Quick answer
To prevent neck and shoulder pain from sleeping, sleep on your back or side with a pillow that keeps your head level with your spine: not so high that your chin tips toward your chest, not so low that it points at the ceiling. Side sleepers need a higher pillow under the neck and should lie on the pain-free shoulder. Avoid sleeping on your stomach, which twists the neck and often traps an arm under the pillow.
Key takeaways
- Neck pain is common: it affects 10% to 20% of adults, according to Cleveland Clinic.
- Neck pain and poor sleep go together: about 70% of people with chronic neck pain report poor-quality sleep, according to the Sleep Foundation.
- Back and side sleeping are the easiest positions on the neck; stomach sleeping is the worst.
- Pillow height is the key factor: your head should stay in a neutral line with your spine.
- With shoulder pain, sleep with the painful shoulder facing up and support the arm so the shoulder does not dip toward the bed.
- Most neck strains improve within a week or two; see a doctor if pain spreads to the arms or comes with numbness or weakness.
Why do you wake up with neck or shoulder pain?
You usually wake up with neck or shoulder pain because your head, neck or shoulder stayed out of alignment for hours during the night. The most common reasons are a pillow of the wrong height, sleeping on your stomach with your head turned, and lying on your shoulder so it gets compressed under your body weight.
- A pillow that is too high or too stiff keeps the neck bent forward all night and can cause morning pain, according to Harvard Health.
- A pillow that is too low or flat lets the head drop and tilts the jaw toward the ceiling.
- Stomach sleeping arches the back and keeps the neck turned to one side for hours.
- An arm under the pillow or body puts pressure on the shoulder joint and the rotator cuff.
- Daytime strain, such as looking down at a phone or sitting hunched over a computer, which Mayo Clinic lists among the most common causes of neck pain.
Our guide The Impact of Sleeping Positions on Shoulder Pain explains how each position loads the shoulder.
What is the best sleeping position for neck and shoulder pain?
The best sleeping position for neck pain is on your back, followed by side sleeping with a supportive pillow. Harvard Health notes that these two positions are the easiest on the neck. For shoulder pain, back sleeping or side sleeping on the pain-free side works best.
Back sleeping
Back sleeping puts the least pressure on the spine, says Cleveland Clinic chiropractor Andrew Bang, DC. Use a rounded pillow or a small neck roll that supports the natural curve of your neck, with a flatter area for your head. If one shoulder hurts, rest that arm on a folded blanket or a low pillow to keep the shoulder aligned.
Side sleeping
Side sleepers need a pillow that is higher under the neck than under the head, so the neck stays in line with the rest of the spine. Look straight ahead instead of tucking your chin toward your chest. If you have shoulder pain, lie on the other side and hug a pillow so the top shoulder does not roll forward.
Stomach sleeping
Stomach sleeping is the worst position for both neck and shoulder pain. The head stays turned to one side for hours, and many people slide an arm under the pillow. Dr. Bang calls that habit "shoulder problem city." If you cannot change, use a very thin pillow or none at all.
Sleeping positions for neck and shoulder pain compared
Back sleeping is the best overall position for neck pain; side sleeping works well with the right pillow height. Use this table to set up your position.
| Position | Neck pain | Shoulder pain | How to support it | Recommended product |
|---|---|---|---|---|
| Back | Best | Good | Contour pillow or neck roll under the neck; small pillow under a painful arm | Confourm Neck Memory Foam Pillow |
| Side | Good | Good on the pain-free side | Pillow higher under the neck than the head; hug a pillow to support the top arm | The HUG Pro |
| Stomach | Worst | Worst | Very thin pillow or none; never put an arm under the pillow | — |
What is the best pillow for neck pain?
The best pillow for neck pain is one that supports the natural curve of your neck and keeps your head level with your spine in your usual sleeping position. For most back and side sleepers, that means a contoured (cervical) memory foam pillow or an adjustable pillow whose height you can change.
| Pillow type | Best for | Why it helps | Our option |
|---|---|---|---|
| Contour / cervical memory foam | Back and side sleepers with neck pain | Raised edge supports the neck curve; lower center cradles the head | Confourm Neck Memory Foam Pillow |
| Adjustable (shredded latex or foam) | Anyone unsure of the right height; combination sleepers | Add or remove fill to get the exact loft for your position and shoulder width | Organic Shredded Pillow |
| Neck roll | Back sleepers; stiff neck | Small cylinder that supports the cervical curve, alone or inside a flatter pillow | Confourm Neck Roll |
| Chambered therapeutic pillow | Side sleepers who want extra neck support | Side chambers support the head and neck and keep their shape all night | Doctor Choice Pro |
| Arm / shoulder support | Side sleepers with shoulder pain | Holds the top arm at the correct angle so the shoulder does not roll forward | The HUG Pro |
Compare specific models in our buyer's guide: Finding the Perfect Pillow for Neck Pain Relief. For a closer look at a contour pillow, read Discover the Neck Contour Pillow.
How to choose pillow height and firmness
The right pillow height fills the space between your head and the mattress without bending your neck up or down. Cleveland Clinic explains that a pillow that is too low sends your jaw toward the ceiling, and one that is too high points it toward your chest.
- Identify your main sleeping position. Side sleepers need the most height, back sleepers medium, and stomach sleepers the least.
- Check your shoulder width. Broad shoulders need a higher pillow when you sleep on your side.
- Consider your mattress. A soft mattress lets your shoulder sink in, so you need a slightly lower pillow than on a firm one.
- Do the mirror test. Lie in your usual position and ask someone to check that your nose lines up with the center of your chest and your neck is straight.
- Choose firmness that holds its shape. A pillow should support your head all night without flattening. Medium or medium-soft memory foam suits most people.
- Adjust over a week. A new pillow can feel strange for a few nights. Adjustable pillows let you remove or add fill until it feels right.
Side sleeping with shoulder pain
If you have shoulder pain and sleep on your side, lie on the pain-free side and support the painful arm with a pillow. Cleveland Clinic advises keeping the arm in a neutral position and avoiding letting the shoulder dip toward the bed, which is when pain appears.
- Sleep on the other side so your body weight does not compress the painful shoulder.
- Hug a pillow in front of your chest to keep the top arm level and stop the shoulder from rolling forward.
- Keep your arm below your head: avoid sleeping with the arm raised overhead or tucked under the pillow.
- Use a pillow high enough for your neck so your shoulder does not take extra load.
- Try back sleeping with a small pillow under the painful arm if side sleeping still hurts.
A contoured arm support such as The HUG Pro supports the arm at the correct angle to reduce pressure on the spine and rotator cuff while you sleep on your side.
For more strategies, read Effective Strategies to Combat Shoulder Pain as a Side Sleeper.
Stiff neck: quick relief at home
Most stiff necks caused by muscle strain improve within a week or two, according to Cleveland Clinic. These steps can ease the pain in the meantime:
- Apply cold or heat. Use a cold pack or heat for about 15 minutes every few hours. Cold helps reduce inflammation; heat helps loosen tight muscles.
- Keep moving gently. Slow neck turns and shoulder rolls maintain range of motion. Stop if the pain gets sharper.
- Fix your sleep setup tonight. Check pillow height and avoid sleeping on your stomach.
- Take screen breaks. Keep your ears over your shoulders when you sit.
- Ask about pain relief. Over-the-counter pain relievers may help; ask a pharmacist what is safe for you.
A flexible cold pack like the Cold Icepack Wrap contours around the neck and shoulder. For causes and prevention, read Alleviating Neck Stiffness: Causes, Prevention, and Treatments.
Pinched nerve and bulging disc in the neck
A pinched nerve in the neck happens when a bulging disc or bone spur presses on a nearby nerve, according to Mayo Clinic. It can cause pain, numbness or weakness that travels into the shoulder, arm or hand. Sleeping with the neck in a neutral position reduces pressure on the irritated nerve.
- Choose a contour pillow that supports the neck curve and keeps the head level.
- Avoid stomach sleeping and positions that turn or bend the neck.
- See a doctor if you have numbness, tingling or weakness in the arm.
Read our detailed guides: Relieve Pinched Nerve in Neck Pain with a Neck Contour Pillow and Managing a Bulging Disc in Your Neck.
Daytime habits that cause night pain
Neck and shoulder pain at night often starts during the day. These prevention habits, most of them recommended by Mayo Clinic, help:
- Keep good posture: ears directly over your shoulders when you sit or stand.
- Take frequent breaks from screens and long drives to move your neck and shoulders.
- Set up your workspace so the monitor is at eye level and your knees are slightly lower than your hips.
- Hold your phone at eye level instead of looking down for long periods.
- Stay active and avoid smoking, which Mayo Clinic links to a higher risk of neck pain.
Upper back tension is often part of the same problem. See Exercises and Stretches to Ease Upper Back Pain Between Shoulder Blades, and for lower back support at night, our guide How to Sleep with Lower Back Pain.
Recommended products for neck and shoulder pain
These Back Support Systems products are designed to support the positions recommended in this guide. All are made in the USA.
When to see a doctor about neck or shoulder pain
Most neck and shoulder pain from sleeping improves with self-care and a better sleep setup. Mayo Clinic recommends contacting your doctor if neck pain:
- Is severe.
- Lasts several days without relief.
- Spreads down the arms or legs.
- Comes with headache, numbness, weakness or tingling.
Get medical care right away if pain follows an injury such as a car accident or a fall, or if it comes with loss of bladder or bowel control, weakness in the legs, loss of coordination, fever or unexplained weight loss.
This article is for informational purposes only and is not a substitute for professional medical advice. Always consult your doctor or a qualified health provider about a medical condition.
Frequently asked questions
What is the best sleeping position for neck pain?
The best sleeping position for neck pain is on your back with a pillow that supports the curve of your neck. Side sleeping is also good if your pillow keeps your head level with your spine. Avoid sleeping on your stomach, because it keeps your neck turned to one side for hours.
Why do I wake up with a stiff neck?
Waking up with a stiff neck is usually caused by a pillow of the wrong height, sleeping on your stomach with your head turned, or holding your neck in an awkward position for hours. Daytime strain from phones and computers can add to it. Most stiff necks improve within a week or two.
How high should my pillow be for neck pain?
Your pillow should keep your head in a straight line with your spine. Side sleepers need the highest pillow, especially with broad shoulders; back sleepers need medium height with neck support; stomach sleepers need a very thin pillow. If your chin points toward your chest or the ceiling, the height is wrong.
Is a contour pillow good for neck pain?
Yes, a contour (cervical) pillow is a good option for many people with neck pain. Its raised edge supports the natural curve of the neck while the lower center cradles the head, which helps keep the spine aligned for back and side sleepers.
How should I sleep with shoulder pain?
Sleep on your back or on the side opposite the painful shoulder. Hug a pillow to keep the top arm level, and avoid sleeping with your arm under the pillow or over your head. If you sleep on your back, rest the painful arm on a small pillow.
Can a pillow cause shoulder pain?
Yes. A pillow that is too low for a side sleeper makes the shoulder carry more of the body's weight, and a pillow that invites you to tuck your arm underneath can strain the rotator cuff. The right height takes pressure off the shoulder.
Should I use heat or ice for neck pain?
Both can help. Cold packs may reduce inflammation and heat may loosen tight muscles. Cleveland Clinic suggests about 15 minutes every few hours. Always place a cloth between your skin and the pack.
When is neck pain serious?
Neck pain is serious if it follows an injury, is severe, spreads into your arms, or comes with numbness, weakness, tingling, fever, headache or loss of bladder or bowel control. See a doctor promptly in these cases.
Sources
- Harvard Health Publishing. Say "good night" to neck pain.
- Cleveland Clinic. Best Sleeping Positions for Pain.
- Cleveland Clinic. Neck Pain.
- Mayo Clinic. Neck pain: Symptoms and causes.
- Sleep Foundation. Best Sleeping Position for Neck Pain.
