Stiff Neck After Sleeping Wrong: What to Do and When to Worry

A stiff neck after sleeping wrong is usually a mechanical problem, not something dangerous. Here’s what helps, what the evidence says about chiropractic care for neck pain, and the warning signs that mean get checked right away.

What to do about a stiff neck after sleeping wrong

Keep moving, gently, inside what’s comfortable. Warmth is a reasonable comfort measure, with a cloth between you and the heat. (The best heat evidence is for low back pain, as we explain in our guide to ice or heat for back pain, so for necks it’s comfort, not proof.) Look at how you sleep, too. Our piece on sleep posture in small apartments has fixes.

Don’t force it. Cranking a sore neck to get a pop is a poor idea, and our pages on the popping sound during a chiropractic adjustment and when not to get an adjustment explain why.

What the evidence says about chiropractic care for acute neck pain

The 2015 Cochrane review looked at manipulation (a thrust technique) and mobilisation (gentler, non-thrust movement). For acute and chronic neck pain, multiple sessions of manipulation produced similar changes in pain, function, quality of life, and satisfaction as multiple sessions of mobilisation (two trials, 446 participants, moderate to high quality). For acute and subacute neck pain, multiple sessions of manipulation were more effective than certain medications for pain and function (one trial, 182 participants, moderate quality).

A Canadian chiropractic guideline panel, peer-reviewed by a medical and chiropractic committee, suggests offering recent-onset neck pain patients multimodal care, manipulation or mobilization, or range-of-motion home exercise. Keep in mind that this panel is from the chiropractic profession.

When a stiff neck isn’t just a stiff neck

Get checked promptly for neck pain after a fall or accident, fever with neck pain, or arm weakness or numbness. After a car accident, read our guide to whiplash in the first 48 hours.

Call 911 or go to the ER for sudden, severe neck pain or a headache unlike any you’ve had, especially with dizziness, vision changes, trouble speaking, or weakness on one side. The American Heart Association describes unilateral headache and neck pain at the back of the neck as possible signs of cervical artery dissection, a cause of stroke in younger adults.

For persistent neck stiffness, headaches, or arm symptoms, see our page on neck pain and headaches. At Brooklyn Chiropractic Care, a first visit starts with a consultation and an orthopedic and neurological exam.

Frequently Asked Questions

References

1. Gross A, Langevin P, Burnie SJ, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database Syst Rev. 2015;(9):CD004249. PubMed: 26397370
2. Bussieres AE, Stewart G, Al-Zoubi F, et al. The treatment of neck pain-associated disorders and whiplash-associated disorders: a clinical practice guideline. J Manipulative Physiol Ther. 2016;39(8):523-564. PubMed: 27836071
3. Biller J, Sacco RL, Albuquerque FC, et al. Cervical arterial dissections and association with cervical manipulative therapy. Stroke. 2014;45(10):3155-3174. PubMed: 25104849