptom that can have a number of sources. Irritated ligaments—tissue that connects bones to other bones—in the neck are one common culprit, and spasms of neck muscles are another. Either of these can be caused by sleeping “wrong,” especially since your neck muscles will be exhausted from holding up your head all day.

Two Reasons for Torticollis

So now we know the “what” of neck pain from sleeping. What about the “how?”

Generally when you wake up with neck pain, there are one or two issues at play here. Either your pillow isn’t right for you, the position in which you sleep is aggravating your neck, or both.

You might think that a hard pillow can hurt your neck, but it’s usually a pillow that’s too soft that makes you wake up with neck pain. Just like you need to keep your cervical spine aligned during the day to avoid overly taxing your muscles and ligaments, you need to do the same at night. It’s harder, though; you can make a conscious effort in daylight, but how can you control your posture when you’re asleep?

Your pillow is the answer. A nice, firm pillow will keep your spine in a straight line from your atlas (the first cervical vertebra, C1) down to your coccyx (tailbone). Any deviation from straight runs the risk of torticollis, so avoid it by making sure your pillow is right.

Neck pain from sleepingYour pillow or your sleeping position could be the culprit.

The way you sleep can also have a profound effect on the way you wake up—ready to face the day or ready to crawl back under the covers and hide from your neck pain. The best sleeping position for neck pain is usually on the back.

Back sleeping may not be right for you—it can aggravate sleep apnea, for example. In that case, sleeping on your side is the next best thing. Try to avoid stomach sleeping; it can put pressure on nerves that start in your neck, leading to further neck pain or radiculopathy (pain that radiates from the spinal cord down to the arms or legs).

What You Can Do About Neck Pain From Sleeping

So, what now? Just go about your day in pain, with your neck tilted? No! Time to take action.

Although time can be some of the best medicine for a sore or stiff neck, we want to speed the healing process along AND cut down on the risk you wake up with neck pain again. First thing’s first: If you woke up with neck pain, get some ice on it. Try 20 minutes on, 20 minutes off. That will cut down on the inflammation. Ditto an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) like Motrin (ibuprofen).

If it’s been a few days and your neck pain is stubbornly hanging around, switch from ice to heat. Again, 20 minutes on, 20 off is a good starting point. If your neck pain is caused by a spasming muscle, heat can help it relax and get the blood flowing to it. A gentle massage of the area can sometimes work for the same reason, but be careful not to overdo it.

Stretching, which may prove helpful as well, straddles the line between treatment and prevention. By the time you’re actually in pain it may be too late for stretching to help, but keeping your muscles loose and supple can reduce your risk of future neck ligament sprains, muscle and tendon strains, and torticollis.

Try stretching your neck through multiple planes of movement:

  • Try to touch your right ear to your right shoulder. Push gently on the left side of your head. Come back through center, and repeat on the left side. Do 10 reps each of left and right.
  • Look up to the ceiling as far as you can. Come back through center, and look down as far as you can. Do 10 reps each up and down.
  • Turn your head to the right. Push gently on your chin with your left hand. Come back through center and repeat on the left side. Do 10 reps each right and left.
  • Make a large clockwise circle with your nose, five times around. Make five circles counterclockwise.
     
  • “Chin-alphabet”: using your chin as a pointer, gently sketch the alphabet from A to Z

 

Neck stretchYou can stretch your neck muscles every day to cut down on strains.

Stretching will help keep your neck limber, but if you want to really cut down on neck pain from sleeping, you need to address the two root causes we talked about above. The first one is easy: Change your sleeping position to your back if you’re a side sleeper, or back or side if you’re a stomach sleeper. Second—and this one might cost a few dollars—get a new pillow, one that will keep your head and neck aligned with the rest of your spine.

By now you know why you woke up with neck pain, what to do about it, and how to reduce the chance of it happening again. Still need help? You may have a chronic condition. Check out our info on herniated discs and cervical spinal stenosis to start, and if your symptoms don’t match up, see if you may have another condition.

Updated on: 03/13/20
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Stiff Neck, Crick in the Neck and Relief
Reginald Q. Knight, MD, MHA
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