Waking up after a night of tossing and turning, only to feel a crick in your neck, is an all-too-common experience for many adults.
There are a host of reasons why this happens, but one main culprit is sleeping in a position that puts strain on your neck, or using a pillow (or even a mattress) that messes with your alignment.
While there isn’t a quick fix for neck pain after sleeping, there are some helpful strategies that can help prevent it. Here’s what to know.
When you’re sleeping, you should aim for neutral neck alignment.
“There definitely are certain ideal sleep positions,” said Dr. Elizabeth T. Nguyen, a physiatrist at the Hospital for Special Surgery in New York, noting that those include “lying flat on your back or side,” sleeping with your neck in a comfortable neutral and straight position.
“We try to recommend avoiding belly sleeping, because it forces your neck to rotate 90 degrees, and that changes and alters the normal alignment of your spine,” Nguyen added.
When you’re sleeping, your neck alignment should be similar to when you’re standing up with good posture, she said — “everything should kind of be aligned neutrally, head on top of your shoulders, try to avoid flexing or bending the neck forward, backwards or to the side for extended periods of time.”
Keeping your neck in a flexed or bent position over many hours overnight can “stretch the neck muscles or compress certain spinal elements, such as the discs or nerves, and this chronically poor sleep alignment over many weeks to months can eventually lead to pain,” Nguyen explained.
It’s potentially about your pillow more than your exact sleep position.
Your pillow choice can play a huge role in that ideal neutral alignment. And while there isn’t one pillow that’s ideal for everyone, a firm, short pillow is generally your best bet, said Dr. Humaira Ashraf, a physiatrist at MedStar Health in Maryland.
“The pillow should not descend well down into where you’re sleeping on it,” Ashraf said. Instead, it should stop just prior to your shoulder. This will give you the support your neck needs to be in a neutral posture when you sleep.
“You don’t want a pillow that’s necessarily too soft … like a feather pillow where your head is sinking down,” said Dr. Peter G. Whang, an orthopedic spine specialist at the Yale University School of Medicine. “You also don’t want a pillow that’s too high, because that’s going to put a crick in your neck the other way.”
Nguyen does like a specific kind of pillow for back and side sleepers — a contour pillow, “because it has a depression in the center of the pillow for your head, and it has better side support if you end up on your side.”
Your mattress is also part of the neck pain equation, she added. “Mattresses are very important because [they] can help you maintain neutral spine alignment throughout the neck as well as the mid- and the lower spine,” Nguyen said, noting that a medium-to-firm mattress provides the best support.
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Sleeping with your neck in a neutral position is the best way to prevent future neck pain.
Forcing yourself to sleep in a certain position can be tough — even impossible.
“When someone says, ‘I’m a stomach sleeper,’ it’s kind of hard to get them not to sleep in that position,” Whang said. You can try to sleep in an ideal position by going to sleep in a certain posture, but you can’t really control your body’s movements as you’re snoozing.
There isn’t too much you can do to keep yourself from moving around, but there are a few things to consider.
First, make sure you’re getting good quality sleep, said Nguyen. “Because some people, they toss and turn because their sleep is disrupted.”
You’ll want to rule out conditions like insomnia, stress-induced restlessness and even too-warm temperatures in your bedroom that could make you uncomfortable and cause the tossing and turning, Nguyen said.
“If [you] have no problems sleeping fully through the night, a strategy one can use is if you have body pillows, you can place them next to you, and that might help prevent you from rolling over to the side as much,” she added. “But it is hard … there’s only so much you can control.”
Your neck pain also may be a sign of bad posture during the day.
Typically, when someone with no existing neck problems wakes up with neck pain, it’s much more telling to look back several weeks at what they were doing to find the cause of the pain, according to Ashraf. “Usually, the one night was kind of the straw that broke the [camel’s back],” Ashraf said.
If you look back at the past two weeks, you may have been scrolling your phone in a bad position, sleeping on a plane in an uncomfortable seat or doing activities that required bad posture, like crawling around with kids or grandkids, she noted.
“And those often ― if you do them for extensive amounts of times ― will aggravate the ligaments of the neck, and then one bad night makes you wake up with a really stiff neck,” Ashraf said.
So, when considering your sleeping position, be sure to think about how you’re treating your neck and spine during your waking hours, too.
Here’s the difference between neck pain that can be treated at home and neck pain that needs medical attention.
While neck pain is always unpleasant, it’s sometimes just part of the reality of sleeping in a bad position.
“It’s a really common problem … because we can’t control what position we sleep in,” Whang said. “That’s why I think the choice of pillow can be helpful, but may not preclude it from occurring.”
If you do have a couple of days of night pains, “don’t think that the sky is falling,” said Whang, “because, I think in most cases, it does get better over time.”
If you wake up with mild neck pain and either don’t have access to or don’t want to see a doctor, you can use certain tools to treat the pain at home. Some easy access pain-relief items include heat patches from the drugstore, according to Ashraf. Over-the-counter medications like Tylenol can also be useful, as well as anti-inflammatory medications like ibuprofen or naproxen, Nguyen said.
It can also be helpful to stretch the painful muscle out. “Apply some pressure to the area that feels tight, and then sort of slowly move away from it to elongate this muscle,” Ashraf advised. “Applying the pressure makes it hurt significantly less while you’re trying to lengthen that tight muscle.”
When should you head to the doctor about your pain? “I would say pain that doesn’t improve over time or with conservative measures like anti-inflammatories,” said Whang. “So, persistent pain, pain that is debilitating where it really affects your life, where you can’t work or do other leisure activities.”
If you have any signs of nerve compression, which can happen when you sleep in the wrong position, are also a red flag. Symptoms of nerve compression include “pain, numbness, tingling going down your arm associated with the neck pain,” Whang explained.
For most people, though, neck pain resolves on its own and only pops up after a night sleeping in a bad-for-your-neck position.
