Pillows – Is your pillow hurting your neck?.
We spend an average of 7.6 hours asleep each night (2774 hours in a year!) and so our choice of pillow can be important in contributing towards a restful sleep and a healthy spine.
Clients with neck pain will often ask us to recommend a pillow that would suit their neck, and so we hope the advice below will be helpful for many people.
If you have any questions that are not answered below, our physiotherapists will be happy to discuss these with you on your next visit.
Interesting Fact!
‘Memory foam’ was invented by NASA-funded researchers looking for ways to keep test pilots cushioned during flights. Its use in pillows was developed by the Tempur company – although astronauts themselves never get to rest their heads on a pillow in space!
Understanding Your Sleep Position
Your sleep position is one of the most important factors in determining which pillow will provide you with the best support. Here’s how it affects your choice:
Back Sleepers
For back sleepers, a medium-firm pillow is usually the best choice. It should be thick enough to keep your head in line with your spine, but not so thick that it tilts your head forward. Memory foam and latex pillows can be excellent for this purpose, offering a balance of support and comfort. As physiotherapists we would suggest that you also place a second pillow under your knees which will keep your lower back in a neutral position for a more comfortable night’s sleep.
https://www.emma-sleep.ie/emma-premium-foam-pillow/?sku=EPWDD040070AAA
Side Sleepers
Side sleepers would benefit from more supportive and in some cases ‘contoured’ pillows to support the gap between the head and shoulders. The research from scientific papers would suggest that those who sleep with latex pillows usually report the best quality of sleep with least wakings. They are also naturally resistant to dust mites and mould, making them ideal for allergy sufferers. We suggest you place a second pillow between your knees to support the alignment of your lower back.
A study by Australian physiotherapists* used 99 patients with chronic neck pain. They were all Side Sleepers. The parameters checked were the degree of night pain, degree of waking pain and the quality of sleep obtained. The conclusions drawn from the study were that:
Latex pillow is likely to provide the most support and best value
The shape of the pillow made no difference to waking pain or abolition of night pain.
The contour pillow was less comfortable & provided poorer quality sleep.
The feather pillow was a consistent poor performer in all outcome measures
The latex pillow performed consistently well & was a better performer than the subject’s own pillow in all outcome measures.
A more recent study** found that ‘there is moderate evidence that some of the following pillow parameters could improve sleep quality/spinal alignment, and decrease sleep-related neck pain. These are: a latex pillow material, a contoured pillow design (higher sides to accommodate side sleepers and a lower, flattened middle to accommodate back sleepers), and a cooling surface’.
Our recommendations to try:
https://www.groovepillows.co.uk/products/the-original-groove-adjustable-pillow
Stomach Sleepers
Stomach sleepers can be more susceptible to waking up with a stiff neck if they have underlying stiffness in the small joints of their neck – the facet joints. Clinically, we would observe that they have less issues with morning neck and stiffness that one might expect and it is likely that if a person has always been a stomach sleeper that their neck joints and soft tissues have adapted to this end of range rotated position over many hours of many years of sleep. Indeed it is more likely that it is either their work posture or a distinct injury eg whiplash that brings them to the care of a physiotherapist to begin with!
If you are someone who sleeps on your stomach, a soft, thin pillow is recommended to keep your spine in a neutral position and prevent strain.
UK company Tempur have designed a star shaped pillow, to allow for easier breathing for front sleepers which may reduce the angle of neck rotation needed.
Our recommendation to try:
https://uk.tempur.com/pillows/browse-by-collection/shaped-pillows-UKOMBRACIO.html
Final Thoughts: Comfort is Key
While all of these guidelines can help narrow down your pillow choice, the most important factor is comfort. There’s no one-size-fits-all when it comes to pillows, so don't be afraid to try different options to find the one that helps you wake up feeling refreshed and pain-free. Whether you prefer the cushy softness of down or the firm support of memory foam, the right pillow can make all the difference in your sleep quality.
Investing in a quality pillow is a simple yet significant step toward better sleep and overall well-being.
Pillows should be changed every two years for optimal support.
Need more personalised advice? Visit one of our experienced physiotherapists for a neck assessment and further help to start each day with a painfree neck and a healthy spine.
* Reference: Gordon, S et al (2009) Pillow use: the behaviour of cervical pain, sleep quality and pillow comfort in side sleepers. Manual Therapy, 14, 6, 671-678
**Effect of different pillow designs on promoting sleep comfort, quality, & spinal alignment: A systematic review
Ahmed Radwan a b, Nicholas Ashton a, Trever Gates a, Austin Kilmer a, Michael VanFleet a
European Journal of Integrative Medicine,Volume 42, February 2021, 101269
