As a Chiropractor, one of the most common questions I get asked is, “What pillow would you recommend for my neck and/or back pain?”Unfortunately, there is not one pillow that works for everybody – all of our bodies are unique and we all have different preferences. Additionally, the ideal pillow for your body also depends on the position you sleep in.

Ultimately, regardless of sleeping position, your pillow should offer support, comfort, and should preserve the natural curvature of your cervical spine. This will reduce the stress and strain on your muscles and joints that can disrupt your sleep and lead to aches in the morning. A pillow that is too high will cause hyperflexion of the cervical spine, which can cause pain upon waking in the morning or even throughout the night. Similarly, a pillow that is too flat or too low will cause hyperextension of the cervical spine. When it comes to firmness, your pillow should be comfortable and adaptable – meaning it should be able to conform to various sleeping positions, as most of us do not sleep in one position the entire night. You should also feel well-rested upon waking and should not have any significant pain or stiffness.

Pillow Types:

There are many different pillows on the market today, ranging from traditional feather and fiber ones in shaped pillows, memory foam, water pillows, and buckwheat pillows. It can be overwhelming and difficult to know what to choose. These tips may help pick the pillow that is right for you.

– Feather pillows can be easily manipulated to offer support where it is needed. This can be especially helpful for those who change sleep positions frequently.

– Cervical pillows have a deeper depression in the center than the edges, which allows for more of a natural contour of the cervical spine. These pillows tend to draw strong reactions, with some people swearing by them and others finding them extremely uncomfortable.

– Buckwheat-filled pillows have become increasingly popular. Buckwheat is hypoallergenic, it will mold to the contours of your head and neck providing good support, but it will also change shape when you move.

– Memory foam is designed to conform to the head, holding it in place.

– Water and gel pillows allow you to customize and easily adjust the amount of water inside, which can be very helpful when trying to determine a height and firmness that is right for you.

Pillows for Different Sleepers:

Back Sleepers:
Sleeping on your back is the ideal position for maintaining the natural curves of your spine. Your pillow should support the natural curvature of the cervical spine, with sufficient support under the head, neck, and shoulders. Pillow height should be lower than for side sleepers. Place a pillow under your knees to minimize strain on the lower back. Extra support can be provided by adding a small rolled towel positioned under the neck.

Side Sleepers:
Your pillow should support the head and neck so the spine maintains a straight and natural horizontal line. A thicker pillow is required for sleeping on your side versus your back.
Draw your knees up slightly toward your chest and put a pillow between your legs. This will help keep the spine in a neutral position and prevent any pelvic rotation. Rest one arm on another pillow to provide additional support for the spine. Of the limited research that has been done regarding pillows and neck pain, latex pillows have proven to be the most helpful for side sleepers. Feather pillows have been reported to cause the most cervical stiffness upon waking.

Stomach Sleepers:
Sleeping on your stomach is not recommended, as it is the most stressful position for your back and neck. If it is preferred, your pillow should be relatively flat, or your head should rest directly on your mattress so your head and neck aren’t strained. Place a relatively flat pillow under the abdomen or pelvis to help the lower back keep its natural

Proper pillow selection is more of an art than a science – it’s a process of trial and error. If possible, test several out before purchasing one, as some can be quite expensive. Be patient – some pillows may be uncomfortable at first but are very helpful over the long term.