Why You Have Upper Back Pain After Sleeping

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Waking up to back pain after a long night of sleep is frustrating. Upper back pain after sleeping isn’t that uncommon, though it does signal a need to make some changes about the way you sleep, but also getting your back muscles in shape. In some cases, there could be underlying causes that are creating those aching moments that also need to be addressed. Here’s where to get started.

What Causes Upper Back Pain After Sleeping?

Several factors contribute to upper back pain while sleeping or after waking up. It could be your sleeping posture. Other times, it may be due to stress and tension in your muscles, especially if you feel tense often. You may have upper back pain if you’re overweight and sleeping in a way that strains the muscles of the back. For others, a bad mattress really is a big factor.


While most upper back pain resolves on its own over time with a bit of support, there are some underlying causes you should seek out help for, especially if you’ve had an accident, suffer from compression fractures, or have arthritis.


Sleeping Positions and Their Affect on Back Pain

Unfortunately, upper back pain while sleeping is often enough to wake you up in the middle of the night to adjust how you are laying. However, most people will also find that making a few adjustments to how they sleep – which is called improving your sleep posture – can help you wake up feeling restored and rested.

Good Sleep Positions for Back Pain

The best way to sleep is in a way that provides support for your spinal cord. The spinal column has a natural curve to it. By supporting that curve, you provide rest for those muscles.

  • Try sleeping with a pillow between your knees while you are sleeping on your side or your back
  • If you are a stomach sleeper, place a pillow just under your pelvis to support that curve
  • Place a rounded pillow under your neck as a back sleeper to help support the curve, and use a flatter pillow under your head
  • Try to keep your legs stretched out while sleeping rather than bent

Bad Sleep Positions for Back Pain

Some sleep positions can make it challenging for your spine to remain in a healthy position. Any type of position that flattens the natural curve of your spine or neck is likely to cause pain in the morning. It can often cause discomfort throughout the day as your muscles move through the day’s activities and become more fatigued.

  • Avoid large pillows that elevate your head.
  • The least beneficial position is sleeping on your stomach (unless, as noted, you have ample support when doing so)

How to Manage Upper Back Pain

It’s not easy to change the way you sleep, and it could take some time to incorporate those adjustments. In the meantime, work to support your back muscles and spine health in other ways.

Exercises

Exercise is an important part of building a strong core system that can help to reduce the risk of injury. Those who have spinal misalignment or muscle spasms will need to perform exercises on a routine basis – at least one time a day – to build up strength in those areas. Aim for low-impact workouts to reduce any risk of further injury.



If you have back pain after waking up in the morning, get in a short period of exercise right when waking up. This could include a yoga routine or going for a swim. You can also go for a short but brisk walk to help reduce pain and tension. Exercises like these can help to stimulate better movement of the joints, improve back muscle strength, and help to reduce stress-causing hormones.

Stretches

Don’t overlook the importance and value of stretching your back muscles, especially when it comes to doing so first thing in the morning. However, stretching before can also be beneficial. As you head to bed, purposefully stretch your neck, upper back muscles, shoulders, and other areas. When you wake up in the morning, do the same. This helps to relax the muscles.


Keep stretches simple before bed and after. Before bed, you want to ensure your muscles are releasing stress and tension, but in the morning, the goal is to improve function and prepare the body for the day ahead. Stretching is good for your overall health and wellness before and after any workout.

How to Prevent Upper Back Pain After Sleeping

Going to bed and waking up rested without pain is the ultimate goal. There are several simple strategies to consider now to get the relief you need:

  • Incorporate stress management techniques into your day. Meditation, deep breathing, yoga, and stretching are a good place to start.
  • Consider holistic therapies like dry needling to treat pain early on, helping to avoid more serious injury later.
  • Work to improve muscle strength and posture by working with a physical therapist. Getting exercise every day can help minimize the risk of injury.
  • Maintain a healthy weight. Work to minimize belly weight, especially since this can stress your muscles and joints.
  • Replace your old, non-supportive mattress with one that offers support throughout the night.

Seeing a Medical Professional

Upper back pain that does not subside quickly or worsens could be an injury rather than poor posture. In these situations, it’s critical to seek out the attention of a medical provider. If you are in pain that limits your ability to function normally or the pain is intense enough to warrant over-the-counter medications, seek medical care.


Physical therapy can help to correct poor function of the joints and muscles throughout this area, alleviating the underlying cause of your pain. By seeking out a physical therapist, if you consistently have pain each morning, you can target the underlying cause of the dysfunction. This could improve the alignment of the joints and spine. It may include improving posture throughout your day, which can also help to reduce the risk of injury and help you sleep better at night.

Know When to Get Help

At Rock Valley Physical Therapy, we offer a wide range of resources to help you reduce your pain, improve your mobility, and create improved overall health. Contact us now or find your clinic to get started.

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By ashley johnson June 4, 2026
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