The Ultimate Guide to Choosing a Pillow for Neck Pain

You spend a third of your life sleeping, yet the most common cause of neck pain we see at our Weston clinic is improper sleep posture—largely dictated by the wrong pillow. The goal is simple: keep your head aligned with your spine. Here is the expert guide to choosing the right pillow.

The #1 Rule: Maintain a Neutral Spine

Your pillow's only job is to fill the space under your neck without tilting your head up or down. This alignment prevents overstretching or compressing your cervical discs and muscles while you sleep.

For Back Sleepers: The Contour is Key

• What you need: A medium-firm cervical contour pillow. These pillows are designed to be higher under the neck and lower under the head.
• Why it works: The raised portion supports the natural curve of your neck (the cervical lordosis), while the lower center allows your head to rest comfortably without being pushed forward.

For Side Sleepers: Match the Loft to Your Shoulder

• What you need: A pillow with the correct "loft" (height). The ideal loft should match the horizontal distance between your ear and the outside of your shoulder.
• Why it works: This fills the entire gap, preventing your head from dropping down towards the mattress and straining your neck muscles all night.

For Stomach Sleepers: The Hard Truth

• What you need: A new sleeping position. We strongly advise against stomach sleeping.
• Why it's harmful: It forces extreme rotation of your neck for hours, overloading your cervical joints and guaranteeing stiffness. If you must sleep on your stomach, use an extremely thin pillow or none at all.

A Note on Adjustable Options

Pillows filled with shredded memory foam or microbeads can be a great choice, as they allow you to add or remove filling to dial in the perfect height and firmness for your body. This customization is especially valuable if you switch positions throughout the night.

Materials Matter

• Memory foam: Conforms to your neck shape, good for consistent support
• Latex: More responsive, better for those who move frequently
• Down/feather: Comfortable but may not provide enough support for chronic pain
• Buckwheat: Excellent moldability and airflow

Choosing the right pillow is one of the most effective changes you can make to achieve long-term neck health. For more on how we treat chronic stiffness and cervical dysfunction, see our main Neck Pain Treatment page.