Why Does My Neck Hurt When I Wake Up? Common Causes & How to Prevent It

Waking up with a sore or stiff neck is a frustrating way to start the day. Whether it's a dull ache or sharp discomfort that limits your movement, morning neck pain can affect everything—from turning your head while driving to concentrating at work. If this sounds familiar, you’re not alone. At Southside Physiotherapy, we often see patients who ask the same question: “Why does my neck hurt when I wake up?”

Let’s break down the most common reasons, and more importantly, what you can do to prevent it.

1. Your Pillow Might Be to Blame

One of the most common culprits of morning neck pain is poor pillow support. Your neck has a natural curve that needs to be maintained during sleep. A pillow that’s too high, too flat, or too firm can put your spine out of alignment and strain the muscles and joints in your neck.

What to look for in a pillow:

• Height (or loft): Side sleepers generally need a higher pillow to keep the neck aligned with the spine, while back sleepers benefit from a medium-loft pillow. Stomach sleepers (more on that later) often need a thin or no pillow at all.

• Support: Memory foam and contour pillows often do a better job of supporting the natural curve of the neck compared to soft, unsupportive alternatives.

• Longevity: If your pillow is older than 2 years, it may be time to upgrade. Pillows lose support over time—even if they look fine.

🛏 Tip: Try placing a small, rolled towel under your neck (not your head) for extra support if your pillow isn’t doing the job.

2. Poor Sleep Posture

Your sleep position plays a major role in neck pain. Certain positions place unnecessary stress on the cervical spine and surrounding muscles, leading to morning tightness or pain.

Best to worst sleep positions for neck health:

• Back sleeping: This is usually the best position, as it allows the spine (including your neck) to rest in a neutral alignment.

• Side sleeping: Also a good option—just make sure your pillow is thick enough to keep your neck aligned with your body.

• Stomach sleeping: Unfortunately, this is the worst position for your neck. It forces you to turn your head to one side for hours at a time, creating strain on your joints and muscles.

🧍 Tip: If you’re a stomach sleeper, try training yourself to sleep on your side by using a body pillow.

3. Underlying Musculoskeletal Issues

Even with the right pillow and posture, neck pain can still strike—especially if there's an underlying musculoskeletal issue. Muscle tightness, previous injuries, or joint stiffness can all flare up overnight due to inactivity or poor positioning.

Common issues we see at our clinic include:

• Cervical facet joint stiffness

• Myofascial trigger points (muscle knots)

• Postural dysfunction from daytime habits (like looking down at screens)

These issues may not cause pain during the day, but after hours of sleep—especially in a suboptimal position—they can lead to morning discomfort.

🧘 Tip: Regular stretching, mobility work, and postural awareness during the day can help reduce overnight pain flare-ups.

4. How Physiotherapy Can Help

If you’ve tried adjusting your sleep setup but still wake up sore, physiotherapy can make a big difference.

At Southside Physiotherapy, we focus on:

• Postural assessment: We’ll identify patterns contributing to your neck pain—even during sleep.

• Manual therapy: Hands-on treatment to reduce joint stiffness and muscle tension.

• Targeted exercises: Gentle mobility and strengthening routines to improve neck resilience.

• Education: We guide you on ergonomic adjustments, sleeping habits, and recovery strategies.

The goal is not just short-term relief—but long-term prevention.

5. Prevent Morning Neck Pain: Quick Checklist

✅ Choose the right pillow for your sleep position
✅ Avoid stomach sleeping when possible
✅ Stretch and strengthen your neck muscles
✅ Be mindful of daytime posture
✅ Seek professional help if pain persists

Final Thoughts

Morning neck pain is more than just an inconvenience—it’s a signal from your body that something needs attention. The good news? Most cases are highly treatable with a combination of better sleep habits and physiotherapy.

If you're waking up with neck stiffness or pain more often than not, don’t wait for it to get worse. Book an appointment at Southside Physiotherapy and let us help you get your mornings—and your neck—back on track.