How to Choose the Best Pillow to Help Reduce Neck Pain

Choosing the best pillow to help reduce neck pain can be very confusing. When you walk down the pillow aisle of your local big-box store (yes, there's a pillow aisle!), you'll find an overwhelming number of choices. On one hand, “comfortable” is subjective and is a personal choice. But there is science behind picking the perfect pillow. Ultimately, the goal is to get a peaceful night of sleep and to wake up with minimal aches and pains.

In a previous post, we discussed sleep tips to help reduce neck and back pain. Now, we're taking a closer look at choosing the best pillow depending on your sleeping style.

Why does choosing the right pillow really matter?

The right pillow is an important part of getting a good night of sleep. If you wake up with a stiff or achy neck, your pillow may be part of the problem. While some people focus on mattress quality, the pillow deserves equal attention.

Your neck supports the weight of your head (5.1 and 11.0 lb.). When you lie down, your pillow becomes the primary support for your head and neck. If it doesn’t maintain a neutral alignment of your cervical spine, muscles and ligaments will work harder. Over time, that can lead to morning neck stiffness, headaches or persistent soreness.

Here’s what neutral alignment means in practical terms:

• Your ears are level with your shoulders.

• Your chin sits parallel to the floor, not tilted up or down.

• Your neck follows the gentle curve of your spine, without excessive arching or flattening.

This graphic depicts incorrect and correct pillow height for side and back sleepers in order to achieve neutral alignment.

Let’s consider how different sleep positions interact with pillow support:

• If you sleep on your back: You need a pillow that supports the natural curve of your neck, but doesn’t lift your head too far forward.

• If you sleep on your side: You should use a thick enough pillow to keep your head aligned with your spine’s horizontal line.

• If you sleep on your stomach: This is the most challenging position for the neck. Your head often turns to one side, twisting your spine.

If you tend to change positions while you sleep, then you should test various pillows and determine which one works best for you.

How to Sleep Properly on Your Pillow

Some people have such an easy time falling asleep and staying asleep through the night. But if you're experiencing neck pain, choosing the right pillow and using it correctly is important part of getting a full night of sleep. Here are some practical steps to improve your sleep posture.

Step 1: Determine the Correct Pillow Height

Pillow height is very important. Your head shouldn’t be pushed forward (which strains your neck) or allowed to fall back (which flattens your curve). The goal: ears aligned with shoulders, chin level.

• Side sleepers: aim for about 4–6 inches of thickness.

• Back sleepers: target around 3–5 inches.

• Stomach sleepers: try a very thin option (under 2–3 inches) or no pillow.

Step 2: Choose a Supportive Material

Different pillow fillings behave differently. Here's a quick overview:

• Memory foam: Molds to your head and neck; offers consistent support.

• Latex: Bouncy, resilient and often longer-lasting.

• Feather/down: Soft and luxurious, but it can sag and lose shape.

• Polyfill (synthetic): Budget-friendly but less durable or supportive.

• Contour/cervical pillows: Pre-shaped to cradle the neck and encourage alignment.

Try various pillow materials so you find one that maintains your neck’s natural curve.

Step 3: Adjust Your Sleep Position

If you're a stomach sleeper, consider transitioning to your back or side. Stomach sleeping is often the most difficult for neck alignment. Try using a body pillow or wedge to help you shift positions gradually.

Step 4: Add Support Beyond the Head

A pillow beneath your head isn’t always enough.

• Side sleepers: Place a pillow between your knees to prevent your upper leg from dragging your spine out of alignment.

• Back sleepers: A small pillow under your knees can relieve lumbar pressure and maintain spine curvature.

Step 5: Monitor Pillow Age and Condition

Pillows don’t last forever. Over time they compress, lose shape and become less supportive or accumulate allergens. If a pillow doesn’t spring back when folded in half, it might be time to replace it.

Takeaways: 10-Step Checklist for Choosing The Best Pillow

Here’s a practical checklist you can implement tonight:

1. Identify your go-to sleep position (side, back or stomach).

2. Measure the distance from your shoulder to your ear while lying down.

3. Choose a pillow that fills that distance without forcing your head up.

4. Try different materials (memory foam, latex, etc.) and note what your neck feels like in the morning.

5. If you’re a side sleeper: use a pillow between the knees.

6. If you’re a back sleeper: place a small pillow under the knees.

7. Assess your pillow’s age. If it’s over two years or doesn’t bounce back, replace it.

8. Wash your pillowcase weekly and give your pillow a good shake/air out.

9. Avoid piling pillows on top of each other unless medically indicated.

10. After one week, check how your neck feels. If you’re still waking with an achy neck, consider a cervical pillow or professional evaluation.

Do you still have neck pain after changing your pillow?

If neck pain persists despite changing your pillow, it may be time to consult a spine specialist. The team at The Centers for Advanced Orthopaedics is here to help. Schedule an appointment today.