Many individuals do not realize the importance of the type of pillow they use for sleep. Sleeping on the wrong pillow is the perfect set-up for neck, shoulder, and back pain. Here are a few chiropractic tips on what to know about picking the best pillow. Knowing which is the right pillow for you can be the key to proper sleep and waking up pain-free.

The Importance Of Sleeping On The Right Pillow

Importance of Pillows

Neck and shoulder pain can be a nightmare, especially when the body cannot get decent rest. The right pillow/s can help with neck and back pain symptoms and recover from injuries quicker. When the head is in an awkward position for sleep duration, this causes neck, shoulder, and headache problems. The importance of finding the right pillow follows a set of guidelines.


The shape of the pillow has a definitive role in the cervical/neck’s curvature.


Sleep posture is important in preventing neck, shoulder, and back musculoskeletal pain.

Sleep quality

Craniocervical pressures and cervical spine alignment are height-specific. Any changes can affect an individual’s sleep quality.


Cervical alignment can become significantly impacted by the shape and height of the pillow.

Pillow Comfort Importance

Trying to find the right pillow will require trial and error. The basics to consider include:

  • One sign that it’s time for a new pillow is waking up with pain.
  • Age of current pillows. The recommendation is they should be replaced every year or two. This depends on the stuffing/material used as different types wear down quicker.
  • If problems are getting comfortable and being able to fall asleep.
  • Constantly readjusting or fluffing the pillow/s.
  • The pillow has become lumpy or lost its shape.
  • It is flat with no cervical support or, too high placing the head in a forward tilt.
  • A new pillow to consider are those that control temperature.
  • Cooling pillows are made to prevent heat retention. If a warm/hot pillow is keeping you up at night.

Temperature affects sleep quality.

  • Tossing and turning all night means loss of sleep.
  • The frustrating, angry, shifting movements can aggravate back and neck pain/issues.
  • Consider bed linens and pillowcases that cool the body.

Pillow Types

Today’s pillows are made from a variety of materials. Learning about the different kinds of materials can help make an educated choice.

  • Choose a retailer or brand that offers a guarantee or fair return/exchange program.
  • If the pillow isn’t right, you can return it and try another type.

Memory Foam

  • This material is polyurethane that has been combined with certain chemicals to make it viscoelastic.
  • These pillows return to their shape, can stretch and conform to the curves of the body.
  • Different kinds of memory foam include Open cell, Egg crate, and Gel.
  • They will mold to the contour of the spine, helping with misalignments.

Down Pillows and Down Alternative/polyfill

  • These pillows are generally softer.
  • They are made from actual down feathers or a non-allergic synthetic alternative that feels like real down.
  • There is not a great deal of firmness, but they are a good option because they are soft and workable.


  • These can be natural or synthetic latex, also known as rubber pillows.
  • They offer soft cushioning and proper support.
  • The latex is generally shredded, meaning it can be customized with more or less filling depending on the individual’s needs.

Combo style

  • There are combination pillows that could have a foam core with down around it for comfort and support.
  • Gel cores are common, specifically in cooling pillows.

How to Choose

Tips and things to keep in mind include:

  • Does it conform to the shape of your neck and spine?
  • How soft is it?
  • Is the pillow stiff?
  • Is it too high?

Remember the importance of sleeping positions. Back, side, or stomach. Pillows that match an individual’s sleeping position criteria:

  • Back sleepers are recommended to use a medium-thick pillow. This keeps the head, neck, and spine properly aligned.
  • Side sleepers are recommended to use a slightly thicker, firmer pillow for proper alignment.
  • Stomach sleepers are a challenge because of the strain placed on the pelvis and lower back. An almost flat pillow is recommended.


  • If possible, try out the pillow before buying it.
  • Most stores will allow this, and some companies take it further.
  • For example, The Sleep Number company offers a service called PillowFit.
  • This is an online quiz along with a personalized process in their stores.
  • The process helps choose a pillow based on individual support preferences and sleep position for the best spinal alignment.
  • Customizable or adjustable pillows are another option. These pillows allow the individual to change the amount of filling to fit their needs.
  • Research, personal preference, and advice from a doctor and or chiropractor will help find the pillow that is right for you.
  • A third of an individual’s life is spent in bed, make it as comfortable as possible.

Body Health

Sleep Body Composition Importance

Not getting enough sleep makes it difficult to gain muscle.

  • Not getting enough sleep means that the body experiences less short wave sleep, affecting the body’s ability to secrete Growth Hormone and develop muscle.
  • Testosterone is negatively affected by lack of sleep.
  • Not enough sleep increases cortisol levels, impairing muscle development.

Not getting enough sleep makes it difficult to lose fat.

  • Irregular sleep throws off the body’s ghrelin/leptin cycles, causing hunger.
  • Not getting enough sleep has been linked to eating more.
  • Not getting enough sleep can cause reductions in the body’s Basal Metabolic Rate, reducing total energy output.
  • Tiredness reduces spontaneous movements.

“Effect of sleep posture on neck muscle activity.” Journal of Physical Therapy. June 2017.

“Effect of pillow height on the biomechanics of the head-neck complex: investigation of the craniocervical pressure and cervical spine alignment.” PeerJ. August 2016.

“How Often Should You Replace Your Pillows?” Sleep Foundation, Seattle, WA.

“Improving the quality of sleep with an optimal pillow: a randomized, comparative study.” Tohoku Journal of Experimental Medicine. July 2014.

“The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis.” Clinical Biomechanics. May 2021.

Okamoto-Mizuno, Kazue, and Koh Mizuno. “Effects of thermal environment on sleep and circadian rhythm.” Journal of physiological anthropology vol. 31,1 14. 31 May. 2012, doi:10.1186/1880-6805-31-14


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The information herein on "The Importance Of Sleeping On The Right Pillow" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*


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