Choosing a Pillow for Neck Pain

Why does my neck hurt when I wake up?

Most of the time the neck has been held at an angle for hours. If your pillow is too high, too low or too soft, the neck bends sideways or forward, and the muscles stay tight all night.

In the warm, humid nights of Ipoh, you may also toss around more, or sleep with a fan or air-conditioner blowing on your neck. Both can leave you stiff.

What does a good pillow do?

Its job is simple: keep your head level with your spine. When you lie on your side, your nose should point straight ahead, not up or down. When you lie on your back, your chin should not push towards your chest.

A pillow that does this lets the neck muscles rest. A pillow does not need to be costly or have a special name to do it.

How do I test my pillow height with a towel?

You can do this before buying anything.

Lie on your side with your usual pillow and ask someone to look from behind.
Check whether the line from your head down your spine is straight.
If your head tips down, add a folded towel under the pillow.
If your head tips up, remove some filling or use a lower pillow.
Repeat on your back, aiming for a gentle support under the neck.

Keep the height that feels natural for a few nights, then buy a pillow of about that height.

Kapok, latex, foam or fibre: which suits a warm climate?

Each has its own feel, and none is magic.

Kapok: soft, breathable and light, but it can go flat and lumpy over time.
Latex: springy and supportive, but can feel warm in humid heat.
Memory foam: moulds to the head, but holds heat unless it has cooling channels.
Fibre or polyester: cheap and washable, but may flatten quickly.
Shaped neck pillows: help some people, but not all feel comfortable.

Try the pillow in a shop if you can, and ask about the return rules. A pillow that feels odd on the first night may need a week, but one that makes you worse should go back.

When is the pillow not the problem?

If you still wake with pain after a good pillow, look at the rest of your day. Long hours at a desk, a bent-down head over a phone and tension at work can matter more than the pillow.

See a doctor first for neck pain that follows an injury, comes with arm weakness, numbness or severe headache. Read about neck pain, waking with a stiff neck and cervical spondylosis.

How can physiotherapy help?

We look at how your neck moves, which muscles are tight and how you sit and sleep. Then we give exercises and habits that last longer than any pillow.

A home visit lets us see the bed you actually sleep on. See our home physiotherapy page, and read how sleeping positions for back pain can also help your neck.

Questions people ask

Is there a pillow that fixes neck pain?

No pillow cures neck pain. The right one keeps your neck in line with your spine so the muscles can rest. If your neck is sore for other reasons, such as posture or a joint problem, a new pillow will help only a little.

How high should my pillow be?

Side sleepers need a pillow as high as the distance from the ear to the tip of the shoulder. Back sleepers need a lower pillow that supports the curve of the neck. Your head should not tip up or drop down.

Should I use more than one pillow?

Stacking pillows tends to push the neck forward. One firm, well-shaped pillow is better. Some people like a small rolled towel under the neck and a flat pillow under the head when lying on their back.

My pillow is old and flat. When should I replace it?

Replace it when it no longer springs back after you fold it, when it has lumps, or when your neck feels worse on waking than going to bed. There is no fixed number of years; your own neck is the test.