Ever wake up with a sore lower back or achy shoulders that just ruin the rest of your day? Or get up from bed and try to greet the morning, only to find your neck is too stiff to turn to the window?
Morning muscle pain along your spine is often the result of hours of improper support while sleeping, says Ellen Wermter, a nurse practitioner who runs Restorative Sleep Medicine, a sleep clinic in Virginia. One easy way to guard against it, say medical experts, is to focus on your sleep posture.
Sleeping in an awkward position tends to create gaps between your body and your pillow or mattress, Wermter says. "Your soft tissue is going to want to sag into those gaps, and the muscles tense to make up for that" in order to protect against potential injury.
Over the course of a night, that muscle tension can cause inflammation and pain, Wermter says — and bad sleep from all that tossing and turning to find a more comfortable position.
Whether you sleep on your back, side or stomach, experts share advice for those looking to minimize morning aches and pains.
Sleep the same way you stand
The best defense against an achy neck or back in the morning is to sleep just like you stand, Wermter says. When you sleep in a position that follows the natural curvature of your spine, it reduces the possibility of muscle strain.
While lying down, your body should form a straight line from the top of your head to your tailbone. Wermter suggests placing your ears over your shoulders and your shoulders over your hips. Point your chin straight ahead, not tucked into your chest or stretched up toward the sky. Aim for symmetry with your arms for proper circulation.
If you're a back sleeper, this tip will be easier to follow. But if you're a side or stomach sleeper, you may need to adjust your sleep space for better spinal alignment — or even train yourself to sleep in this position, Wermter says.
Avoid sleeping on your stomach
While this position can open up airways for struggling snorers, it's often associated with its potential downsides, Wermter says. That includes neck, back and shoulder aches, and fragmented sleep from switching positions more often throughout the night.
When you sleep on your stomach, it's easy to overextend your neck, she says. Creating breathing room for yourself often pulls your neck out of that ideal spinal alignment.
Choose the right pillow for your head
It's important to rest your head on something that supports your spine and promotes maximum restfulness at night, says Dr. Fabian Morales, a sports medicine physician.
Back sleepers: Morales suggests a pillow with medium firmness and loft, or something with an ergonomic design. "A good orthopedic pillow designed to support the curvature of the neck can minimize your risk of neck pain down the line. It reduces pressure on the neck and supports alignment," he says.
Side sleepers: To find a pillow with the right loft for side sleeping, "measure from the bend of your neck to the edge of your shoulder," Wermter says. The ideal pillow will support your head without pushing your head and neck further up.
Stomach sleepers: If you're stuck on stomach sleeping, Wermter says it might be best to go without a pillow to avoid extra strain on your neck. If you do need some cushion, aim for low-loft options to keep your spine aligned.
Replace your pillows every few years or as soon as you notice your pillow starts to lack support, Morales says. Pillows hold on to dirt and dust — and they lose their structure over time, which can lead to aches and pains.
Support any gaps with smaller pillows
When your spine isn't properly supported, pain is likely to follow, Wermter says. That's why it's important to align and cradle the entire length of your spine — not just your head and neck — to make up for any gaps between your body and the mattress. Use smaller pillows or even rolled up blankets or towels.
Back sleepers: Be mindful of any gaps at the small of your back or under your knees, which can be a source of lower back pain. Add support to those areas as needed, Wermter says.
Side sleepers: Many side sleepers like placing a small pillow between the knees or hugging a body pillow to align the hips and reduce pressure in the hips and lower back, she says.
Stomach sleepers: Wermter says just sleeping on a flat surface is fine for stomach sleepers, but some may find that a thin pillow under the hips and stomach can reduce strain on the back.
Opt for a mattress that's not too soft and not too firm
Evaluate the quality of your mattress and replace your bed every seven years at most, says Wermter. If a mattress is too soft, the heavier parts of your body can sink and your spine will likely get out of alignment. If a mattress is too firm, it can create those pain-inducing gaps between body and bed.
Try other pain relief remedies
What should you do if you have a great sleep setup and you still wake up with an achy back or a crick in your neck?
It's a very common experience, especially as we age and our spines experience more wear and tear, says Dr. Charla Fischer, an orthopedic spine surgeon at NYU Langone Health.
That kind of muscle pain can be, well, a pain in the neck — but is usually not cause for major concern. Consult a medical professional if you have consistent pain for a week or more; experience numbness, tingling or weakness in the neck, arms or hands; or if you just have concerns, Fischer says.
Otherwise, don't forget the power of basic pain relief remedies. Take over-the-counter anti-inflammatory medication, massage the area, do gentle stretches, or place ice or heating packs in 20- to 30-minute bouts on your body.
Don't underestimate the power of a hot shower, she says. "It can go a long way in calming down those unhappy muscles."
This story was edited by Malaka Gharib. The visual editor is Beck Harlan. We'd love to hear from you. Leave us a voicemail at 202-216-9823, or email us at LifeKit@npr.org.
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