Do you often wake up with neck pain or feel stiff throughout the day? You’re not alone. In fact, most of us have experienced it. Up to 70% of adults report that neck pain negatively impacts their lifestyle and daily activities —that’s a staggering number considering how easy it may be to reverse it.

You might not know that relief may be as simple as changing your bed pillow. The pillow you sleep on plays a surprisingly big role in how well you rest and how much neck pain you experience.

The Secret Connection Between Sleep and Your Spine

Did you know that the position you sleep in is a type of posture? When you think about poor posture and how it can cause neck pain and lower back problems, sitting and standing may come to mind. But your sleeping position has just as big of an impact on your spinal alignment, especially considering the average person spends one-third of their life asleep!

So before determining which pillow works best for you, think about how you sleep. What is your normal sleeping position? There are three:

Sleeping on your back is one of the best positions for maintaining a neutral spine alignment. In this posture, your head, neck, and spine form a straight line, distributing your body weight evenly and reducing pressure on your joints.

This is a good alternative to back sleeping, as it helps maintain a straight line from head to toe, making you less likely to wake up with a sore neck. This can be an ideal position to ease pressure in the hips and the lumbar spine, but if your pillow isn’t the right height or firmness, it can create more problems than it solves.

Because your entire body lies flat in this position, the natural curvature of the spine—particularly the lumbar curve—gets compressed or flattened. This is less than ideal, causing tension that leads to muscle strain, joint stiffness, and even long-term damage to the cervical spine if it becomes a habit.

Any aches or neck pain from sleeping is often the result of your sleeping position and a poor pillow. Each position requires a different kind of pillow to better align your cervical spine and soothe your aching neck.

Why the Right Pillow is Key to Preventing Chronic Neck Pain

He then continues to explain, “Selecting the proper pillow based on your primary sleeping position is crucial. For example, if you are a side sleeper with a pillow that is too flat, your head will be tilted towards the bed. This will increase muscle activation throughout the night and pressure on the intervertebral discs.”

Without the right support, the imbalance of your spine may lead to chronic pain in your neck and even affect your shoulders and back.

Which is Better: A Hard or Soft Pillow?

While many debate the merits of a hard versus soft pillow — which varies subjectively with personal preference — the truth is that a medium-firm pillow is generally the best option. A pillow that's too hard can put undue pressure on your neck, while a pillow that's too soft might not provide enough support. You should aim for that in-between, just-right firmness, not too hard or too soft.

Your sleeping position, however, may affect the exact type of pillow that’s best for you. Remember that what feels perfect for one person might not be ideal for another. So, don't be afraid to experiment with different pillow options until you find the one that helps you sleep soundly and wake up refreshed.

The Best Pillow for Back Sleepers

Sleeping on your back is one of the best positions for relieving neck pain, though it’s the second most common. For those that sleep best in this position, a thin or a cervical pillow are excellent options. A cervical pillow is specially designed to support the neck and head. It provides the correct spinal alignment and relieves pressure better than a thin pillow.

Alternatively, you can slide a small neck roll pillow (or a rolled-up towel) into the pillowcase of your thin pillow, as it aids in proper neck positioning. Also, try placing a pillow under their knees to help cut the strain on the lower back.

Here are some tips when searching for a pillow for back sleepers:

• Choose a pillow with medium height to prevent neck strain
• Look for (and prioritize) cervical support to relieve pressure on the neck and shoulders
• Opt for medium firmness to keep your spine in a neutral alignment
• Consider memory foam or latex as they contour to the shape of your head and neck
• Add extra support with a neck roll if you prefer a flatter pillow

The Best Pillow for Side Sleepers

Sleeping on your side is considered the second-best position for relieving neck pain. Side sleepers benefit most from a thicker, firmer pillow — one that supports the space between the shoulder and head. Side sleepers find that a taller pillow better aligns their neck and back in a straight line.

Here are a few things to consider when looking for a pillow for side sleepers:

• Choose a pillow with a higher loft to fill the gap between the mattress and your head
• Opt for firmer support to keep the head elevated
• Use a pillow with memory foam or latex materials to offer consistent support
• Consider placing a pillow between your knees to help keep your spine straight

Adding support to other areas of the body in this position can further improve comfort and reduce strain on the neck and chronic pain. A body pillow is a good one to try for this particular body and leg positioning.

The Best Pillow for Stomach Sleepers

Stomach sleepers are at a huge disadvantage since this sleep position causes the most neck pain. Sleeping this way makes the head turn and the back arch in awkward positions, putting unnecessary stress on the neck. Try to train yourself to sleep on your side or back. But if you must sleep in this position, use a skinny pillow, or even better, no pillow at all.

Here are things to keep in mind when selecting a pillow for stomach sleeping:

• Look for soft or plush materials that compress more easily
• Consider going pillow-free! Or find a thin one with a low height
• Use a breathable pillow to reduce discomfort and improve sleep quality
• Try placing a thin pillow under your pelvis for improved lower spine support

Common Causes of Neck Pain

Many factors can contribute to neck pain, including poor posture, stress, and injuries. However, one of the most overlooked contributors to chronic neck pain is poor sleeping habits and the use of unsupportive pillows.

Here are some common causes of neck and back pain that stem from poor sleep:

• Incorrect pillow height or firmness causing a misaligned spine. When a pillow is too high, too low, or lacks the right firmness, it can throw your spine out of alignment, leading to discomfort and neck strain.
• Neck strain from poor sleeping positions, especially stomach sleeping. Certain sleep positions, as we mentioned above, put excessive stress on your neck, forcing it into unnatural angles that can cause pain and stiffness over time.
• Lack of support for the lower back or neck during sleep. This forces your muscles to overcompensate, increasing tension and discomfort by morning.
• Overly soft mattresses or pillows that don’t provide the support you need. While soft bedding may feel comfortable initially, overly soft pillows and mattresses fail to provide the necessary structure to keep your spine properly aligned, leading to pain.
• Sleeping in a recliner instead of a bed. Although a recliner can relieve existing back pain in some cases, it can cause more strain on your neck due to poor posture and misalignment for longer periods of time.

Why Does Spinal Alignment Matter?

When your neck and spine are aligned, the pressure is evenly distributed across the vertebrae and discs, reducing the risk of strain or injury. Poor alignment, on the other hand, can cause the muscles to work harder to support the spine, leading to tension and pain.

In addition to using the right pillow, physical therapy can play a significant role in addressing chronic neck pain. A personalized treatment plan can help improve mobility, strengthen supporting muscles, and provide long-term relief, promoting better posture habits and spinal alignment during sleep and throughout the day.

Additional Advice on Correcting Chronic Neck Pain

For those suffering from chronic neck pain, simply changing your pillow or sleeping position might not be enough. According to Wolosiansky, increasing mobility in the thoracic spine (upper back) is essential. This compensation can put additional stress on the neck, leading to chronic pain.

To alleviate this, consider the following strategies:

• Improve thoracic spine mobility. Incorporate exercises and stretches that target the upper back. Physical therapy is a great way to guide you through these movements safely and effectively.
• Work on posture training. Learn techniques to improve your posture during everyday activities and focus on habits that encourage proper long-term alignment.
• Avoid repetitive stress on your neck. Do your best to keep your neck in a neutral position during daily activities, especially throughout your workday.

In addition to finding the right pillow, you should also optimize your workstation ergonomics. Many work environments are prone to neck strain, and spending long hours at a desk or in front of a screen can lead to chronic pain. 

Tips to reduce chronic pain and improve your workspace:

• Position your monitor so the top of the screen is at eye level.
• Use a well-designed ergonomic chair with proper lumbar and neck support.
• Make sure your desk is at a comfortable height.
• Use anti-fatigue mats for standing work to reduce strain on your spine.
• Take breaks to stretch regardless of your work environment.

Healing Neck Pain with a Personalized Physical Therapy Plan

When pain persists, you may need more than a new pillow. While adjusting your sleep environment can contribute to better posture and spine alignment, chronic neck pain often requires a more comprehensive approach. That’s where a personalized physical therapy plan can make all the difference.

If you change out your pillow yet still experience neck pain, consult with your doctor to rule out other conditions or possible neck injuries. Your doctor may prescribe physical therapy to relieve your neck aches. If so, consider on-demand physical therapy. With Luna, a board-certified physical therapist will come to your home at a time that fits your schedule and when it's convenient for you.

Also, a physical therapist can provide fast neck pain relief with simple lifestyle and postural changes. Don't wait — begin healing and take the necessary steps for effective neck pain relief. Contact us today to find a Luna Therapist near you and experience the benefits of expert care delivered directly to you.