4 Reasons Sleep Makes Your Back and Neck Ache

McKenna Princing Fact Checked
A woman sleeping on her side.
© Eddie Pearson / Stocksy United

So you woke up with a backache or neckache — again. It’s frustrating when sleep, an activity that is supposed to be restorative, feels just the opposite.  

Most people have aches and pains every now and then. But if you’re noticing chronic pain when you are trying to sleep or wake up, there’s a chance one of these four things is causing it. 

Your mattress is old 

Rather than what type of mattress you have, it’s more likely the condition it’s in that is affecting your back and neck, says Dr. Joseph Ihm, a specialist in physical medicine, rehabilitation and sports medicine who sees patients at the Spine Center at Harborview Medical Center. 

“If it’s not holding its shape, it could be a problem and could put the spine in painful positions,” he says. 

Mattresses may need to be replaced after six to eight years. If your mattress is saggy, lumpy or damaged, or if you notice you’ve been waking up achy, it’s time for a new one. And what type of new mattress you get doesn’t matter as long as it’s something you find comfortable, be it soft, firm, a California king or a smart bed. 

“Many patients come in asking about mattress types, and sometimes people have already bought three or four, but it’s not very common that the type of the mattress is the problem,” Ihm says.  

The same goes for pillow types. So if you want to try that contour pillow or body pillow, more power to you if it helps. 

You may be wondering: Can I make my mattress last longer by flipping or rotating it? Maybe, though most mattresses nowadays aren’t designed to be flipped and there isn’t much research on whether or not this helps with pain, Ihm says. But if your mattress is flippable and you want to give it a try, go for it.  

You sleep in the same position all night 

Sometimes, if you’re a regular side, back or stomach sleeper, staying in the same position for the night can strain your neck and cause pain. 

“When you turn your head as far as you can go, that’s called your end range,” Ihm explains. “If someone’s end range becomes 45 or 30 degrees instead of 90, the neck pain may be at that end range for a long time during sleep, and for many of us, if we’re at end range for a while, it starts causing symptoms.”  

But simply changing the way you sleep isn’t, well, that simple. If you’ve slept a certain way your whole life, even if you try to sleep differently, you may find yourself waking up in the same old position.

Working with your doctor can help you devise a plan to address chronic pain caused by your sleep position. This may involve trying to change the way you sleep, but it may also involve physical therapy or doing exercises to strengthen your neck or back and hopefully prevent pain.  

You sit all day 

The way you treat your spine during the day affects how it feels at night. Sitting all day and keeping your spine in the same, rigid position can trigger joint and muscle pain during sleep (when your spine is in yet again in the same position for hours).

The best way to prevent this kind of pain is to move your body and your spine throughout the day to loosen up the muscles and joints. This could be with exercise — core strengthening is particularly helpful for back pain — physical therapy, switching between a sitting and standing desk or taking more breaks to get up and walk around for a few minutes.

You don’t get enough sleep (ironic, right?) 

It seems obvious that pain can cause sleep disruptions, but the inverse can also be true.  

The number of people who have back or neck pain because they have a sleep disorder, like insomnia, is higher than you may think, Ihm says. 

He and his colleagues have completed a review article showing that sleep loss can actually contribute to more pain and can put someone at risk for injury. They found that getting less than seven hours of sleep consistently for two weeks or more was enough to have these impacts. The study focused on athletes, but there’s no reason to believe the principle doesn’t apply to other people, Ihm says.

Suboptimal sleep isn’t necessarily causing your pain entirely, but it can worsen it so that you notice it more and have a harder time managing it — and, in a truly vicious cycle, an even harder time sleeping.  

How to manage and treat back and neck pain 

“If you have problematic back pain that doesn’t get better after several days, talk to your doctor. The chance it’s something serious is low, but it’s worth having a doctor take a look,” Ihm recommends.  

Your doctor may have you get an MRI or X-ray scan to help diagnose and find the best treatment options for chronic back pain. The need for surgery or injections is rare, Ihm says, and physical therapy and medication are the two main types of treatment. Regular exercise can also be helpful, as can working with your doctor to address insomnia or any other sleep disturbances you have.

The point is you don’t just have to deal with sleep-related pain: There are treatments that can help you get back to resting easy.