Neck Pillows

Neck Pillows: Anatomically & Ergonomically Designed Pillows For Cervical Spine Support To Help Alleviate Neck Pain & Headaches

Everyone is different, however, having a variety of quality neck pillows allows everyone to choose one that works best. If your wondering which pillow is best for me? We have some tips and information to help you choose from a selection of pillows that fit your particular sleeping needs and cervical spine requirements.

Tips For Choosing The Best Pillows For Neck Problems

We define neck pillows as those not just wrapping around your neck, but those the maintain the proper relationship between the head, neck and shoulders when sleeping, based on sound ergonomic principles. Having well designed pillows for cervical problems is one important factor in achieving long term pain relief. Since there is no one pillow designed for every specific neck pain condition, an important consideration in choosing the best pillow is to choose ones according to your specific sleeping preferences. It is always easier to choose from neck pain pillows that conform to the positions you are most comfortable when sleeping.

Pillows & Sleeping Positions

sleeping positions

Sleeping in different positions is normal and we rarely stay in one position the entire night. There are benefits and disadvantages to each sleeping position, and it is important to choose from neck support pillows that allow comfort and good alignment in your favorite sleeping positions.

Back Sleeping

back sleepingBack sleeping is generally best for the spine and the health of your neck. This assumes a good mattress and pillow, allowing the spine to remain in a neutral position without any torsion or compression. This position allows a good mattress and pillow do their jobs of providing support. Another benefit of back sleeping is the effects it has on your face, with no direct pressure and in fresh air, it can help with reducing wrinkles.

A problem often seen is using a number of pillows under the neck for watching TV or reading, then falling asleep in this position. This not only causes pain in the neck, but can result in breathing problems and loud snoring. Another condition related to back sleeping is sleep apnea. Back sleeping can increase gravity’s influence on the tongue, allowing it to obstruct the airway.

  • A 2016 study published in PeerJ found higher pillow heights when back sleeping significantly increases peak and average pressures of the head and neck regions, believed to adversely effect sleep quality by negatively affecting head-neck biomechanics. Contoured neck pillows can help reduce this problem.

Side Sleeping

Most individuals sleep on their sides. Sometimes, which side to sleep matters. If you have acid reflux or heartburn, sleeping on the left side can help. The left side is often recommended for pregnant women to permit better heart circulation. It also helps support the belly and take pressure off the spine when back sleeping. There are special body pillows designed for pregnancy.

side sleepingSide sleeping requires an adaptation with your pillow. Side sleeping requires an increase in pillow height due to the width of the shoulders. A baby pillow is not needed until the shoulder become wider than the head. Special cervical pillows will have separate back and side sleeping sections to allow for this change in support according to sleeping position. This can help prevent compression between the neck and shoulder, which often leads to waking with arm numbness or pins and needles in the hand. Because the body knows what is best for it, you will often change from left to right positions. This helps to reduce strain on internal organs.

While requiring special adaptation for the cervical spine, side sleeping reduces obstructive sleep apnea and increases average minimum oxygen saturation, as well as lowering the heart rate and decreasing the average awakening index. So, there are benefits to side sleeping and having an accommodating pillow.

  • A 2019 study in Sleep and Breathing found over a third of patients with severe obstructive sleep apnea were influenced by position. By sleeping in the side position, over 75% of these patients saw significant inprovement in symptoms and almost 10% had no symptoms. Of those patients using CPAP, almost 20% had more benefit from avoiding back sleeping than CPAP therapy.
  • We know from a 2018 study in Biomedical Engineering Online, that side sleeping affects the heart. When lying on the left side, the effect of gravity and because the the left lung is smaller than the right causes the heart to move down considerably. Because the heart is upheld by the mediastinum, the amount of motion is limited and shows no obvious difference than back sleeping. This can be discussed with your doctor for any specific conditions.

Stomach Sleeping

stomach sleepingSleeping on your tummy may straighten out the lower back curve, which can be associated with back pain. This may be reversed if you have a very soft mattress. So, depending on your mattress, sleeping on your belly can cause extremes of pressure on the lower back. Since you can’t sleep face down, turning the neck to the side can place great amounts of torsion into the ligaments, joints and discs; not to mention the constant strain on the neck muscles. This can lead to morning stiffness, pain and headaches.

Some will suggest using a pillow under the lower abdomen and hips to help the lower back, however, this depends on the mattress, your anatomy and any back condition – you will need to experiment a bit. For the neck, a lower pillow usually works better to minimize torsion strain. With a habit that won’t go away, or for some of the benefits of stomach sleeping like maintaining warmth, you can sleep with a low pillow or sleep on the edge of the pillow where the head can be at a 45 to 60 degree angle. This helps to minimize cervical spine strain.

  • A 2021 study in PLoS One found those with waking spinal symptoms spent more time in provocative sleep postures, and experienced poorer sleep quality. Sleep postures sustained for more than 10 minutes or repeated, may cause micro damage and result in spinal symptoms.

Sleep posture is also been associated with sleep quality. Poor quality of sleep is delayed sleep onset, more awakenings after sleep onset, increased total wake time, and poor continuity of sleep. Therefore, factors like sleep posture that provokes spinal pain, potentially causing increased total wake time, could impact on sleep quality.

How Does Your Mattress Effect A Pillow?

We have discussed positions depending on your mattress. Here are some pictures to show how the sleeping surface can effect your pillow as well as your posture. This illustrates the side sleeping posture, but goes for any sleeping position. As a general tip, good mattresses should be medium/firm to avoid extreme postures of the neck and back. Preference is personal, just like pillows.

how mattress alters pillows

If you have a very plush or soft mattress, you may consider using the lower side of a contour pillow or choose a smaller size of the pillow that come in different heights. The opposite is true of firm mattresses, use the larger side or consider going up a size. Why? Your shoulders will sink further down in a soft mattress, while the pillow remains the same.

General Tips For Choosing Neck Pillows

As we have seen, there are some health benefits to different sleeping positions, however, most people will sleep in the position they feel most comfortable with, or the one they feel is the most natural. Even if one position is preferred, most use a combination of positions that changes throughout the night. Therefore a good selection of cervical pillows to accommodate different sleeping positions is important.

You may have a specific condition that requires a special pillow for your neck like a CPAP pillow for sleep apnea. Most people will benefit from having a wide selection to suit their particular sleeping habits. Our pillows range from special pillows with contours to ease muscle strain, reactive pillows that change to accommodate different positions and specific pillows that have separate side & back sleeping areas. Choosing a pillow may require more research, and one of the best tips for picking a good pillow is to learn more and you are encouraged to spend as much time as necessary.

Neck Pillows: Ergonomics

Neck support pillows come in 2 main categories: 1) Pillows with separate sections for back, side and/or stomach sleeping (functional pillows), 2) Pillows with a uniform surface for general back, side and stomach sleeping.

1) With pillows to relieve neck pain that have separate sections for different sleeping positions, you will need to change positions deliberately. This requires conscious maneuvering at night. This is not a problem for many that suffer with neck pain and is a reason why the therapeutic is one of the most popular. However, this may pose a problem for those who are very deep sleepers, or if you are on pain or other medications that cause you to fall in a deep sleep. So, you don’t want to wake up on your side with your head in the back sleeping position.

The idea behind having separate areas for different positions is posture requirements change when you change positions, therefore, these pillows will have raised or higher side sleeping sections than for back sleeping. As you sleep on your side, a pillow needs to be higher to accommodate the shoulders. This keeps the neck in proper alignment, preventing a stiff neck. Often, these will require some measuring or may size according to your height in order to get the perfect fit for your body size.

2) Pillows with a uniform surface provide a constant sleeping area for any position. These pillows do not require conscious changing of positions and are more like typical pillows in that respect. They can be a single height throughout or, typical of cervical pillows, may have contours that conform to the contours of the head, neck and shoulders.

In order to accommodate changing positions, these type of pillows use contours and/or different types of materials. Many will have a different height and/or shape in the front and back in order to permit personal preference. A typical memory foam pillow will have properties that conform to different positions. Some employ a fill that will automatically react to changes in positions like water or air. Water or inflatable pillows work similarly, however, require some set up and adjustment time.

Note: While some think they cannot sleep with a pillow that requires changing positions on separate sections; one thing that comes out from observing sleeping studies is that by having patients adjust their positioning consciously throughout sleep, the frequency of sleep apnea events and respiratory disorders can be reduced.

  • A 2014 study in the Journal of Physical Therapy Science indicated that current pillows on the market are too high for back sleeping and too low for side sleeping. The authors concluded, “Pillows with uniform heights are not suitable for a supine or side-lying position. In the case of both positions, users should be allowed to select pillows in shapes that can support the neck.” This supports the use of multi-sectional pillows for proper ergonomics, where more difficult conditions require more precise positioning.

Strategy: Combining Neck Pillows

It is not a good idea to use two of the same pillows of the together, however, some may benefit from alternating pillows of different designs, as a strategy to help with neck pain and headaches in difficult cases. This would combine a single surface with a multi-surface functional pillow used according to your symptoms; one as a standard, the other as an alternate when the condition changes or gets worse.

Do Pillows Really Help Neck Problems?

Just like using ergonomic principles has proven benefits in reducing pain symptoms, the same principles applied to sleeping and neck pillows can help as well. It will not work for everyone due to varying anatomical issues, however, efforts aimed at improving posture and reducing stress on muscles, ligaments and joints have been show to generally be helpful. It gets more difficult when you are choosing between two similar pillows or one that is similar to the one you have, which you do not like. A new one with a new shape and size designed to improve your sleeping posture can take some time to get used to, especially when you have been using the same old pillow for years, but this situation can also show the greatest help for those suffering from neck problems.

Chances are if you have bad neck posture resulting from pillows without correct support, this can result in bothersome snoring, headaches, lack of restorative sleep, tingling and/or numbness of your hands and arms in addition to neck pain and stiff muscles. So, having some of these problems can indicate that a good, supportive pillow can help. Since most of us invest approximately 33% of our lives sleeping, an important part of managing neck pain should include ergonomic pillows. You should not look for a pillow to solve all your neck pain issues, but it can help as part of a more comprehensive strategy.

How About Scientific Evidence For Neck Pillows?

This is a difficult area of research because there are so many different types of pillows designed for the neck. However, what evidence exists does indicate efforts to use pillows that are more supportive or ergonomic really does help. Individually selected and tested pillows for cervical problems using an anatomically designed shape, which offer support for the normal neck curve can minimize neck pain as well as headaches, providing a greater quality of sleep.

neck pillows help

A classic article that has been republished in 2010 by Dr. Ruth Jackson, in The Cervical Syndrome noted that a special neck roll pillow helps to restore normal neck posture as it supports the neck and head, while decreasing neck pain and increasing comfort levels during sleep. She indicated that cervical spine pain can be aggravated by sleeping on more than one pillow which causes neck flexion, sleeping without a pillow which offers no support under the neck, and stomach sleeping can cause excessive neck rotation. Dr. Jackson states. “In some instances this ‘cervical contour pillow’ gives relief of symptoms without other treatment.”

  • A study in Stuttg Rehabilitation (Germany) 1999; 38(3): revealed a considerable pain intensity reduction and sleep disorder improvement for individuals using cervical pillows. The study indicated that individuals can reduce chronic neck and arm pain using supportive pillows.
  • A comparative study in a 1998 Journal of Manipulative and Physiological Therapeutics indicates neck support pillows have a positive effect on quality of sleep and neck pain in comparison to usual pillows. They found the ideal pillow to be soft, not too high, and has extra support for the neck, with recommendations of use as part of neck pain treatment.
  • A 2010 study in the Journal of Pain Research found that lack of pillow support results in biomechanical stresses associated with waking neck symptoms. They found latex pillows can be recommended over other types for controlling waking headache and scapular/arm pain. Feather pillows performed the worse and there was no difference between a regular or contour foam pillow.
  • A 2016 study in PeerJ quantified the effects of back sleeping related to pillow height. They found the correct height significantly increased the average and peak pressures of the cranial and cervical regions. The results provided a quantitative and objective evaluation of the effect of pillow height on the biomechanics of the head and neck complex.

pillow height

Cervical spine alignment or curvature represent key factors affecting sleep and the biomechanics of pillow height is a critical design parameter. Cranio-cervical pressure distribution, cervical angle and lordosis distance we effected by pillow height and is crucial to maintaining quality of sleep and overall health.

  • A 2019 study in Health SA found sleep ergonomics are increasingly prescribed as a part of treatment in chronic neck pain. They postulated benefits to to be improved tissue repair related to the facet joints, decrease in muscle tension and better quality sleep. They concluded a memory foam pillow to be beneficial for chronic pain and disability when included with chiropractic treatment.
  • A 2020 study in the International Journal of Environmental Research & Public Health studied support and comfort qualities of pillows and the association between sleep quality and pillow design. The authors indicate to reduce neck fatigue as well as shoulder pain, design factors need to consider the neck height support in the side sleeping position as compared to back sleeping as seen in functional pillows. They found reduced cervical spine fatigue with materials like latex or memory foam that offer support and can improve sleep quality.
  • A 2021 review in Clinical Biomechanics indicates specifically designed pillows are effective in reducing neck pain, waking symptoms, and disability and enhancing pillow satisfaction in patients with chronic neck pain. The cervical alignment may be significantly impacted by the shape and height of the pillow.

Support For Neck Pillows

Neck pillows provide important ergonomic support of the neck during sleep. Many standard orthopedic pillows for neck pain often lose their support with time. Biomechanically, they offer support to inflamed areas of the neck and the normal relationship between the head, neck and upper back which can work to correct poor neck posture and allow injured parts to heal with less stress.

Scientific research is confirming clinical data that the use of cervical pillows can aid in neck pain treatment. Clinical evidence indicates neck and back posture correcting pillows to be employed for various neck and related issues like: sleep difficulties, headache, neck and arm pain, disc conditions, arthritis, as well as injury related sprains and strains like whiplash.

Because there is no clear choice that benefits everyone, we have articles to learn more about choosing a good neck pillow, please invest some time to read about How To Choose The Right Pillow, which details specific functions of pillow designs. Additionally, there is information on the best pillow for neck pain, pillows for neck pain, geared towards information on which neck pillows may be the bring the most satisfaction to our customers.

Scoliosis & Pinched Nerve

These conditions can complicate the process of choosing a good pillow, however, there are solutions. With scoliosis and what is called an antalgic position, one side will be higher than the other. In the case of scioliosis, this is a long term issue. With an antalgic posture, like having a pinched nerve where it feels better holding your head more to one side, you will need to have an adjustable pillow when side sleeping.

An adjustable memory foam pillow can help, but you have to adjust the pillow as you change positions. In order to avoid interruptions, have a pillow that you can pre-adjust to your specific needs. The Neck Pain Pillow is one that has separate sections and the microfiber fill can be adjusted to different heights on either side.

Neck Pillows: Conclusion

Sleep is an important process in life that is necessary for repair and recovery, as well as consolidation and integration of memory. It is a crucial part of human health. Proper sleep helps eliminate fatigue, restore strength and energy, and ensure well body function.

Neck pain can greatly interfere with sleep. So, there are many types of pillows to provide solutions and it is important to have a good selection because there are many variables to cervical spine conditions and related ergonomics. There is a maze of neck pillows out there, so we have a nice selection of pillows recommended for neck problems and a better night’s sleep.

  • A 2015 study in the journal Work. shows that simple instructions on sleeping postures and ways to improve them can have a positive benefit on pain. In a group of active female seniors, those who received information of the recommended sleeping position, 90% indicated a decrease in pain and improvement in well-being.

recommended sleeping positions for neck and back pain

Those who suffered upper or lower back pain were instructed to sleep in posture A, while those suffering neck pain were oriented for posture B. Those who slept on their stomach, position C, were instructed to assume position A or B. Although the population sample was small, the results were quite significant. This is a general guide and we do provide some very specific examples regarding specific conditions and present some very ergonomically sound pillows, however, without adopting new pillows, some general advice can go a long way.

Sleep Quality

Now more than ever, it is important to improve your sleep quality. Quality of sleep is related to immune function. So, don’t let pain interfere with your sleep. A good pillow may help you sleep better and this can not only improve pain and function, but boost your immune system.

  • A 2009 study in Archives of Internal Medicine show that poor sleep quality in terms of duration and efficiency prior to exposure to a rhinovirus were associated with lower resistance to illness. This was also presented in a 2015 study in the journal Sleep, where it was found that shorter sleep duration prior to viral exposure, was associated with increased susceptibility to the common cold.

The authors of the study also noted that short sleep duration is associated with elevated inflammation and sleep disruptions are related to impaired secretion of factors such as insulin-like growth factor-1 (IGF-1), an important regulator of both muscle mass and function.

neck pillows at amazon

Author Bio

Stephen Ornstein, D.C. has treated thousands of neck, shoulder and back conditions since graduating Sherman Chiropractic College in 1987 and during his involvement in Martial Arts. He holds certifications as a Peer Review Consultant from New York Chiropractic College, Physiological Therapeutics from National Chiropractic College, Modic Antibiotic Spinal Therapy from Dr. Hanne Albert, PT., MPH., Ph.D., Myofascial Release Techniques from Logan Chiropractic College, and learned Active Release Technique from the founder, P. Michael Leahy, DC, ART, CCSP.