Mar. 20, 2025

Upper Back Pain After Sleeping: Causes & How to Get Relief

Karen Shackelford, MD

Physician

General Medicine / Resources /

Upper Back Pain After Sleeping: Causes & How to Get Relief

Back Pain

Most morning upper back pain stems from a poor sleep position, pillow placement, or mattress.
In some cases, upper back pain after sleeping could be due to a chronic condition, like inflammatory arthritis or spinal stenosis.
Simple changes to sleep habits prevent many cases of chronic morning back pain.

Morning upper back pain transforms restful sleep into a daily challenge. This common problem affects nearly 60% of adults at some point. Causes of upper back pain after sleeping range from simple muscle tension to severe medical conditions. Understanding the difference between standard morning stiffness and concerning symptoms helps guide appropriate treatment decisions.

Is upper back pain after sleeping normal?

Upper back pain–and back pain in general–is common but may not necessarily be “normal.” While upper back pain and stiffness after sleeping are particularly common in older adults, they are not expected for younger people (under 20). People under 20 or over 50 who experience new persistent back pain should see their doctor for evaluation.

Normal vs. abnormal back pain after sleeping

It’s not uncommon to feel a bit stiff and uncomfortable after sleeping, particularly if you fell asleep in an unusual position. Standard morning stiffness typically resolves within 15 to 30 minutes of activity and lacks associated symptoms, such as numbness or radiating pain.

Abnormal back pain, on the other hand, may persist for hours and worsen despite movement. It might also come with other symptoms, like tingling in the limbs, weakness, or even bowel and bladder dysfunction. Pain that is so severe that it wakes you up or makes it hard to fall back asleep may also be abnormal.

Symptoms associated with back pain after sleeping

In many cases, the cause of back pain isn’t immediately clear. When this is true, the presence of other symptoms can be an important clue that helps you understand what’s going on beneath the surface.

Muscle stiffness and strain

Staying in the same position during sleep often results in muscle stiffness, particularly in the trapezius and rhomboid muscles of the upper back. Sleeping positions that misalign the spine or fail to provide adequate neck and upper back support can exacerbate this issue.

You may experience neck, shoulder, or arm pain with upper back pain. Upper back pain while bending forward can sometimes result in numbness and tingling in the arms.

Numbness and tingling

Some causes of back pain also affect the nerves in and around the upper back. When nerves are compressed or damaged, you might feel numbness and tingling in the affected areas or in your extremities.

Weakness

Muscle weakness often accompanies back pain. In fact, weak muscles can sometimes be a contributing factor to pain. Experiencing temporary weakness in muscles affected by pain is also possible.

Inflammation and tenderness

Swelling, redness, and tenderness are all signs of inflammation that may accompany upper back pain after sleeping. The area may feel “tight,” and your skin may be warm to the touch.

Fatigue

People who experience back pain after sleeping may also have a hard time getting a good night’s sleep. Persistent back pain issues can affect sleep quality over time, leading to fatigue (a persistent, intense feeling of tiredness).

Considerations based on the specific location of upper back pain after sleeping

While stiffness lasting 15-30 minutes falls within normal limits, extended pain needs attention. The area where you experience pain can sometimes point to specific potential causes. Pinpointing the location of your pain may also help you discover what you can do to avoid it.

Upper left back pain after sleeping

Left-sided morning upper back pain causes particular concern among medical professionals. While usually muscular, pain on the left side occasionally signals heart problems, especially with shortness of breath or chest tightness.

When you have accompanying chest pain or pain radiating to the left arm, neck, jaw, or back, it is particularly concerning for a heart attack. Other symptoms consistent with a heart attack include nausea, sweating, and shortness of breath. If these symptoms accompany your upper left back pain, you should call 911.

Your positioning can also cause upper left back pain after sleeping if you lay on your left side or sleep in a way that puts extra stress on your left side’s muscles.

Upper right back pain after sleeping

Right-sided pain typically indicates mechanical issues, like poor posture or pillow placement. However, in some cases, it may reflect gallbladder problems, especially if it’s accompanied by nausea.

Upper back pain between shoulder blades after sleeping

Pain centered between shoulder blades often points to postural strain. Sleep position combined with daytime desk work creates cumulative stress on the trapezius and rhomboid muscles. This causes muscles to tighten more overnight, leading to morning stiffness and reduced mobility.

Severe upper back pain after sleeping

If you wake up during the night due to severe pain, your pain is probably not musculoskeletal. It could be related to structural spine problems or, more concerning, respiratory and cardiovascular conditions, like pneumonia, a tumor, pulmonary embolism, or an aortic aneurysm.

These conditions can be life-threatening. Each has a specific symptom pattern, so recognizing associated signs and symptoms is critical to knowing when to see a doctor.

Neck and upper back pain after sleeping

The cervical spine is immediately above the thoracic spine, and some nerves send signals to and from the cervical and thoracic spine. This means that back pain can extend to the neck. It might be the result of poor posture, or it could be related to a condition that’s affecting the upper back.

How to get relief from upper back pain after sleeping

In most cases, your pain should resolve within 15 to 30 minutes as you get up and move around. If your pain persists, you can take steps like those below to find relief.

Heat

Apply heat–like a warm compress or heating pad– to the affected area for about 15 to 20 minutes at a time. This increases blood flow to tight muscles and can help reduce pain levels.

Stretching

Simple stretches targeting the upper back help restore flexibility. When you reach overhead, the shoulder blade squeezes, and gentle twisting motions prove particularly effective.

Physical therapy

Physical therapy, acupuncture, massage, and spinal manipulation may relieve persistent pain in the upper back after sleeping.

How to prevent upper back pain after sleeping

One of the best ways to prevent upper back pain after sleeping is practicing good posture during the day and as you sleep. You can also keep your muscles strong and healthy to reduce the risk of straining them.

Prepare for a good night’s sleep

Set yourself up for success each night by practicing a nighttime routine that supports pain management. Here are a few tips:

Showering before bed can help release the muscle tension accumulating during the day.
Try to stretch a bit before bedtime - in addition to relieving muscle tension, this can help you avoid leg cramps.
Ensure your bedroom temperature is comfortable so you can avoid tossing and turning.

Improve your sleep posture

Proper sleep posture is critical in reducing strain on the upper back. Experts recommend sleeping on the back or side with a pillow that supports the neck's natural curve. Selecting a medium-firm mattress has also been shown to reduce the risk of developing musculoskeletal pain.

Here are some more tips related to sleep posture that may help you avoid pain:

Sleep in a neutral position with your head, neck, and shoulders in alignment.
Stretching out during sleep when sleeping on your side can reduce pressure on your lower back. Avoid sleeping in a fetal position.
Don’t tuck in your chin while sleeping on your side. Keep your face forward and avoid dropping your head forward, which can result in neck pain the next day.
Don’t always sleep on the same side, as it can result in misalignment over time.
Avoid sleeping face down, as that will most likely put pressure on your back.

Choose a supportive pillow placement

To avoid upper back pain after sleeping, use a pillow that supports your neck and head in alignment and neutral position.

If you sleep on your back, consider putting a pillow under your knees to avoid pressure on the lower back. When sleeping on your side, place a pillow between your legs to prevent your upper leg from rotating your torso. A knee pillow can help keep your spine aligned with your hips.

Exercise

Regular exercise focusing on strengthening the core and upper back muscles can improve posture and resilience to strain. Exercises such as shoulder blade squeezes, or gentle thoracic extensions can help reduce the likelihood of stiffness after waking up.

When to see a doctor about upper back pain after sleeping

While many cases of upper back pain resolve with minor adjustments or self-care, specific symptoms warrant medical attention.

You should see a doctor if:

If you experience one or more of the following, contact your doctor:

Pain lasting beyond two weeks despite home care.
Pain that is worsening despite medication, rest, and home care.
Numbness or tingling suggesting nerve involvement.
Difficulty with basic movements, indicating possible structural problems.
An underlying back condition with new upper back pain after sleeping.
Difficulty performing daily tasks or sleeping due to pain

You should go to the emergency room if:

Seek immediate medical care for symptoms such as:

Progressive weakness or numbness, particularly if developing rapidly.
Severe pain that’s unrelieved by any position change.
Difficulty breathing.

Questions to ask your doctor about upper back pain after sleeping

What is the most likely cause of my upper back pain after sleeping?
What are the most effective treatments for my type of back pain?
Should I consider physical therapy or other specialized treatments?
Are there any activities I should avoid while recovering?

How a doctor can help treat upper back pain after sleeping

Your doctor can evaluate the cause of your back pain and offer targeted treatment. Treatment plans often combine approaches for optimal results. Below are some initial treatment options for upper back pain after sleeping.

Physical therapy

Physical therapy programs strengthen weak muscles and improve flexibility, both of which help reduce the risk of back pain. Manual therapy techniques release muscle tension. Meanwhile, posture training prevents pain recurrence.

Medication management

Some patients benefit from medication management. Your doctor may prescribe medications like muscle relaxants to help with severe pain. They might also recommend anti-inflammatory medications to reduce pain and swelling.

Treatment of existing back conditions

If your doctor believes a chronic condition–like spinal stenosis–is the cause of your symptoms, they will likely take steps to begin a treatment plan for that condition. This might involve medications that treat nerve or muscle pain, exercise routines, and, in rare cases, surgery.

Frequently asked questions: upper back pain after sleeping

Many people have upper back pain while sleeping at some point in their lives. Some commonly asked questions people by people with upper back pain after sleeping are detailed below:

What if you’re experiencing upper back pain after sleeping while pregnant?

Pregnancy changes sleep patterns and increases the risk of upper back pain after sleeping. Support pillows help maintain proper alignment. Gentle stretching proves safe for most pregnant people. Regular movement prevents prolonged stiffness.

What if your upper back pain after sleeping fades away during the day?

Upper back pain after sleeping fades away during the day in most cases. Musculoskeletal pain in your upper back after sleeping typically fades away in 15 to 30 minutes. If your back pain is due to a chronic condition, however, it will take longer to resolve.

What if you experience upper back pain after sleeping on your side?

If you have upper pain after sleeping on your side, consider alternating sides or sleeping on your back. Add supportive pillows to take pressure off the back. Keep your head from drooping forward during sleep, increasing your risk of upper back pain.

What to remember about upper back pain after sleeping

Most people with morning back pain improve through proper sleep habits and basic care. Regular attention to sleep position and support prevents many cases of morning back pain. Still, understanding the signs and symptoms of more serious conditions ensures appropriate medical care when needed.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.