Waking Up With a Sore, Stiff Neck

One of the most common reasons why someone might wake up with a sore back each morning is due to an improper mattress, as mentioned in a previous article by Dr. Ghahary. While the mattress you sleep on is entirely your choice and solely based on personal preference, it’s usually recommended that individuals choose a mattress that isn’t too soft nor too firm and is instead somewhere in-between the two. Sleeping on the wrong type of mattress can cause a plethora of issues, including problems with spine alignment, as well as worsen pre-existing back problems. Aside from mattresses being the culprit, waking up with a stiff, sore neck or back in the morning can also be due to the pillow you’re using or the position that you’re sleeping in.

If pillows are causing the problem, you could be using too few pillows or too many. Or, just like a mattress, the pillows you’re using could be too soft or too firm. Your neck pain or lack thereof can also depend upon the way in which your pillow is positioned. In order to relieve our muscles, our necks should be supported in a neutral position. However, if your pillow is positioned too high then your neck is instead in what’s known as a “flexed” position, causing the muscles to stretch and resulting in that pain you feel when you wake up. Alternatively, if your pillow is positioned too low, this causes the neck joints between your vertebrae to compress, resulting in stiffness. The softer your pillow is, the more your muscles will be working as you sleep to help stabilize your neck, and this is another reason why you might wake up feeling sore or stiff.

So how do you know which pillow is right for you? There are a few different options. If you’re someone who tends to sleep on your back, Dr. Ghahary recommends using two pillows. One that supports the curve of your neck, and another flatter pillow to cushion your head. Some bedding stores sell special pillows that actually have built-in support specifically for this. If you’re not allergic to feathers, you can try using a feather pillow as these will easily conform to the shape of your neck. However, you should replace a feather pillow every year as they collapse more easily than the traditional pillow would. Speaking of traditional pillows, buying a memory foam pillow is also great for supporting your head and neck, and they also promote proper spine alignment. When travelling by plane, bus, or any other method of transportation, your head and neck can also benefit from the use of a travel pillow. This horseshoe-shaped pillow not only provides your neck with support, but it supports your head as well and prevents it from dropping if you happen to fall asleep.

As for the position you sleep in, it’s recommended that you avoid sleeping on your stomach as this can be hard on the spine. To get a better night’s rest and one that is as pain-free as possible, Dr. Ghahary recommends either sleeping on your back or your side.

When it comes to actually reducing neck and back pain, this is something that may not necessarily improve overnight. While switching pillows is certainly a good start, it can take some time for the body to adjust and get used to something new. Especially if it’s a change from a firm to soft pillow, or vice versa. So be patient. In the meantime, you can use over-the-counter pain relievers such as acetaminophen or ibuprofen to help reduce your neck pain. You can also find relief by applying both hot and cold to the neck. For the first 48 to 72 hours, it’s suggested to apply cold to the affected area (either with a cold back, back of ice, frozen peas, etc.) After that, you can switch to a hot application (such as a hot shower, heating pad/hot water bottle, or even a warm towel.)

If neck pain persists, Dr. Ghahary may refer patients to a physiotherapist. This is someone who can provide you treatment to help relax and mobilize your muscles, which can ultimately provide you with more relief. If, after trying all of the above, you still have neck pain, then you may need to be referred for medical imaging tests, such as an X-ray, MRI or CT scan to see if there are any other underlying conditions that may be contributing to your pain (such as arthritis), and may even need to be referred to an orthopaedic specialist – a type of doctor who treats disorders of the bones and joints.