Why Your Upper Back Might Hurt in the Morning

Do you occasionally (or often) wake up with an aching upper back? If yes, you’re definitely not alone—and it’s more common than you might think. While it may feel like something that appeared overnight, upper back stiffness or pain first thing in the morning often signals a deeper issue linked to your sleep habits, posture, and even spinal health.

It’s Not Just About the Back

Upper back discomfort is often connected to issues in the neck. “Anytime we see chronic neck issues, we often see upper back issues,” says Winnipeg chiropractor Dr. Pascal. That’s because major muscles like the trapezius and levator scapulae extend from the neck into the upper back. If your head is constantly jutting forward during the day—say, while working at a desk—those muscles stay under stress. And if your pillow pushes your head further forward at night? That strain doesn’t get a break.

Pillows, Posture & Positioning

The wrong pillow, whether it’s marshmallow soft or overly firm, can be a pain in the neck… literally. A pillow that’s too thick or too thin might throw your head and spine out of alignment. This, paired with forward head posture, puts undue tension on your neck and upper back all night long.

What’s Happening While You Sleep?

During sleep, your joints stop moving, especially the ones between your vertebrae. And that stillness can allow inflammation to build. “Joints are designed to move,” Dr. Pascal explains. “When they don’t, such as at nighttime, they feel stiff because inflammation has time to set in.” This is particularly true for spinal discs, which can swell overnight. That morning stiffness may be your body asking for help, not just stretching.

Signs of Something More

Morning back pain isn’t always a standalone issue. It can point toward deeper spinal concerns like disc swelling, restricted movement between vertebrae, or long-standing postural imbalances. A thorough spinal exam—including posture analysis, palpation, range-of-motion testing, and, if needed, X-rays—can help identify the root cause.

What Can You Do?

If you’re waking up sore more often than not, there are some things you can do. Pay attention to your posture during the day and review your sleep setup, especially your pillow. Gentle morning stretches can also help. But if you’re dealing with recurring pain, a proper spinal evaluation can make all the difference.