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Pillow Talk – Selecting the Best Pillow to Avoid Neck Pain

Authored by Dr. Colin Haines, MD. August 24, 2021

There’s nothing better than resting your head on the pillow after a long day — unless you’ve selected the wrong pillow. With 70% of Americans experiencing neck pain at some point in their lives, this is a topic we revisit often. But finding that perfect pillow seems both as difficult and rewarding a task as finding the fountain of youth! This is especially true for those suffering from neck pain. So how do you choose a pillow that is right for you? Here are my tips for choosing the right pillow for a restful, pain-free night’s sleep.

Understanding Why Spinal Alignment Matters When Sleeping

It is important to understand that the spine is divided into three main sections — the neck (cervical spine) is at the top, followed by the mid-back (thoracic spine) in the middle, and finally, the low back (lumbar spine) is at the bottom just above the sacrum and tailbone. Each of these three sections (cervical, thoracic, and lumbar) has a natural curve in opposite directions when looking from the side profile view. Together they create your spinal alignment. If one or more of these curves decrease in size over time (due to a normal aging process, chronic poor posture, or as a result of a traumatic event), overall malalignment can result. This can lead to difficulty maintaining that horizontal gaze, which can be painful and cause muscle fatigue. Therefore, it is very important to do what you can to maintain good posture during the day and while you sleep.

Determine Your Sleep Position

Since the shape of our bodies can vary tremendously, you can imagine that the size of our spinal curves will differ too. And in correlation with those two factors, our preference for sleep position will vary from person to person as well. Some people prefer to sleep in one particular position for their whole night’s rest, either on their back, side or on their stomach. While others move around when they sleep and need a pillow that can be used no matter what position they are in.  

So first determine which position(s) you sleep in, then imagine how the natural curve in your neck needs to be supported in that particular position. For example: if you sleep on your back, you need enough support in that reverse ‘C’ curve to support this area while you sleep. The right amount of support will keep your eyes looking at the ceiling. While too much support will force your chin to your chest, which is a posture we need to avoid!  

Picking Out the Correct Pillow

Once you feel comfortable with your understanding of your sleep position and maintaining spinal alignment, then I recommend going to a reputable site that reviews hundreds of pillows to create a “best of” list, such as Forbes. There you will find a breakdown of the advantages of each of the top pillows they found, based on consumer reviews. These pillows usually range in price from about $40-$100. They have a variety of materials, such as memory foam, down feathers, cooling mesh, ventilated gel, organic filling, and even water pillows. Some are adjustable, and others come with different size options. There are even some that come with a money-back guarantee, which is especially nice because you can try it out a bit before you decide if it’s right for you.

Does the Pillow Choice Really Make a Difference?

While most quality pillows last between 1-3 years, your spine needs to last you a lifetime. Purchasing a new pillow is an investment worth making. The correct support for your specific spine is what will keep neck pain at bay. There is no ‘one pillow fits all’, and your back and neck will definitely thank you when you wake up every morning feeling refreshed and recharged for the day ahead of you. 

If you do start to feel the aches and pains from sleeping on a bad or worn-out pillow, make sure you make it a priority to find a new one. And if that new one still doesn’t help you out like it should, schedule a consultation with one of our physicians at Virginia Spine Institute. We can make sure there are no underlying issues or conditions that have been left untreated. 

There is just nothing better than a good night’s sleep. Waking up feeling well-rested and refreshed not only starts the day off right but may also give you that extra energy boost to engage in other healthy habits, like exercising and eating well. Getting a good night’s rest should happen every night, so don’t let back or neck pain stops you from getting that.


Dr. Colin Haines is a board certified spine surgeon and the Director of Research at Virginia Spine Institute. Dr. Haines performed the world’s first combined endoscopic and robot-guided spine surgery. His patient success has earned him a national feature on The Today Show and WebMD, and Top Doctor recognition in consecutive years.. Learn more about Dr. Haines.

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Reviewed by: Dr. Colin Haines, MD.

Reviewed by: Dr. Colin Haines, MD.

About The Author

Dr. Colin Haines, MD

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