Waking Up With a Stiff Neck: Why It Happens and What You Can Do About It

By: Kelsie Mazur, DPT 

We’ve all been there… you wake up in the morning and realize you can barely turn your head. A stiff neck can be a frustrating and painful way to start the day, but it’s also a very common issue we see in our physical therapy clinic. The good news is that there are clear reasons it happens and effective ways to treat and prevent it. A stiff neck is usually the result of one or more of the following:

Poor Sleeping Position
The way you sleep matters. If your head is at an awkward angle or your pillow doesn’t support your cervical spine, muscles and ligaments can become overstretched or compressed, leading to stiffness.

Inadequate Pillow Support
Too much or too little support under your neck can cause strain over several hours, especially if you're a side or stomach sleeper.

Sudden Movements
Tossing, turning, or jerking your head during a dream or due to sleep apnea can stress muscles or irritate joints.

Stress and Tension
Mental stress often leads to physical tension, especially in the neck, shoulders, and jaw. If you go to bed tense, your muscles may remain in a semi-contracted state throughout the night.

The Nervous System’s Role in Morning Stiffness

While mechanical strain and posture are major causes, there’s also a natural neurological reason why we often wake up stiff. You knew I could not get through a blog without looping in the nervous system. HEHE. 

When we sleep, especially during the deeper stages like REM, our nervous system downregulates. This means the brain reduces motor output to our muscles to allow for rest and recovery AKA it  means your brain tells your muscles to relax and stay mostly still so your body can rest and recharge. This phenomenon is known as nocturnal muscle atonia during REM sleep.

Here’s what happens. Your body essentially goes into a state of low muscular activity to conserve energy and reduce unnecessary movement. Circulation slows slightly, and joint lubrication is reduced while we’re still, particularly if we’ve been in one position for a long time. This means that when you wake up, your muscles and joints can feel temporarily frozen, stiff, or achy until the nervous system fully reactivates and your body warms up. In other words, stiffness is sometimes a normal response to rest and immobility. It isn’t always a sign of injury. That said, if your body is already under stress from poor posture, inflammation, or tight muscles, the natural stillness of sleep can magnify that stiffness.

What Can You Do About It?

If you wake up with a stiff neck, here’s how to ease the discomfort and prevent it from coming back.

Gentle Stretching
Start with slow, controlled neck movements like nodding, turning side to side, and light shoulder rolls. Avoid forcing any motion that causes pain.

Soft Tissue Work
A self-massage or a gentle roll on a massage ball can release tension in the muscles around your neck, upper traps, and shoulder blades.

Stay Active During the Day
Frequent movement keeps your nervous system and muscles alert. Take posture breaks if you work at a desk or drive long hours. Pro Tip: lie on your back and perform 3x10 chin tucks with a 5s hold (AKA make a double chin while lying down) to get those deep neck muscles in the front working!

Physical Therapy*
Recurring morning stiffness might be a sign of deeper postural issues or muscular imbalances. Seeing a qualified Doctor of Physical Therapy can help restore mobility, improve muscle coordination, and train your nervous system to move more efficiently.

Check Your Sleep Setup
It's easy to blame the pillow or mattress, but they're not always the real issue. In many cases, morning neck stiffness has more to do with how you're positioned at night and what your body is already bringing into bed. Things like tight muscles, poor daytime posture, or stress from the day all play a role. That said, your pillow should support your neck in a neutral position so your head isn't tilted too far forward, backward, or to the side. Side sleepers may find a contoured or memory foam pillow helpful, but there's no one-size-fits-all solution.

At Wattage Physical Therapy, I often find that neck stiffness has more to do with what’s happening during the day than with the surface you’re sleeping on. That being said: don’t go running to buy a new mattress or pillow. 

When to See a Professional

If your stiff neck doesn’t improve after a few days or gets worse with numbness, tingling, or pain radiating down your arm, it’s time to get evaluated by a Doctor of Physical Therapy. We can help you figure out the root cause and guide you toward long-term relief. Waking up with a stiff neck is common, but not something you have to live with. Understanding the role your nervous system plays and how your daily habits influence it can empower you to take action and feel better faster!

Let’s chat! Book an assessment and let’s get you back to feeling good in your body.
No referrals, no waiting, just answers. Did you know that we offer free 1-on-1 injury screens? Wattage Physical Therapy will take an in depth look at your ergonomics, posture, muscle tone, muscle weaknesses, and movement patterns to create a plan for YOU. If this article intrigues you, you can directly email me, Kelsie at Kelsie@wattagept.com. I would be happy to help you start the process of living a life free from pain.