Waking Up With Neck Pain: Causes, Prevention, Treatment, Best Exercises

October 19th, 2022  by  Hinge Health Staff – Hinge Health

Medically reviewed by orthopedic surgeon Jonathan Lee, MD, senior expert physician at Hinge Health


Waking up with neck pain? Talk about a rough start to your morning. When your neck hurts, it can be hard to turn your head from side to side, making everything from driving to working much more challenging. Morning neck pain can take a big toll on your quality of life and your daily routine at school, work, or home.

Here, learn more about what causes neck pain after sleeping, and how to prevent and treat it --- especially with exercises from our Hinge Health physical therapists.

What Is Neck Pain?

Around 10-20% of all adults experience neck pain. Even if you don't normally experience neck pain, you may still occasionally wake up with a sore, stiff neck first thing in the morning. Talk about an unexpected pain in the ... well ... neck.

"When we sleep, there isn't a lot of blood flow to the neck area," explains Steven Goostree, PT, DPT, OCS, a physical therapist at Hinge Health. This makes it more likely that muscles will stiffen up and cause pain. Add in a poor pillow and less-than-stellar sleep position, and it's no wonder you wake up with an out-of-whack neck. While sleep-related issues can be a big factor, they're not the only potential triggers. Read on to learn more about causes of morning neck pain.

Why You Wake Up with Neck Pain

Here are some of the most common reasons you may experience neck pain in the morning.

Your pillow. There's nothing like resting your head on a comfy fluffy pillow at the end of the day. But the wrong type of pillow can cause neck pain, says Dr. Goostree. "If it's too soft, it won't give the proper amount of support to the structures in your neck," he explains. Not sure if your pillow is the culprit? Try this test: Bend the pillow, then quickly let go, Dr. Goostree advises. If it flops right back over quickly, chances are it's too soft, he says.

Your sleep position. If you sleep on your stomach, your head has to turn to one side, which will twist your neck and head out of alignment with your spine. "Your joints don't like to be in that position for a sustained period of time," says Dr. Goostree.

Other sleep issues. In addition to your pillow and sleep position, it's important to get a handle on anything that's messing with your good night's sleep. Research suggests that as many as five percent of all cases of chronic neck pain can be tied back to sleeping problems. Lack of sleep may also make you more sensitive to pain, Dr. Goostree notes.

Check your posture. A 2019 review of 15 studies published in Current Reviews of Musculoskeletal Medicine found that posture contributes to neck pain among adults. If you notice neck pain, try to figure out if certain posture habits provoke your pain. If you slump in your chair, try to sit up straight. If you hold a nice tall posture, relax a bit. It may help.

Cervical spine pain. Certain conditions, such as neck osteoarthritis, or nerve compression caused by a herniated cervical disk, can cause neck pain that worsens at night, when the neck is in one position for a prolonged period of time. (Your cervical spine is the neck region of your spinal column.) Whiplash. If you've been in any sort of situation where you've experienced an abrupt forward/backward neck movement (for example, an auto accident), neck muscles may tighten and spasm during the night, which can cause  you to wake up with neck pain.

When to See a Doctor

Waking up with neck pain usually doesn't indicate a serious problem, though it's normal to be concerned about it. You probably want to know how to tell if your morning neck pain is serious, and when you should seek medical advice. "Most of us will experience a stiff neck, or neck pain, when we wake up at some point in our lives," says Dr. Goostree. "The good news is most of the time, it can be improved with non-surgical treatments such as rest, NSAIDs [non-steroidal anti-inflammatory drugs like ibuprofen], stretching exercises, and some simple posture and pillow changes." See a doctor if you notice any of the following:

  • You wake up with neck pain so intense that you can't turn your head 

  • Your neck pain makes it hard for you to fall asleep

  • You begin to experience morning neck pain after a severe injury to your head or neck, such as a car accident or fall

  • Your morning neck pain is accompanied by numbness or weakness in your arms or legs

  • You also lose control over your bladder and/or bowels

  • Your morning neck pain doesn't get better after a week of at-home treatment

Prevention Tips

If you experience morning neck pain, there are many things you can do to manage and prevent achiness and stiffness.

Do a neck workout. Simple exercises such as turning or gently tilting your head, or shoulder rolls, can stretch your neck, shoulder and back muscles and make them stronger to relieve neck pain. "Like Benjamin Franklin said, an ounce of prevention is worth a pound of cure," says Dr. Goostree. "If you keep your neck muscles fit and mobile, you can prevent neck pain and stiffness from recurring."

Reduce stress. Research shows a link between chronic neck pain and mental health issues such as anxiety and depression, according to a 2022 review published in the journal BMC Musculoskeletal Disorders. Mindfulness-based stress reduction practices (e.g., meditation, yoga, tai chi) may help you cope better, and also improve sleep.

Adjust your posture. When sitting or standing, try to keep your neck straight in line with your body and try not to hunch forward, advises Dr. Goostree. If you sit at a desk for a long period of time, try to take movement breaks, or adjust your position often. While there's no such thing as "perfect posture," moving around frequently can prevent stiffness from hunching over.

Pick the right pillow. You may wonder, "Is it better for your neck to sleep without a pillow?" There's no right or wrong answer to that, says Dr. Goostree. "I've had a handful of patients tell me that their neck feels better without one, so it really comes down to what you prefer," he says. If you do sleep with a pillow, consider a feather one, which molds to the shape of your neck. You can also consider a regular pillow with memory foam, which also conforms to your head and neck. Another option is a cervical pillow, which is specifically designed to align the neck and spine. One small study of 12 athletes found that it helped improve neck pain, and helped with falling asleep as well as improved sleep quality. Also consider a horseshoe shaped pillow to support your neck muscles while you're riding in a plane or car, or reclining to watch TV.

Switch sleeping positions. If you normally sleep on your stomach, switch to your back or side, advises Dr. Goostree. If you're already a side sleeper, use a pillow that is higher under your neck than your head to help keep your spine straight. If you're a back sleeper, opt for a rounded pillow to support your neck's natural curve, or opt for a pillow with an indentation that your neck can rest in.

Woman massaging man's back.

Treatment for Morning Neck Pain

The right course of treatment depends on the nature and cause of your pain. The following tips from our Hinge Health physical therapists and medical doctors can provide morning neck pain relief for most mild to moderate cases:

  • Ice and heat. Alternate using an ice pack and heating pad for 20 minutes at a time as needed to reduce inflammation (ice) and increase blood flow to combat stiff neck (heat).

  • Over-the-counter (OTC) medication. Pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol), can be helpful for neck pain. It's important to make sure that you are safely able to take these medications, based on your medical history.

  • Complementary treatments. Talk to your provider if you're interested in trying alternative treatments for neck pain relief, such as massage, acupuncture, or chiropractic care.

While all of the above steps can help neck pain, one of the most effective is exercise therapy. While your neck may not be able to handle vigorous high-impact workouts (such as running), other activities such as walking, biking, or using an elliptical are all good ways to get blood flow to all areas of your body, including your neck, Dr. Goostree adds.

Exercises for Neck Pain 

Gentle movement also includes targeted stretches and exercises, which can make a big difference in relieving neck pain and preventing future episodes. Here are a few gentle exercises from Hinge Health that are commonly used to prevent and treat  morning neck pain. Dr. Goostree says they're great for easing a sore neck when you wake up.

Chin Tucks

Chin tucks activate and "wake up" stiff muscles in the front and back of your neck. If it really hurts to draw your head back and tuck your chin, draw your head back far less.

Head Turns

If you've slept at a funny angle or on a poor pillow, your neck muscles may be strained and tight. When you move your neck from side to side, you help restore range of motion. It's common to have less range of motion as you start doing head turn exercises. This will increase as you warm up.

Discover more neck exercises in our Hinge Health exercise therapy library.

PT Tip: Stay Hydrated

As soon as you wake up in the morning, drink a full glass of water. "Dehydration can contribute to neck stiffness and pain, because when you're dehydrated your neck muscles tighten up," explains Dr. Goostree. In addition, the discs in your cervical spine rehydrate at night, which may lead to stiffness in the morning.

Learn More About Hinge Health for Neck Pain Relief

Our digital programs for back and joint pain are offered for free through benefit providers. Click here to see if you're eligible.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References:

  1. Canivet, C., Östergren, P. O., Choi, B. et al. (2008). Sleeping problems as a risk factor for subsequent musculoskeletal pain and the role of job strain: Results from a one-year follow-up of the Malmö shoulder neck study cohort. International Journal of Behavioral Medicine, 15, 254--262. doi:10.1080/10705500802365466

  2. Di Cagno, A., Minganti, C., Quaranta, F., Pistone, E. M., Fagnani, F., Fiorilli, G., & Giombini, A. (2017). Effectiveness of a new cervical pillow on pain and sleep quality in recreational athletes with chronic mechanical neck pain: a preliminary comparative study. The Journal of Sports Medicine and Physical Fitness, 57(9). * https://doi.org/10.23736/s0022-4707.16.06587-7

  3. Isaac, Z., & Kelly, H. R. (2020). UpToDate. Uptodate.com. https://www.uptodate.com/contents/evaluation-of-the-adult-patient-with-neck-pain

  4. Kazeminasab, S., Nejadghaderi, S. A., Amiri, P. et al. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskeletal Disorders, 23, 26. doi:10.1186/s12891-021-04957-4

  5. Mahmoud, N. F., Hassan, K. A., Abdelmajeed, S. F., Moustafa, I. M., & Silva, A. G. (2019). The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis. Current Reviews in Musculoskeletal Medicine, 12(4), 562--577. https://doi.org/10.1007/s12178-019-09594-y

  6. Publishing, H. H. (2022, February 2). Say "good night" to neck pain. Harvard Health. https://www.health.harvard.edu/pain/say-good-night-to-neck-pain

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