Ryan Fiorenzi
January 21, 2021
Ryan's sleep issues stem from back pain associated with years of vigorous athletic training. He has owned a gym for several decades, and as you can imagine, he is always researching health-related topics for athletic performance. Ryan quickly realized the importance of sleep and that compelled him to become a Certified Sleep Coach.

Our research is supported by our readers. We may earn a small commission when you make a purchase through links on our site - advertiser disclosure

Your Pillow Matters

If you’re like most people you haven’t given much thought to your pillow but if your sleep isn’t ideal, you should. Sleeping is a critical recovery period for our bodies and mind and if you have trouble sleeping or waking up with pain, especially in your neck, shoulders, or back, it may be related to your pillow. Your pillow alone can often be what is causes your pain and especially neck pain. The neck is one of the most susceptible areas of the body to pain and injury according to the American Chiropractic Association.

Finding the right pillow comes down to a variety of factors like your sleeping position, weight, sleep temperature, and anatomy of your neck and shoulder area. Some of the most common causes of pillow related neck pain are:

  • Your pillow is too thin or too thick
  • Your pillow isn't a good match for your sleeping position
  • Your pillow causes you to sweat or sleep hot
  • Your pillow doesn't support your neck or shoulders well

Ideal Pillow Position for Neck Pain Sufferers

When you sleep you should be trying to find a neutral spinal position where your pillow enables your spine to be straight vs overly supported (causing an upward bend in your spine) or under-supported(causing a downward bend in your spine). Keep in mind depending on your sleep position you may need a thicker or thinner pillow to find this neutral position. Use the following as a rule of thumb. Also, it may help to have a partner take a look at your position because some of these difficult to observe yourself.

For Side Sleepers:

  • Keep your spine as level with the surface of your mattress (side view)
  • Make sure your pillow provides support from the base of your neck to near the top of your head.
  • Position your pillow up against your shoulders

For Back Sleepers:

  • Keep your spine straight (view from above your mattress) with minimal twists of flexion in your neck
  • Make sure your pillow allows your nose and chin to be level with one another - this check can ensure your head isn't too high or too low.
  • Make sure your pillow provides support from the base of your neck to near the top of your head.
  • Position your pillow up against your shoulders
Proper Neck and Spine Position - Best Pillows for Neck Pain

Matching Your Pillow to Your Sleep Position

Choosing a pillow can seem fairly straightforward but if you're suffering from sleeping-related neck pain or sleeplessness it becomes very important to choose not only a high-quality pillow but a pillow design that matches your sleeping position, anatomy, and personal preference.  While there are dozens of unique sleeping positions they are mostly variations of the list below. Here are the common sleeping positions and which pillow pairs the best with them:

  • Side - Side sleeping is the common sleeping position and there are many pillow options for side sleepers. While a traditional pillow design (rectangular, filled with shredded foam, fiber, etc...) can work great, cervical design, or more commonly known as neck pillows are a great match for side sleepers. They are designed to properly support your neck, head, and shoulders while. Proper side sleeping has numerous benefits for joint pain and arthritis sufferers. Side sleeping also reduces the likelihood to snore.
  • Back - Back sleeping is also very common and is considered one of the best sleep positions for getting quality rest. Back sleepers have plenty of options. Like side sleepers, you can use either a traditional pillow or a cervical pillow. Some cervical pillows cater even more to back sleepers like our #4 pick below that includes a contoured cut-out to cradle your neck and head while laying on your back. Back sleepers usually make better use of thinner pillows as the gap between your mattress and head/neck is much less sleeping on your back.
  • Stomach - Sleeping on your stomach can lead to back and neck pain but is reported to be great for your digestive system. Pairing a pillow with stomach sleeping leaves few options beyond a traditional pillow design. Stomach sleepers need to be especially careful about the thickness of their pillow. You may want a pillow on the thinner side or try losing the pillow altogether
  • Combination Sleeping - Combination sleepers tend to sleep in multiple positions through the night, often turning into a new position unconsciously. This is a common source of neck pain for a lot of people because rarely is your pillow suited for two positions (except for flipping from stomach to back sleeping). The main issue is going from side sleeping to stomach or back or vice versa. Side sleeping generally requires a thicker pillow than back or stomach sleeping, so while your pillow may work for one position it is likely, not ideal for the others. Some contoured pillows are designed with separate areas for back and side sleeping but unless you are waking in the night to turn you're not likely able to position yourself properly.

To further illustrate the points above check out this fun video made by the Spine Health Institute below actually provides some great guidance on selecting a pillow and finding a neutral spinal position:

Types of Pillows

Types of Pillows - Best Pillows for Neck Pain

Best Pillow for Neck Pain

Like many of our sleep recommendation guides, we start with in-depth consultations with experts on the topic. In this case, we've sought out experts on sleep, joint and muscle pain as well as spine health to give us the best perspective and guidance on recommending products we think can help you sleep better.

If you’ve researched sleep you’ve probably learned there is no silver bullet for getting quality sleep. What works for you may not work for someone else. Selecting your pillow is no different. Because of this fact, we worked with our experts to define common categories for sleepers and what you may be looking for in your next pillow. Our top picks are tailored to different pillow designs, sleeping positions, materials, and budgets.

We've created the following common categories to help narrow down your search:

  • Value - You're looking for the maximum combination of function and cost
  • Budget - You're on a tight budget but want to compromise as little as possible.
  • Cervical Support - You want a pillow that is contoured to your body for maximum ergonomics.
  • Cooling - Staying cool is your top priority, if you're cool, you're happy with your pillow.

Level Sleep Restore™ Pillow

Level Sleep Restore Pillow - Best Pillows for Neck Pain

Best for Side and Back Sleepers with Neck Pain

  • Three independent inserts for custom pillow height and softness
  • Built-in ear wells reduce pressure on ears when sleeping on the side
  • A proven 78% reduction in the number of snoring events
  • Supported in clinical trials at Stanford University
  • Breathable, durable fabric with a 4-way stretch
  • 365 day trial with a warranty
  • Made in the USA

Verified Review Quote:
"I have had a dramatic improvement in my chronic neck pain... was much pricier than other pillows I researched, but I decided to try it largely because of the excellent reviews and the 365-day return policy."

Purple Pillow

Purple Pillow - Best Pillows for Neck Pain

Best Cooling Pillow for Neck Pain

  • Very innovative Elastic Polymer construction built around the concept of column buckling
  • The unique design has a lot of open-air pockets that keep you cool as opposed to dense memory foam pillows
  • Expensive but purple stands by their products
  • Great support on the edge of the pillow, which is particularly useful for neck pain sufferers

Amazon Review Quote:
"This pillow is a total game changer!"

Coop Home Goods Adjustable Memory Foam Pillow

 Coop Home Goods Adjustable Memory Foam Pillow - Best Pillows for Neck Pain

Best Value Pillow for Neck Pain

  • Adjustable loft enables you to set different pillow thicknesses to cater to your body and desired support
  • Great for all sleeping positions
  • Cover designed to keep you cool and prevent sweating
  • By far one of the most popular pillow options for its ability to adjust to your body and work with all sleeping positions.
  • Great value despite being the most expensive option on our list.
  • 100-day satisfaction guarantee

Amazon Review Quote:
"By far the best pillow I have ever owned in 50+ years"

Simply Sova Shredded Memory Foam Pillow

Simply Sova Shredded Memory Foam Pillow - Best Pillows for Neck Pain

Best Value Runner Up

  • A slightly less expensive alternative to the Coop Home Goods pillow, the Simply Sova Pillow offers an adjustable loft but is limited to two levels of adjustment due to the two removable layers.
  • The plus is no foam mess and consistent firmness across the entire pillow.
  • Great for all sleeping positions
  • Breathable hypoallergenic materials and design
  • Great value and frequently discounted.

Amazon Review Quote:
"This hybrid pillow is everything I was looking for"

Beckman Hotel Collection Gel Pillow

Beckman Hotel Collection Gel Pillow - Best Pillows for Neck Pain

Best Budget Pillow for Neck Pain

  • Gel fiber-filled pillow that resists shifting and loss of firmness and support.
  • The package includes two pillows
  • Great for all sleeping positions
  • High thread count shell
  • The best option for those on a tight budget and or looking to replace both pillows on a full, queen, or king bed.
  • 30-day satisfaction guarantee

Amazon Review Quote:
"I have also noticed I sleep much better throughout the night"

Epabo Contour Memory Foam Pillow

Epabo Contour Memory Foam Pillow - Best Pillows for Neck Pain

Best Cervical Support

  • Innovative and ergonomic cervical design pillow that provides support for shoulders, neck, and head.
  • Ideal for back sleepers but could also be used for side sleeping if you desire a firm pillow and the height is a good match for your body.
  • Breathable cover reduces sweating.
  • Great value when it comes to a highly ergonomic pillow.
  • 30-day satisfaction guarantee

Amazon Review Quote:
"This pillow is the best contour pillow I have tried for my chronic neck pain"

WonderSleep Adjustable Loft Memory Foam Pillow

WonderSleep Adjustable Loft Memory Foam Pillow - Best Pillows for Neck Pain

Best Cooling Pillow Runner Up

  • Two-setting adjustable loft cooling pillow that is highly breathable with a great cooling effect
  • Great for all sleeping positions
  • The package includes two pillows
  • Hypoallergenic materials
  • Great value for the cooling performance and getting two pillows for less than many other single pillow options
  • 1 year limited warranty

Amazon Review Quote:
"I highly recommend these pillows, to anyone who has pain like we do"

Mediflow Water-Based Pillow

Mediflow Water Pillow  - Best Pillows for Neck Pain

Best Water-Based Pillow

  • Innovative water-filled bladder allows you to fine-tune your pillow to your sleeping position.
  • Doesn't lose firmness or loft over time, a common issue with virtually any other pillow
  • Great for multiple sleeping positions as water has unique characteristics to change shape and distribute support.
  • Clinically proven to help people fall asleep faster and wake less frequently than other pillows.

Amazon Review Quote:
"Ordered the Mediflow pillow, and am pain-free after 2 nights of sleep on it"

Compare Table

Pillow Material Positions Adj. Loft? Price
Level Sleep
Back and
Yes $149
Purple Elastic Polymer Back and Stomach No $109
All Yes $59.99
All Yes $48
Gel Fiber Back and
No $32 ($16 ea.)
Epabo Solid
Back and
No $44
All Yes $50 ($25 ea.)
Mediflow Water All Yes $50

Key Features in Quality Pillows

Pillows are getting more innovative by the minute and now you can shop for pillows to suit your every need. Here are some key features you should look out for in buying your next pillow:

  • Adjustable Loft - Adjustable loft pillows are a great choice if you've found yourself sensitive to the height of your pillow in the past. They give you the ability to make adjustments to tailor your pillow's comfort and support. Adjustable loft pillows like our #1 and #2 choice are also great if you can't see the pillow in person or buying online.
  • Cooling - Most of us don't like to sweat while we sleep. Many quality pillows are already designed to reduce or prevent sweating but some pillows are designed exclusively for those of us that are hot sleepers.
  • Washable - While most pillows are washable make sure you confirm. Always follow the washing instructions but washing your pillow can extend its life and help re-fluff the material inside.

Neck Pain and Pillow Frequently Asked Questions

Here are our answers to some of the common pillow questions we get from our readers.

Which pillow is best for neck pain?

The best pillows for neck pain keep your spine straight, whether you sleep on your side or back. Many pillows under or over support the spine, which can aggravate neck pain.

What is the best pillow for side sleepers with neck pain?

Side sleepers with neck pain should pay special attention to the thickness of their pillow, especially those with broad shoulders. Side sleepers should seek a neutral spinal alignment. You can refer to the image at the top of the page. There is no specific pillow that is great for everyone, it simply depends on you. Beyond finding an ideal thickness you should also consider the material you use as a side sleeper. A study done in Australia aimed to learn which type of pillow material performed best for side sleepers in neck stiffness, headache, and arm pain compared to the participant's pillows. It was found that latex pillows were most effective in reducing neck stiffness, headache, and arm pain compared to feather, foam contour, foam regular, and polyester pillows. We thought this was a very interesting study; you can check it out on the US National Library of Medicine. If you're looking to learn more about pillows for side sleeping, check out the guide I wrote.

Can pillows cause neck pain?

Yes, pillows can cause neck pain by taking your spine out of a neutral position, which can put pressure on vertebrae in the neck and increase muscle tension in the muscles of the neck.

Is a firm or soft pillow better for neck pain?

The general rule is that the heavier your head is, the firmer the pillow should be. You may need to experiment with different pillow densities to find what's best for you. The firmness of your pillow is a key part of ideal sleeping positions and getting a neutral spinal alignment. Generally, the heavier your head is the more firm your pillow should be to compensate. Likewise smaller and lighter individuals may benefit more from a softer pillow. The average head weighs around 12 pounds - think about how much your pillow may compress with a 12-pound weight added to the middle.

What is the ideal sleeping position for neck pain?

There's no one sleeping position that's best for neck pain. Although some argue that sleeping on your stomach is bad, most agree that any position that puts your neck in a neutral position is best.

How do you use a pillow for neck pain?

Side sleepers can benefit from a contoured pillow, back sleepers can use a traditional or contoured pillow, and stomach sleepers benefit from a very thin or no pillow.

What pillow should I use for neck pain and neck arthritis?

Neck pain sufferers should make sure their pillow matches their sleeping position and anatomy. Pay attention to your spinal alignment and avoid common mistakes like using a pillow that is too thin or too thick. Regarding arthritis, Marian Minor, PT, Ph.D. says, "Look for a pillow that supports your neck but does not tilt your head forward when you are lying on your back. If you sleep on your side, the pillow you choose should support your head in line with your neck, not tilt your head up or down. The pillow should fill just the space between the mattress and your ear."

What is the best pillow for neck and shoulder pain?

Your sleeping position has the most impact on shoulder pain and while your pillow can make a difference sleeping on your back provides the best relief of shoulder pain. In terms of pillow selection, it is best to make sure your pillow allows your neutral spinal alignment which best relieves the muscles extending from your neck to your shoulders.

Is it better for your neck to sleep without a pillow?

This ultimately comes down to personal preference in our experience. We generally recommend that most people use a pillow when sleeping to avoid neck pain. To maintain proper spine alignment, side sleepers should use a relatively thick pillow. Back sleepers should use a thin pillow and stomach sleepers oftentimes shouldn't use a pillow at all.

Can a water-based pillow help my neck pain?

Water-based pillows like the Mediflow or ChrioFlow pillows offer essentially unlimited loft adjustment which is great for fine-tuning your pillow. Another advantage is the characteristics of water to conform to your body, especially for those of us that sleep in multiple sleeping positions. While your traditional pillow may be great for back sleeping, it can't support you for side sleeping. Water pillows are great for this situation.

When should I replace my pillow?

If you are suffering from back or neck pain or find yourself having trouble falling asleep, staying asleep, or waking up with feeling refreshed your pillow may be among the causes, especially if it is older, flat, and lacks support. While a good pillow can last for years we recommend evaluating your pillow once a year, to confirm it still supporting your body properly and not harming your sleep quality.

Can I wash my pillow?

Most pillows have instructions included on how to wash them and often they are written on a label similar to what you see on items of clothing. We recommend following these instructions but always account for extra drying time. Nearly all pillows are notorious for drying on the outside while still being sopping wet on the inside, especially when dried in a machine dryer. While most down or feather-filled pillows aren't intended to be washed, some methods can increase your success such as drying with tennis balls to prevent the feathers from clumping.

Should your pillow be under your shoulders?

Generally, no your pillow shouldn't be under your shoulders. Ideally, your pillow is there to help align your spine and neck with the rest of your body maintaining a neutral position. The Thoracic Kyphosis region of your spine below your shoulders has a natural outer curve that tends to be a pressure point. Raising this area, especially when sleeping on your back is counterproductive to aligning your spine. Fewer side sleepers have concerns about this but it's also not ideal for them either. If there is a need to have your pillow under your shoulders, you may have an issue with your mattress as it may be too soft.

Can pillows be recycled?

Typically pillows cannot be recycled, unless they are made from recyclable material, appropriately labeled, and your recycling company can process them. If your pillow is like most and can't be recycled, there is a lot you can do before resorting to throwing it away (sending it to a landfill). Read the bottom of our mattress disposal guide for 6 great ideas on how to reuse or donate your pillow.

Nothing is wrong with my sleep position, why am I in pain?

You may be doing everything right when it comes to your sleep position, mattress and pillow but there is a known relation between the actual quality of your sleep, problems falling asleep and pain in your muscles and joints according to a Swedish study done in 2008. Improving your sleep quality(and reducing pain) may require reducing stress, exercising, reducing alcohol intake among other things. Your sleeping position is important but it can be other things in your life that are causing pain.

Can pillows cause headaches?

Headache is a deep topic that has many complexities. While your pillow can be part of the reason you're having headaches it is rarely the single cause. We always recommend talking to your doctor if you have troublesome headaches.

Other Remedies You Can Try

There may be more to your neck pain than your pillow and sleep position. Here are some other things you can do besides finding the perfect pillow to treat your neck pain (and general musculoskeletal pain)

  • Massage - massage, especially in the area of pain can be very effective at providing relief when done by a professional.
  • Go to a Chiropractor - Chiropractors are a great resource for pain sufferers. They can help you identify issues with your sleeping position and perform an in-depth valuation of your pain areas and offer ideas to treat them.
  • Over the counter pain relief  - for times when your pain is the worst over the counter drugs like ibuprofen and acetaminophen can be a great help.
  • Try adding more movement to your day-to-day. Many neck exercises will reduce inflammation in your neck. Working these exercises into your daily routine may reduce neck pain over time.
  • Try Inversion - Inversion tables can offer great relief for your entire spine taking up to 250% of the strain off your vertebrae depending on the angle of inversion. While some dispute it's more abstract claimed benefits most agree it can help with back and neck pain.


Overall, neck pain sufferers should make sure their pillow is a good match for their sleeping position and anatomy. Pillows come in a variety of shapes, sizes, and materials and you may need to experiment with different options through some trial and error. Adjustable loft pillows take some the risk away since you can fine-tune the height of the pillow to your liking - a feature we've come to love at StartSleeping. If you're looking to learn more about sleep and the studies we've referenced in this guide check them out here:

Ryan Fiorenzi
January 21, 2021
Ryan's sleep issues stem from back pain associated with years of vigorous athletic training. He has owned a gym for several decades, and as you can imagine, he is always researching health-related topics for athletic performance. Ryan quickly realized the importance of sleep and that compelled him to become a Certified Sleep Coach.