Choosing the Best Pillow for Neck Pain and Back Pain

Choosing the wrong pillow is a recipe for neck and back pain. Here’s what you need to know about picking the best pillow for your neck and back.

Most people know the importance of mattresses when you have back pain. Firm, soft, foam, spring – we hear about mattresses all the time. But many people don’t realize that the type of pillow you sleep on it just as important – maybe even more so, if upper back or neck pain is your worry. Choosing the right pillow can be the key to a good night’s sleep and to waking up free of pain.

Woman choosing the best pillow for back pain and neck painYour pillow matters at least as much as your mattress when it comes to waking up pain-free every morning.

Why Pillows Matter

“Neck and shoulder pain can be very painful, and it is important to choose a pillow to sleep with that won't make your injuries worse, " explains Allen Conrad, DC, a chiropractor at Montgomery County Chiropractic Center in North Wales, PA.

Orthopedic specialists agree. According to Navinder S. Sethi, MD, an orthopedic surgeon practicing at The Centers for Advanced Orthopaedics in Olney, MD, “If the head is at an ergonomicly disadvantaged position for the duration of one's sleep, that would cause neck and head issues.”

Medical studies suggest the importance of finding the right pillow. While not every researcher or doctor agrees on what kind of pillow is best, there are a few constants:

Get Comfortable in Bed

Deciding on which pillow is right for you can mean a bit of trial and error. There are some basics to consider first, such as the age of your current pillows—they should be replaced every year or two, depending on the filler material.

The first and most obvious clue that it’s time for a new pillow is waking up with pain. If you are having trouble getting comfortable enough to fall asleep and are constantly readjusting or fluffing your pillow, that’s another sign it’s time to go pillow shopping.

The overall feeling of the pillow is also something to watch. Has it gotten lumpy or lost its shape? Is it too flat or, in some cases, too high? Your own level of discomfort along with the age and feel of your pillow will tell you that it’s time to go shopping.

Another important factor to consider is temperature. While the jury is still out on whether temperature actually has an effect on back pain, it definitely has an effect on quality of sleep. Tossing and turning all night long means a lack of quality sleep, and that movement can also aggravate spine and back problems.

Comfort is key, so consider both your pillow and your bedding. Some bed linens and pillow cases are better to keep cool. Cooling pillows are specially constructed to prevent heat retention, so this is something to keep in mind if a too-warm pillow is keeping you up at night.

Types of Pillows

Gone are the days when your only choice in pillows was down or down-alternative. Now, pillows are made from a variety of materials. Learning about the different kinds of pillows can help you make an educated choice, but it can still be trial and error. When you’reshopping, choose a retailer or brand that offers a guarantee or a good return/exchange program. That way, if the pillow isn’t right for you, you can return it to the manufacturer and try again.

  • Memory Foam: Remember those old infomercials where people jumped up and down on the bed while a glass of wine on the same mattress didn’t spill a drop? That’s memory foam. The material is polyurethane that has been combined with certain chemicals to make it viscoelastic. These kinds of pillows return to their shape easily and can stretch and conform to the curves of our bodies. There are several different kinds of memory foam now, including open cell, “egg crate” and gel. “Memory foam pillows differ than traditional pillows in that they will mold to the contour of your spine, which will help you from becoming misaligned,” says Dr. Conrad.
  • Down Pillows and Down Alternative (polyfill): These pillows are generally softer. They are made from either actual down feathers or a non-allergenic synthetic alternative that mimics the feeling of real down. Both of these are the most common pillow fillings. They don’t offer much firmness, but because these pillows are soft and malleable, they can be a good option.
  • Latex: These can be made from natural or synthetic latex. Sometimes called rubber pillows, latex pillows offer both soft cushioning and good support. To form this kind of pillow, the latex is generally shredded, which also means this kind of pillow can be customized with more or less fill depending on your needs.
  • Combination: Pillows nowadays may be a combination of materials, such as a foam core with down around it for comfort and support. Gel cores are also common, especially in cooling pillows.

How to Choose the Best Pillow for Neck Pain or Back Pain

Ultimately, you are the best resource for finding the right pillow. After all, it’s about your comfort and your sleep. There are tips, of course. According to Harvard Health Publishing, a division of Harvard Medical School in Cambridge, MA, things to keep in mind are:

  • Will the pillow conform to the shape of your neck and spine?
  • Is the pillow too soft or too stiff?
  • Is the pillow too high?

It’s also important to consider your sleeping position. Do you generally fall asleep on your back, your side or your stomach? Pillow manufacturers are now touting pillows that match with your sleeping position, and many of the reviews for these special pillows are very positive.

Byron Golub, Director of Product and Merchandising for Saatva, a mattress and bedding accessories company based in New York, NY, makes sure their pillows match up with sleep positions for the most comfort. The company offers different pillows for different people. In an email interview, he explained their criteria in a list:

  • Back sleepers will want a medium-thick pillow to keep the head, neck, and spine well-aligned.
  • Side sleepers (most people) need a slightly thicker, firmer pillow for optimal alignment. Keeping your spine properly aligned while lying on your side is the challenge.
  • Stomach sleepers are more challenging because stomach sleeping itself puts strain on your lower back. A nearly flat pillow is best.

When shopping, don’t be afraid to try out the pillow before you buy it. Most stores will allow you to do this, and some companies offer help. For example, the Sleep Number company offers a customized pillow service called PillowFit. They offer an online quiz as well as a personalized process in their stores. The process “helps you pick a pillow based on your support preference and sleep position to help you find your best spinal alignment,” explains the company.

Customizable or adjustable pillows are another option. These pillows let consumers change the amount of filling in the pillow so they can find their perfect loft. Companies including Sleep Number, GhostBed, Coop and Pluto offer this option, in shops and via online quizzes.

Research, personal preference and advice from your doctor are the best ways to find the pillow that is right for you. Less pain and better sleep are possible, despite your back and spine problems. After all, we spend a lot of time in our beds, so let’s make them as comfortable as possible.


Updated on: 08/01/21
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