My friend lives in a small size camper and he is having a lot of neck pain. I told him that I thought it had to do with never being able to sit or sleep comfortably at any time living in that camper. He's always looking up and to his left watching TV and his bed is basically just blankets piled up with pillows. Am I correct in my theory or not?

Maybe, maybe not, could be nerve issues, muscle strain or other pain from jobs he does.

What are the blankets piled on ? Can he lay out or is he balled up ?

But a hard surface is what 1/2 of the world population sleep on. My bed is a basically a bamboo mat laid on a plywood frame, with a few blankets on top, best sleep ever.

There's no way to say for sure. Uncomfortable sleeping conditions can cause pain, but so can other things. Unless he sees a doctor your guess is just that, a guess, and not a diagnosis, which only a doctor can give.