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Pillows for Neck Problems 

One of the most common question that people with neck pain ask a physiotherapist is “which is the best pillow for me?”. This is a good question as research suggests that many people are sleeping on the wrong pillow (for them).  There are many factors to consider when selecting a pillow.

The purpose of your pillow is to support your head and neck in a neutral position and reduce stress on the neck while sleeping. Stress on pain sensitive neck structures while sleeping is thought to be related to waking symptoms.

Factors to consider when selecting a pillow include preferred sleeping posture, your build, symptoms, age and gender. These will influence which pillow height, shape and composition is best for you.

  • Pillow height

With the purpose of the pillow being to support the head and neck in a ‘neutral’ posture, ideal pillow height will vary according to your size. Most people are side sleepers and shoulder width will affect ideal pillow height. There is little scientific evidence to support pillow height selection but clinically we find that back sleepers often need less pillow height than side sleepers. Clinically, we find that patients who report needing to put an arm under their pillow at night are sleeping with a pillow that is too low.

  • Pillow shape

There is no evidence to support the benefit of contoured pillows over regular shaped pillows (Gordon, 2009). In fact research suggests that contour pillows should not be recommended to people who are troubled by waking with a stiff neck. Most contour pillows are designed for back sleepers and are not suitable for side sleepers. However, foam contour pillows are better than regular foam pillows or feather pillows.

  • Pillow composition

Latex pillows can be recommended over any other type for reducing waking headache, neck pain and scapular/arm pain. Feather pillows are not recommended as research indicates that they cause reduced sleep quality, low levels of comfort and waking symptoms. Latex rubber, foam contour, and polyester pillows are better than foam regular or feather pillows (Gordon, 2010).

  • Gender and age

Field trials researching people’s pillow preferences suggest that men and women in different age groups may be suited to different kinds of pillows (Gordon, 2010). However, as yet there is no conclusive guide on which pillow is better for these groups of people.

When purchasing a new pillow it is recommended that you try it first. Many bedding shops will allow you lay and rest your head on a sample pillow to test pillow height and comfort. It is a good idea to take a friend pillow shopping so that you have someone to observe your neck from behind checking that your spine is straight when your head is resting on the pillow. The firmness of your mattress can affect pillow performance. If you change your mattress you may find that you need a pillow of different height or density.

Summary

Your personal characteristics will determine which pillow is best for you but consider using a pillow other than your regular choice as research suggests that many people select pillows that are wrong for their needs. Feather pillows are not recommended. There is a growing body of evidence suggesting that latex pillows are the best for people who wake with headaches, neck and arm pain.

References

Gordon SJ, Grimmer-Somers K, Trott P.  Pillow use: the behaviour of cervical pain, sleep quality and pillow comfort in side sleepers. Man Ther. 2009 Dec;14(6):671-8. Epub 2009 May 7.

Gordon SJ, Karen Grimmer-Somers K. Your pillow may not guarantee a good night’s sleep or symptom-free waking. Physiotherapy Canada. 2010 Volume 63, Number 2

Helewa A, Goldsmith CH, Smythe HA, Lee P, Obright K, Stitt L. Effect of therapeutic exercise and sleeping neck support on patients with chronic neck pain: a randomized clinical trial. J Rheumatol. 2007 Jan;34(1):151-8.


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