Pillow for Neck Pain: What to Pick for Better Sleep

Using the right pillow can help relieve neck pain and may promote better sleep. Here’s what to look for in a pillow that’s good for neck pain.

Published Date: Jan 23, 2023

Our Hinge Health Experts

Steven Goostree, PT, DPT
Physical Therapist
Dr. Goostree is a Hinge Health physical therapist and board-certified orthopaedic clinical specialist.
Jonathan Lee, MD, MBA
Orthopedic Surgeon and Medical Reviewer
Dr. Lee is a board-certified orthopedic surgeon with subspecialty training in hip and knee replacement, as well as advanced clinical expertise in spine care.
Dylan Peterson, PT, DPT
Physical Therapist and Clinical Reviewer
Dr. Peterson is a Hinge Health physical therapist who focuses on developing our exercise therapy programs and member education.

It’s no fun to wake up with a stiff, sore neck for no apparent reason. When this happens, there may be a sneaky culprit behind your neck pain: your pillow.

"When you sleep, your head and neck should be mostly in line with the rest of your spine but sometimes your pillow or sleeping position can place your neck in an awkward position that leads to pain or discomfort."
Steven Goostree, PT, DPT, OCS, physical therapist at Hinge Health

In many cases of neck pain, a pillow may be one factor to consider among many. Neck pain can also commonly occur because of stress or tension, injury, or chronic conditions like arthritis. But if your neck pain occurs first thing in the morning or happens when you sleep in a new place (like on vacation), it’s worth looking at your pillow situation.

Hinge Health does not recommend specific products or brands. This article is a general guideline for what to look for in pillows that can help prevent or reduce neck pain.

Can Your Pillow Cause Neck Pain?

It's unlikely that your pillow is the sole cause of your neck pain, but it could make your neck pain worse, especially in the morning. In fact, you may wonder, “why does my neck hurt when I wake up?” 

Your pillow’s job is to hold your neck and head at the right height. If the pillow is too high or too low, your neck muscles try to compensate for the lack of support. Sometimes this can trigger neck strain and pain.

“We spend about one-third of our lives sleeping, so it’s important to have a good pillow that promotes proper neck and spine alignment,” explains Dr. Goostree. “The right pillow will provide support to ease neck pressure.”

An ill-fitting pillow, on the other hand, can make it harder for you to get a good night’s rest, which causes a vicious cycle. The more tired you are, the more likely you are to notice — and be bothered by — neck pain.

What Causes Neck Pain?

Here are some of the most common reasons you may experience neck pain. 

  • Muscle strain. This can be from tense muscles, posture issues, or sleeping habits.

  • Osteoarthritis. As with other joints in the body, neck joints tend to wear with age. This can cause pain in the middle or side of your neck, as well as around your shoulder blades and at the base of your head. 

  • Disc-related pain. This is when the discs in between the vertebrae in your neck begin to wear. It can cause pain in the neck when you turn or tilt your head and can worsen when you hold it in one position for a long period of time.

  • Whiplash. The most common cause of whiplash is a car accident. The head jerks backward and forward, which strains the soft tissues and joints of the neck. It can also happen in sports.

Types of Neck Pillows 

There are several different types of pillows you can use to help neck pain, says Dr. Goostree. They include:

  • Neck roll. This is a cylinder-shaped pillow that you can place inside your usual pillowcase for extra support while you sleep. 

  • D-core shape. These pillows have a D-shaped center that cradles your head and allows the built-in neck roll to support your neck. It’s designed for back sleepers.

  • Standard contour. These pillows have a slight dip in the middle which mirrors the curve of your upper spine and neck, to encourage natural spine alignment.

  • Horseshoe shaped. These pillows are often used while traveling. They can support your neck if you nap on a plane or during a car ride.

What to Look for in a Neck Pillow 

It can seem overwhelming to shop for the best pillow for neck pain. Here are some things to keep in mind.

  • Pillow loft. This is the compressed height of the pillow when your head rests on it. There are usually low, medium, and high loft options. You don’t want a pillow that is too high, since it keeps the neck flexed, which can lead to morning pain and stiffness. Try a medium loft pillow (usually between three and five inches), suggests Dr. Goostree.

  • Pillow firmness. “You want something firm that won’t budge on you,” says Dr. Goostree. Aim for medium firm, which is comfortable but provides enough support to cradle your head and help your spine stay in alignment while you sleep. 

  • Support. D-core and standard contour pillows are often the best options, since they gently contour to your neck and support it. This is especially important if you’re a back or side sleeper.

  • Pressure relief. Look for a pillow that’s a good shape and size for your sleeping position and is firm enough to reduce pressure at contact points.

Choosing the Right Materials

Here are common options:

  • Down and feather pillows. These are a good option for people with neck pain, since they easily conform to the shape of your neck. Since they will collapse over time, however, they need to be replaced frequently — ideally, every year.

  • Memory foam. These conform to the contours of your head and neck, which can help with spinal alignment. 

  • Latex. These pillows tend to have medium firmness, which makes them a good choice for neck pain. They also have a buoyant feel that holds your neck in place. A 2020 study published in the International Journal of Environmental Research and Public Health found that memory foam or latex pillows provide good neck support and improve sleep quality.

  • Buckwheat. Since buckwheat hulls interlock and hold their shape, they are a good choice for people with neck pain who need more support. They tend to be more expensive than other types of pillows, and can take some time to get used to.

  • Polyfoam. These offer some contouring and respond to pressure more quickly than memory foam. However, they do need to be replaced more frequently than other types of pillows, since they develop permanent indentations over time.

When to Change Your Pillows

The National Sleep Foundation recommends that you change your pillows every year or two.

Otherwise, your pillow will begin to sag and flatten, which means you won’t get the head and neck support that you need. Signs that your pillow needs to be replaced include:

  • You wake up with a sore neck

  • You’re unable to find a comfortable sleeping position

  • Your pillow sags or develop lumps

  • Your pillow is excessively yellow

Certain pillow materials last longer than others. A polyester pillow may only last a year, while a latex pillow could last for three years. You can make all pillows last longer if you take good care of them. Wash your pillowcases every time you wash your sheets, and hand wash your pillows every two to three months.

PT Tip: Stick to One Pillow

“A lot of folks like to stack them up, but that puts your neck in an awkward position, no matter how soft and squishy they are,” says Dr. Goostree.

Learn More About Hinge Health for Neck Pain Relief

Our digital programs for back and joint pain are offered for free through benefit providers. Click here to see if you’re eligible.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

Frequently Asked Questions

What’s better for your neck: a hard or a soft pillow?

Neither. “You want to use a medium to firm pillow — nothing too soft or too hard,” advises Dr. Goostree. Back and side sleepers in particular should go for the Goldilocks rule — not too hard, not too soft, just right. It’s also good to bear in mind that factors like how wide or narrow your shoulders are and how soft or firm your bed is can impact how a pillow works for you. 

What’s the best type of pillow for each sleeping position?

If you sleep on your back, you’re best off with a rounded pillow to support the natural curve of your neck, and a flatter pillow to cushion your head. You can do this if you tuck a small neck roll into the pillowcase of a flat, soft pillow, or if you use a pillow with built-in neck support, including an indentation for your head. The best pillow for side sleepers with neck pain is one that’s higher under your neck than your head, which helps keep your spine straight. Stomach sleeping isn’t recommended for neck pain, notes Goostree. But if you do find yourself gravitating toward this position, look for a thin pillow that won’t elevate your head and neck too much.

References:

  1. Noyed, D. (2022, November 7.) Best Pillows of 2022. Sleep Foundation. https://www.sleepfoundation.org/best-pillows/best-body-pillow

  2. Isaac, Z. & Dec, K. D. (2022, September 20). Neck Pain (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/neck-pain-beyond-the-basics?search=neck%20pain%20(beyond%20the%20basics&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

  3. Say Goodnight to Neck Pain. (2022, February 2). Harvard Health. https://www.health.harvard.edu/pain/say-good-night-to-neck-pain

  4. Cushner, K. (2022, December 22). Best Pillows for Neck Pain. Sleep Foundation. https://www.sleepfoundation.org/best-pillows/best-pillow-for-neck-pain 

  5. Son, J., Jung, S., Song, H., Kim, J., Bang, S., & Bahn, S. (2020). A Survey of Koreans on Sleep Habits and Sleeping Symptoms Relating to Pillow Comfort and Support. International Journal of Environmental Research and Public Health, 17(1). doi:10.3390/ijerph17010302

  6. Fountain, L/ (2022, March 11). How Often Should You Replace Your Pillows? Sleep Foundation. https://www.sleepfoundation.org/bedding-information/how-often-should-you-replace-your-pillows Foundation. 

  7. Cushner, K. (2023, January 5). Best Pillows for Stomach Sleepers. Sleep Foundation. https://www.sleepfoundation.org/best-pillows/best-pillow-for-stomach-sleepers