Waking With Neck Pain

Categories: Assessment.

neck pain

How should I sleep?

Much of the neck pain I see in clinic occurs when a patient wakes in the morning or it is waking them in the night. So, is this due to the position a person sleeps in, the pillow they use, or, the mattress they lie on? In this article we discuss these very issues and offer some advice on how to look after your neck while sleeping.

Some people report “a crick in the neck” upon waking and feel that they may have slept at an awkward angle. In fact, some sleeping positions can put the neck under tension and due to the nature of sleeping, it may be under tension for some time. There probably is no one perfect pillow that suits everyone. In fact, some people spend significant amounts of money on pillows when perhaps they do not need to.

Firstly, assess how you sleep. If you sleep on your front, you likely turn your neck to one side over a prolonged period so that you do not suffocate. If your head rests on a pillow while in this position, the head is being raised and the neck is tilted backward into extension while being rotated. This compresses the side of the neck that the head is turned to and may lead to injury. As we get older, the spaces between our joints in the neck become smaller. Therefore, those younger people who have slept on their front for years and never had a problem, may one day wake with pain and wonder why. It may simply be a case that age has crept up on you and your neck can no longer tolerate such positions for so long.

Lying on your side is a good position to lie. However, if one adopts the recovery position, there may be a degree of rotation in the neck which again may cause compression of the neck joints and lead to pain. Lying in a foetal position allows you to lie on your side without the sustained rotation of the neck that the recovery position delivers. You should then think about the height of the pillow you are using. It is useful to get someone else to look at you while you lie on your side to ensure the correct height of your pillow. The head and neck should remain in line with the rest of the spine.

Lying on your back in a supine position is also a good position to lie in as it avoids prolonged rotation or side bend. However, ensuring that your pillow is not pushing the head and neck forward should be considered. The head should rest comfortably on the pillow with the face parallel to the ceiling and not tilted downward towards the chest as it would if the pillow were too large.

Choosing a mattress is down to the comfort of the user. However, when changing a mattress it may benefit you to recheck your pillow height as a more or less firm bed will change the height at which the head is being rested on the pillow.

Pain at night or first thing in the morning can be attributed to either poor positioning as discussed above or to an inflammatory response in the neck. If you have injured the neck causing swelling within the neck, this tends to become worse at periods of rest. The body tries to heal itself while resting and therefore an increased volume of swelling may attribute to increased levels of discomfort at this time. If you are unable to change your sleeping position and get relief from your symptoms, you should see a physiotherapist who will assess your neck pain.

To view our video on neck pain and sleeping positions, click below:


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