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Expert advice to help you feel better.

Which pillow is the best for neck pain?

Which pillow is the best for neck pain?

Are you a “pillow zealot”?  When you go on vacation, do you have to bring your “special” pillow with you, because you just can’t sleep without it?  I know a few people who fall into that category (in fact, I am married to one!) and maybe you are one of them yourself!  For some people, sleep is very difficult to attain, without that special pillow.

As a physical therapist, I work a lot with people that struggle with neck pain.  Usually at some point during our treatment sessions the question comes up, “What kind of pillow should I be using?  Can you recommend one?”  Today one of our spine pain specialists, Toby Bluth, PT, DPT, will be answering those very questions! Find out which pillow is the best for stomach, side, and back sleepers and unlock the key to your best night’s rest!

First, let’s keep it pretty simple.  If you are waking up with neck pain, then it is probably time to consider a change in your current pillow.  The pillow discussion can get pretty in-depth, and you can spend a lot of money on that “special” pillow.  However, the one piece of advice that we give out all day everyday is this: the right pillow for you comes down to the one that helps maintain good alignment during your sleeping position of choice.  Maintaining proper sine alignment while sleeping is absolutely crucial.  Having poor posture during an extended period of rest can cause painful mechanical neck pain.  After hours in a poor position the joints and ligaments surrounding those joints tighten up and actually get used to that painful position during the night.  That tightening effect can result in a painful, inflamed neck in the morning with the initial movements of the day. Sometimes that pain can even linger for some time, requiring some “TLC” from your physical therapist.

In general, no matter what position you prefer to sleep in, it is good to have a pillow that provides support that allows the ear to stay in line with the tip of the shoulder. The following graphic helps you to visualize what the proper pillow would look like for a side sleeper:

proper pillow alignment

Now let’s consider that concept for the three different sleeping positions and how it relates to picking the right pillow:

1. Back:  a good medium fill pillow should do just fine here.  Try to find a pillow that will allow your neck to curve without extending it too far backwards or forwards. The main position we want to avoid would be letting the head fall back too far, putting that optimal positioning out of line with the ear falling behind the shoulders.
2. Side:  a medium to low fill pillow should allow for that proper positioning for the side sleeper.  Too flat or a pillow that is too old will put the head too far down in relation to the shoulders.  Conversely stacking pillows too high puts an uncomfortable “crink” in the neck all night long. Both of these are a sure recipe for neck pain in the morning.

3. Stomach:  In my opinion this is about the worst position you can sleep in for your neck. It’s impossible to maintain your neck in a neutral position as it has to rotate (typically 45 degrees or more) to allow you to keep breathing. However, I understand that that is the sweet sleeping spot for a lot of folks out there.  If this is you, a thin pillow will most likely get best results. Try to add a little more support under the back of your head that tapers down towards your nose/face.

I am always in awe at the overly full pillows out there.  These always seem to be found in hotels.  (Thus the reason my wife always travels with a pillow).  No matter the position of preference, I don’t know how anybody sleeps on those type of pillows.  Back and side sleepers get pushed way too far forward, and I just cringe at the stomach sleeper trying to rest on one of those, as they get pushed into extreme extension with rotation. Ouch! If you do have neck pain and know you have a trip coming up, it’s not uncommon that I recommend people take their own pillow with them. Of course, I didn’t always feel this way…

Up until a few years ago, I never had too much patience with my pillow zealot wife.  It was then that significant neck pain crept into my life and I became a little more picky about that all-important pillow.  I had been using an el cheapo synthetic fill pillow for many years that had flattened and hardened with time, and it was catching up to me.  It was time for a new pillow, and an upgrade at that.  A simple switch to a feather fill pillow, with more support and fill, really made all the difference for me.  My neck has felt great since.  My point is that pillows do need to be changed occasionally and your body will usually let you know when it is time.

So let me know if you have any questions or feedback, I would love to hear back about your own pillow experiences, what has worked, helped or not helped.  The options for pillows are outright dizzying, so start with these simple adjustments discussed here first before going out and spending a ton of money on the newest and greatest “Cadillac” of pillows.  It may come down to making a significant investment like this, but usually subtle changes with positioning, using more economical pillows will do the job.

If you have neck pain or need some more pillow advice, we would love to talk to you! Call or come in today to one of our four convenient PT locations:

Heber City        Salt Lake        Farmington        Murray

Toby Bluth, PT, DPT
Fit Stop Physical Therapy – Heber City
345 West 600 South Suite 200
Heber City, UT 84032
(435) 654-5607

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