Managing neck pain with physiotherapy
11.11.19|Posted by Lovely Figueroa

Waking up with severe neck pain

Lovely Figueroa is an Ascenti Physiotherapist based in the East Midlands. The sudden onset of neck pain and stiffness when you wake up is a common condition that can be very worrying. Lovely explains why this happens, what you should do and how to prevent future problems.

Waking up in the morning with a limited range of movement or very painful neck is really common. 

It can happen to anyone and is almost always due to the neck being locked in an awkward position whilst sleeping, which leads to tension and irritation to the soft-tissues (your muscles and ligaments). 

Many people worry that they have slipped a disc or done something serious, which is incredibly rare. 

The important thing to remember is that whilst the symptoms and pain in your neck may feel very intense, the severity of your pain does not necessarily reflect a severe underlying cause. 

This type of neck pain is easily treated and will usually recover with the right management in a week or two. Here are some tips on managing the pain and what to do.

Use heat and ice 

Using ice and heat therapy at home will offer you immediate relief from the pain.

This can also improve blood flow to the area and help to relieve tension. 

Some people find ice more effective and others find heat more effective. You should use whatever feels right for you. 

Leave the ice or heat on the area for up to 15 minutes and repeat roughly every two hours. 

Always wrap a tea towel around the ice or heat before you apply to avoid any irritation to the skin. 

You can read more about applying ice and heat at home here


Tensing into your pain and restricting the movement of your neck further is not good and can aggravate the problem. 

Try to relax and be mindful of how you are holding your neck and the other muscles around it, such as your shoulders. 

Taking a hot bath or shower can help.  

Stretch gently 

If you feel that you are able to, try these gentle stretches to relieve and loosen the tension in your neck. Repeat these exercises every hour.

Listen to your body and do these exercises very gently working through any areas of tension slowly.

Don’t force your neck further than you feel able to move comfortably or push through your pain threshold. 

Avoid bed rest and neck collars 

Moving as much as you can is an important part of your recovery.

It keeps blood flowing to the area and mobility in other important muscles that help to support your neck and body.

Bed rest and completely immobilising your neck area with a collar will not help you in the long run. 

Keep moving within your limits

Staying as active as you can is important, but you must also think carefully about your posture and movements within the first 24-48 hours. 

Avoid any overly strenuous activities that may aggravate your neck, such as training in the gym or lifting heavy objects. 

You may also want to think about how you are carrying any bags. For example, it might be better to wear a backpack for a few days as opposed to holding a heavy handbag on your shoulder. 

Once you are feeling more comfortable, gentle activities like swimming and yoga can help you to recover. 

Living a sedentary lifestyle increases the likelihood of neck and back problems like these reoccurring. 

Good sleep posture 

Poor sleep posture or an awkward sleeping position is most likely how you ended up with this neck pain in the first place. 

Don’t make the same mistake again or aggravate the problem further when you go to bed. 

Think about the pillow that you are using and your sleeping environment. 

Do what you need to do to get comfortable, but be aware of propping your neck up too high or too low. 

As a general rule your ear should be roughly the same height as your shoulder. 

Sleeping on your front with your face down or twisted to the side can also aggravate the neck muscles. Try to lie on your side or on your back while you recover. 

For more tips on sleeping you can read our sleep well and feel better article. 

See a physiotherapist 

You should see a physiotherapist as soon as you can and especially if you are seeing no improvement within 2-3 days. 

Neck pain like this can easily become a vicious cycle, as you are likely to be tensing your neck further and suffering from a lack of good quality sleep which can prevent recovery. 

If you see a physiotherapist they will be able to loosen tense areas of muscle by using manual therapies, such as soft-tissue massage and joint mobilisation. 

Manual therapies are highly effective in treating this type of neck pain as they help to restore proper movement to the neck, relieve the pain and accelerate healing. 

Your physiotherapist will also give you home exercises and management advice tailored to you. 

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