What pillow should I use? This is a common question I hear from my patients with neck pain. They want to know if there is a specific pillow or type of pillow that I recommend, so here is my advice.
The height of your pillow(s) is the most important factor. For back sleepers: if your pillow is too high, your neck will be in a flexed or forward-bent position throughout the night. But if the pillow is too low, your neck will be extended or too far backwards. For right-side sleepers: if your pillow is too high, your neck will be bent toward the left while you are sleeping. So how high should your pillow be? Simply find the pillow that puts your neck in a neutral sleeping position.
The firmness of the pillow you select depends on your own comfort. If you like a firm pillow, you may only need one to attain the proper height for your head. But if you prefer soft, you might need two pillows, as your head will sink down into them.
For specific brands, I do not have a recommendation. There are some very inexpensive pillows that work well, but they obviously need to be replaced more often. The only two specialty pillows I have personally used are memory foam and down-filled. The memory foam pillow is very firm and has two curves, one of which is a little larger. So it can be used two ways, depending on the size of your head/neck. I liked the way it supported my head and neck, but it was too firm for my comfort. It could potentially be comfortable for back or side sleepers. The down-filled pillow was mildy comfortable for me, but there were two reasons I stopped using it. First, the feathers were pointy sometimes, and even extra pillowcases did not smooth out the surface. Second, the pillow sunk down too low for my preferred pillow height.
I have seen TV ads for more expensive pillows, but I have never tried them. If you have exhausted cheaper options, you may want to purchase a higher quality or specially designed pillow. However, be sure to identify if your neck pain is only a result of sleeping or if you have a neck problem that needs medical attention. If your neck pain is present during the day or before going to bed, it may not be a pillow issue. Be sure to consult your physician if you have chronic neck pain, severe neck pain and/or neck pain that shoots down the arm(s).