The Best Pillows For Neck Pain Relief

A Chiropractor's Review and Recommendations

Dr. Spathis Pic

As a chiropractic physician my recommendations are made based on a variety of factors including spinal biomechanics, research evidence and practical considerations such as ease of advice implementation and the cost of particular products. I would like to disclose that, although I may get a referral fee from some of the items advertised or reviewed, this will never impact the integrity of my reviews or recommendations. I hope you find my recommendations useful; however, if you have a specific spinal problem or condition, and have not yet done so, it is recommended that you contact your qualified health care provider for recommendations that may apply to your particular case.

Peter C. Spathis, DC

Chiropractor Recommended Pillows For Neck Pain

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A good pillow can help relieve neck pain and stiffness by providing proper neck and upper back support during the night. However, before deciding on a particular pillow, it may be useful to review some general considerations that may helpful in deciding which type of pillow you are most likely to benefit from. The biggest consideration is whether you normally sleep on your side or on your back. (If you sleep on your stomach you may want to try to change this for the reasons I discuss below.)

Our overall goal is generally to keep the neck close to a "neutral position" and aligned with the upper back. This is the position of the neck when someone is standing looking forward without their head tilted to either side. The reason I gave this description instead of something like "lying on your back on a hard surface" is because, even though this may be a similar position for many people, for some it is quite different. Consider someone of advanced age that has had spinal compression fractures which have resulted in a significant forward curvature of the upper back. Lying on their back this person would have their neck extended backwards - not the "neutral position" that we would prefer.

So, in keeping with our original definition of a neutral position, we want a pillow that achieves something close to this when we are lying in bed. For a back sleeper that doesn't have a significant forward curvature ("hyperkyphosis") of the upper back a thinner pillow is preferred - most people fall into this catagory. For a back sleeper that does have a hyperkyphosis, the pillow should generally be a little thicker, the degree of which should generally correspond to the degree of hyperkyphosis as well comfort. A simple way to look at this is, there should not be a pronounced angle between the neck and upper back when lying down. A pillow that is too thick will cause a back sleeper to have their neck angled too far forward ("hyperflexion"), one that is too thin will cause the neck to be angled too far backwards ("hyperextension").

For side sleepers, the biggest consideration is usually how wide/broad the shoulders are. Those with broad shoulders have more space between their head and the mattress when lying in bed on their side. This space should be filled by the appropriate pillow to keep the head lined-up with the upper back. A pillow that is too thin will have the neck angled toward the mattress while one that is too thick will have the neck angled away from the mattress. A position that avoids significant angles is preferred with, perhaps, some degree of deviation from the ideal due to underlying structural issues and comfort considerations.

Finally, those who sleep on their stomach may wish to try changing this habit unless there is a health/medical reason not to. The problem with stomach sleeping is that the head is turned to one side so the person can breath. This takes the neck far out of the neutral position discussed earlier and creates asymmetrical and unnecessary stress on spinal structures. In the long run, it may result in some lengthening of supportive structures and tissue on one side of the spine and a shortening on the other. There may also be a degree of unnecessary stress placed on vascular structures. Incidentally, in addition to stomach sleeping being less than ideal for the neck (cervical spine), the lower back (lumbar spine) is also affected. As the abdomen sinks into the mattress, there may be some increased pressure on structues in the back of the lumbar spine. Simply changing to side sleeping may help some people avoid waking up with a stiff lower back.

So, what is the best pillow for neck pain relief? From this discussion it should be apparent that there is not one best pillow for everyone but, rather, a pillow that is best for YOU. In considering the above factors in your pillow choice, I believe you will have the best chance of finding the one that will give you the most restful sleep as well as possibly even provide some relief from conditions such as neck pain, upper back pain and morning stiffness. In your search for the "perfect pillow" I believe the following deserve consideration:

LOFE Pillow Picture
LOFE Pillow

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The best choice of pillow for any given person depends on various factors such and their size, whether they are a back or side sleeper, personal preferences, etc., so there will not be unanimous agreement of which pillow is "best". However, this pillow comes with 4 memory foam layers allowing adjustable thickness if the full height is too much for your particular body or sleeping position. The adjustable thickness of this pillow provides the versatility required to maximize the chance of it being the "just right" pillow for you. This should make this a good choice for most people, especially those that have tried a number of different pillows and have still not found one they are happy with. At this risk of sounding nitpicky, I do have to comment on the company describing their pillow as one that is perfect for all kinds of sleepers, including stomach sleepers. As a chiropractor concerned about spinal biomechanics, I do not recommend stomach sleeping and generally advise against it for the reasons outlined above. However, if there is a particular reason that this is unavoidable, this pillow does allow a minimum thickness to help decrease the negative effects of stomach sleeping. Finally, at the time of this review, the company includes product pictures suggesting that a thicker pillow height is preferrable for back sleepers compared to stomach sleepers. Unless one has certains conditions - like an increased forward curvature of the thoracic spine or "hyperkyphosis", a thinner pillow is usually preferrable for back sleepers compared to side sleepers.

Coop Pillow Picture
Coop Pillow

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People are often surprised that, as a chiropractor, my pillow recommendation for most people is not automatically a specialized "cervical pillow". However, as people come in different sizes and neck support requirements, many find that the specialty products are not quite right for them - the thickness or firmness may not be ideal and they are often happier with a more basic pillow that they can fluff up to the correct height for THEM. As with the above product, the advantange of this pillow is that it allows you adjust its thickness - this time by adding or removing some of the memory foam fill it contains - to get the perfect height for you and your preferred sleeping position. As reflected in the customer review ratings, this is another pillow that I believe would be appropriate for the majority of the population. An Amazon link is provided for more information and current price.

Utopia Pillow Picture
Utopia Pillow

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A common problem with many specialty pillows is that they are too thick for the average person to find comfortable, especially for back sleepers - the head should not be flexed forward to the point of creating an unwanted angle in the neck. This pillow is a good choice for someone that has found this to be a problem with other pillows. Back sleepers, those smaller in stature - including smaller side sleepers - and those that don't enjoy an overly firm pillow are most likely to benefit from this one, esp. for the price!

Mediflow Water Pillow Picture
Water Pillow

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The chiropractic school that I graduated from was involved in a study of a "water based pillow" and, overall, the study was supportive of these pillows reducing neck pain in some people. Although this is meant to be filled with water to your ideal level of firmness and sleeping position - less water for back sleepers, more water for side sleepers - I believe side sleepers are more likely to benefit from this pillow as, even with very little water, it may still be too thick for smaller back sleepers. This most recent version of the pillow uses "memory foam" around the core, a change being well received by users as noted by an improved customer rating. Another benefit of this pillow is that it stays cooler during the night - a big plus for some people for which this is an issue.