How to Sleep With a Stiff Neck
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How to Sleep With a Stiff Neck

We spend around one-third of our lives sleeping—or trying to sleep. Sleep is vital to our health and well-being because that is when the body repairs and recharges itself. Finding a position of comfort is critical to support that deep, restorative sleep we all crave.

New aches and pains when you wake can be caused by your sleeping position. One night of sleep in an awkward position can be a literal “pain in the neck” making it difficult to drive, work or even just turn your head.

We will explain how to sleep with a stiff neck and shoulders, improve your sleeping posture and the quality of your sleep.

Why Your Sleep Position Matters

Just as when you are sitting and standing, good posture is just as important when you sleep. When you sleep, your position should generally help you achieve a “neutral spine.” This is the position that reflects the natural curvature of the spine. In the neck, this is called a ‘lordosis.’

Proper alignment during sleep can help to reduce strain on the neck and back and allows those muscles and ligaments to relax and can decrease tension on the neck. A healthy sleep position also reduces pressure on the joints and internal organs and encourages healthy blood flow.

The Best Sleep Positions to Prevent Neck Pain

The following sleep positions are best for the neck and back.

On Your Back

For someone who is generally healthy, sleeping on the back can provide the right support for the neck and back to create proper spine alignment. A supine position allows for the even distribution of body weight, preventing undue pressure on certain parts of the body.

If you sleep on your back, it is important to choose the right pillow. A feather pillow or memory foam pillow that conforms to the shape of the neck is a good choice. Just be mindful to replace it yearly, as they tend to lose their volume over time.

The pillow you choose should be at a height that keeps your head in a neutral position.
If your pillow is too thick it can flex your neck increasing strain on the muscles, too thin and it cannot provide enough support. The best option is a small, cylindrical pillow placed in the crook of the neck to keep the head, neck, and shoulders in a neutral position. You can also place a small pillow under the knees to help maintain your spine’s natural curve.

Keep in mind, while this is generally considered the best position for sleeping, it is not recommended for everyone. Pregnant individuals, people who snore, those with sleep apnea, or someone with acid reflux or GERD should not sleep on their back.

On Your Side

It is estimated that more than 60% of people sleep on their side every night, with most developing a preference for one side or another by the time they reach adulthood.

If you sleep on your side, try to keep your legs outstretched. Curling your knees up into the fetal position will throw your back out of alignment and can cause neck pain. When sleeping on your side, choose a pillow that allows the neck to be neutral and doesn’t tilt your head up to the ceiling or lean down toward the bed. A small pillow between your knees also promotes a neutral spine.

Anyone with hip or shoulder pain often finds that sleeping on the affected side is painful. Sleeping on the non-painful side often feels better and using a pillow under the arm or between the knees can help relieve excess strain on the joints. If you don’t have pain in one of these areas, but you wake during the night, try switching sides to alter pressure on different parts of the body.

Side-sleeping is not only good for your neck and back. It has been shown to reduce snoring and sleep apnea for some people. During pregnancy, this position can help ease pressure on the back and joints.

(Always check with your healthcare provider if you are unsure about the best sleep position based on your condition or symptoms.)

The Worst Sleep Position for Neck Pain

Of all the sleep positions, sleeping on your stomach is often the most likely to cause neck stiffness and discomfort. This position puts the most pressure on the joints and muscles of your spine and flattens its natural curve. Because most of your body weight is in the middle of your body, it is difficult to maintain good spine alignment when you are sleeping on your stomach.

Also, as you sleep on your front, your head is forced to one side or the other so you can breathe. That unnatural position is likely to cause moderate to severe neck and upper back pain in the morning.

You may not have symptoms after one night on your stomach, but if you sleep in this position night after night, you increase the risk of a stiff neck, sharp neck pain, headaches, and pain that radiates to other parts of the body. Some people can’t fall asleep unless they are on their stomach. If that sounds like you, you may be asking “what can be done!?” Placing a pillow under the chest and using a flatter pillow for your neck can reduce the stress on the neck and allow you to rest comfortably in this position.

How to Adjust to a New Sleep Position

If we have convinced you to change your sleep position to reduce your neck pain, keep in mind this may take some adjustment.

Here are some tips to help:

  • Be patient: For many people, changing how they sleep involves breaking a lifelong habit. Initially, your sleep may be disrupted until your new position begins to feel more natural.
  • Experiment: Try different pillow sizes and firmness under your head, neck, and knees until you land on the most comfortable combination.
  • Try technology: There are a few innovative wearable devices on the market can tell you how many times you are waking during the night to see if you are getting restful sleep
  • Adapt: Through your lifetime, the best sleep position for your neck and back may change through pregnancy, sleep disorders, injuries, and other conditions. Be mindful of how you feel when you wake up. That’s a big indicator of whether or not your sleep position is working for you.
    Physical Therapy for Neck Pain and Stiffness
    Physical therapy is a common and effective treatment for neck pain and neck stiffness caused by poor posture, accidents, injuries, disease, and surgery.

The benefits of physical therapy for mobility problems, pain, stiffness, and other symptoms related to the neck are many. If you suffer from neck pain or stiffness, a physical therapy protocol can help you improve and prevent symptoms.

Passive physical therapy treatments like massage, and ice/heat therapy help loosen stiff muscles and reduce pain and swelling. Active physical therapy treatments include exercises and stretches to stretch and strengthen the neck can improve range of motion increase strength and stability to maintain good posture.

Beyond those benefits, your therapist will teach you how maintain ideal posture when you sit, stand, and sleep for optimal spine health. They also create a home program with activities and exercises you can do on your own to continue the work you do with your therapist in the clinic.

Stretches to Relieve Neck and Shoulder Pain

Here are a few simple exercises you can do at home to ease neck pain and increase mobility.
(If you are recovering from an injury or surgery, be sure to ask your healthcare provider or physical therapist to ensure these exercises are safe for you.)

Forward Bends

  1. Begin in a seated position. Sit up straight and look forward.
  2. Lower your chin to touch your chest and look down, flexing your head forward as far as you can comfortably.
  3. Hold that position for 10-20 seconds.
  4. Lift your head and return to the neutral position.
  5. Repeat.

Neck Rotations

  1. Again, begin in a seated position, looking forward.
  2. Slowly and gently turn your head to the left. Hold for 10-5 seconds.
  3. Return your head to the starting position.
  4. Now turn your head to the right slowly. Hold for 10-15 seconds.
  5. Repeat.

Side Neck Bends

  1. Begin in a comfortable seated position as we did in the previous exercises.
  2. Slowly, bend the head to the left side, bringing the left ear to the shoulder, while keeping the back and shoulder still.
  3. Hold the stretch for five seconds before returning the head to the starting position.
  4. Repeat the stretch on the other side, holding the head in position for five seconds.
  5. Repeat.

Shoulder Rolls

  1. Start in a seated position, with your chin tucked in.
  2. Roll your shoulders up, back, and down in a backward motion.
  3. Repeat several times before reversing your direction and rolling your shoulders forward.

If you have considerable pain or tightness in the neck, start out by doing each stretch once or twice. The following day, add another set. As you loosen the muscles of the neck and build up your strength, these stretches will become easier. Continue them daily to prevent symptoms from recurring.

Sleeping with neck pain is not ideal. Chronic sleep deprivation is linked to a host of health problems including a higher risk of depression, high blood pressure, diabetes, and stroke. If you have neck pain or stiffness in your neck and shoulders every morning, your sleep position may be to blame. A change in position, daily stretching, and proactive physical therapy may just be the key to relief–and a good night’s sleep.

Find a physical therapy clinic near you.

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