Medically reviewed by Patricia Salber, MD, MBA
Updated on April 2, 2021
Research has found that imbalanced activation of the neck muscles related to sleep posture can be a cause of neck & shoulder musculoskeletal pain.
Bothered by pain in the neck? You’re not alone. A 2017 population-based study determined the prevalence of neck pain (1) in a population of adults aged 20 and above was 20.3% or 1 in 5 people. Although a variety of risk factors for neck pain have been identified, including your posture/positioning while at work, one risk factor that isn’t often talked about how you position yourself when you sleep. A study published in the Journal of Physical Therapy Science (2) on June 29, 2017, was specifically aimed at identifying the effects of sleep posture on neck muscle activity.
The authors found that the activity of the affected muscles was significantly different in each of the three main sleeping positions: supine with both hands at the side (BHS), supine with both hands on the chest (BHC), and supine with the dominant hand on the forehead (DHF). The authors concluded that
“sleep posture is important and prevents neck and shoulder musculoskeletal pain.”
7 Ways to Relieve Neck Pain from Sleeping in the Wrong Position
Based on these findings and other research detailed below, here are 7 ways to relieve neck pain from sleeping in the wrong position:
1. Don’t sleep in the supine DHF position
If you’re one of those people who put one hand on their forehead while sleeping, you’re may be contributing to your neck pain. When you sleep in this posture, the upper trapezius and scalene muscles are activated on one side. The imbalanced activation of the muscles causes a rotation in the neck, and that leaves you with a misalignment of the cervical spine.
2. Avoid the supine BHC position
The supine BHC position is more symmetrical than the DHF since you have positioned both hands on the chest while lying on your back. The difference in the activity between the scalene and upper trapezius muscles is lower. Still, this position of the arms causes some level of tightness of the upper trapezius, which can cause numbness and neck pain.
3. Get used to the BHS position
The researcher found that the difference in muscle activity was the smallest in the supine BHS (both hands at the side) position. When you go to a relaxation course, they tell you to lay in the so-called Savasana or corpse pose (3).
You lay on your back, with the legs slightly separated and both arms relaxed by the side. The head is in a straight continuation of the neck, without falling to either side. It’s a balanced position, and it turns out it’s the best posture for sleep.
4. Your pillow makes a difference
According to a 2019 article in the Physical Therapy, the Journal of the American Physical Therapy Association, the “ideal” pillow should have the following characteristics: (4)
- moderately high (about 10 cm)
- support cervical lordosis in supine
- prevent neck lateral flexion in the side position.
- allergy-tested, lightweight, and washable.
Other factors that the cited in the article as influencing neck pillow acceptability are the degree of thermal dispersion, the material, the shape, and the length of time it has been used.
There is no clear winner when it comes to the best pillow to avoid neck pain. You need to find the right one that works for you. To get you started, check out the list of the best pillows for next pain that was compiled by the Sleep Foundation (5).
5. Do something about insomnia
If you suffer from both insomnia and neck pain, you may be interested to learn that there is apparently a reciprocal relationship between these two factors:
Neck pain can interfere with sleep and insomnia heightens your perception of pain the next morning.
A 2015 study published in the journal Pain(6) found that sleep problems “significantly increase the risk for reduced pain tolerance.” So, if you suffer from insomnia, you should seriously consider taking action to address the problem.(7) Some experts feel that the most reliable improvement in the quality of sleep comes from psychological and behavioral therapy(8).
Related article: Sleeping Pills Not Working? Here’s What You Need to Know
6. Try stretching in the morning
If you’re waking up with stiffness in your neck and the entire body, morning stretches can help. Gentle Hatha yoga, for example, will improve the mobility of all muscles and joints and will make you feel relaxed. A randomized controlled trial identified the effects of home-based yoga practice for chronic neck pain.(9)
The participants who practiced yoga reported significantly less neck pain when compared to the participants who did another type of exercise. Yoga seemed to influence the functional status of the muscles in the neck area as it improved the physiological measures of neck pain.
7. Consider acupuncture
If you suffer from chronic neck pain that doesn’t go away no matter how much you try to improve your sleeping position or the pillow, perhaps it’s time to consider acupuncture which can be an effective treatment for cervical pain. A controlled trial showed that relevant acupuncture treatment combined with heat resulted in a reduction in neck pain.(10)
The bottom line
There’s no doubt that neck pain causes a huge amount of discomfort. When you wake up with stiffness and pain, your entire day can be impacted by how you feel. But remember that you do have options to make the pain go away or at least reduce it to a significant degree. Hopefully, the eight methods suggested above will help.
If you have tried something that worked for you and is not on this list, please share it in the comment section below.
- Caio Vitor Dos Santos Genebra, Nicoly Machado Maciel, Thiago Paulo Frascareli Bento, et al. Prevalence and factors associated with neck pain: a population-based study, Braz J Phys Ther. 2017 Jul-Aug; 21(4): 274–280.
- Won-Hwee Lee, PT, Ph.D. and Min-Seok Ko, Ph.D. Effect of sleep posture on neck muscle activity, J Phys Ther Sci. 2017 Jun; 29(6): 1021–1024.
- Nikki Costello. The Subtle Struggle of Savasana, Yoga Journal, Nov 2013 https://www.yogajournal.com/practice/beginners/corpse-pose/
- Carla Vanti, Federico Banchelli, Claudia Marino, Andrea Puccetti, et al. Effectiveness of a “Spring Pillow” Versus Education in Chronic Nonspecific Neck Pain: A Randomized Controlled Trial.National Library of Medicine 2019 Sep 1;99(9):1177–1188 https://pubmed.ncbi.nlm.nih.gov/30939188/
- Best Pillows for Neck Pain, the Sleep Foundation. Updated April 2, 2021. https://www.sleepfoundation.org/best-pillows/best-pillow-for-neck-pain
- Børge Sivertsen, Tea Lallukka, Keith J Petrie, Ólöf Anna Steingrímsdóttir, et al. Sleep and pain sensitivity in adults, National Library of Medicine, Pain 2015 Aug;156(8):1433–1439. https://pubmed.ncbi.nlm.nih.gov/25915149/
- Patricia Salber, MD, MBA. How Aging Affects Your Sleep and What To Do About It. The Doctor Weighs In, Aug 2017
- Charles M. Morin, Ph.D., Richard R. Bootzin, Ph.D., Psychological And Behavioral Treatment Of Insomnia: Update Of The Recent Evidence (1998–2004), Oxford Academic. Sleep, Volume 29, Issue 11, November 2006, Pages 1398–1414, https://academic.oup.com/sleep/article/29/11/1398/2709225
- Cramer, Holger MSc; Lauche, Romy PhD; Hohmann, Claudia MD; Lüdtke, Rainer MSc; et al. Randomized-controlled Trial Comparing Yoga and Home-based Exercise for Chronic Neck Pain, The Clinical Journal of Pain: March 2013 — Volume 29 — Issue 3 — p 216–223 https://journals.lww.com/clinicalpain/Abstract/2013/03000/Randomized_controlled_Trial_Comparing_Yoga_and.4.aspx
- Birch S, Jamison RN. Controlled trial of Japanese acupuncture for chronic myofascial neck pain: assessment of specific and nonspecific effects of treatment. The Clinical Journal of Pain, 31 Aug 1998, 14(3):248–255 https://europepmc.org/article/med/9758075
Warren Fowler is a marketing enthusiast and a blogger at BestEssays.com, who loves music. If he doesn’t have a guitar in his hands, he’s probably embracing new technologies and marketing techniques online! You can meet him on Twitter and Facebook. https://www.bestessays.com/
Originally published at https://thedoctorweighsin.com on April 3, 2021.