Neck pain and sleeping position

April 22, 2025

Neck pain from sleeping?

Does your sleeping position and correct pillow support really affect neck pain?

Neck pain is one of the most common musculoskeletal conditions that we see as physiotherapists. It is often non-specific, meaning there isn’t a specific structure we can diagnose as causing the problem. It can often be caused by a few different factors, including stress, sustained static postures, muscular imbalances, and repetitive activities. People often want to know if their sleeping position could be affecting their neck pain, and what pillow they should be using.

If we look at the research, there is some evidence to show that sleeping posture and pillow adjustment does have an impact:

Research suggests that:

• Adjustment of pillow height does have a significant positive impact on neck pain and symptoms
• People waking with neck pain tend to spend more of the night in provocative sleep positions (unsupported side lying or on their front) and have poorer sleep quality
• Different sleeping postures can affect which muscles are more active in the neck, which may therefore affect neck pain

What does this mean for you and what can you do about it?

• Adjust pillow height so your neck is in a neutral position (i.e not in a side bend or extended position)
• Try to avoid lying on your front, as this can put your neck in an awkward position and potentially lead to musculoskeletal discomfort
• A firmer pillow can help keep the neck in a neutral position, rather than one that is too soft and offers no support
• The brand or style of pillow doesn’t matter as much as the height of the pillow or your body position
• Try some simple neck stretches in the morning to reduce any tightness associated with sleeping posture

If you have neck pain and would like some treatment and advice on how to manage the condition, an assessment by one of our physiotherapists can help determine what is contributing to the problem and help guide you through a rehab plan to improve your symptoms. Get in touch via email – info@physiotheapymatters.co.uk, or give us a call on 0191 285 8701.

References:

Cary, D., Jacques, A. and Briffa, K., 2021. Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PLoS One, 16(11), p.e0260582.

Lee, W.H. and Ko, M.S., 2017. Effect of sleep posture on neck muscle activity. Journal of physical therapy science, 29(6), pp.1021-1024.

Yamada, S., Hoshi, T., Toda, M., Tsuge, T., Matsudaira, K. and Oka, H., 2023. Changes in neck pain and somatic symptoms before and after the adjustment of the pillow height. Journal of Physical Therapy Science, 35(2), pp.106-113.