It is important to remember when choosing a pillow for your neck pain that there is a lot of variability in neck thickness, shoulder width and neck length. This means that there is no one pillow that will suit everyone. The type of pillow that may be beneficial for you is partly determined by the current density and thickness of pillow that you are used to. A large change may not be tolerated and can affect your ability to sleep. Too soft a pillow will not support your neck, neither will a very hard pillow.  It also depends on if you sleep on your side, back or front. A thicker pillow is required if you sleep on your side compared to your back or front.

 

Research about Effective Pillows for Neck Pain

There is conflicting evidence in research regarding what type of pillows are helpful for neck pain. This is not surprising as pillow designs vary widely, not only between fibre types but also within types. Visco-elastic (memory foam) pillows can have a flat design or quite large curves to support your neck. Those curves can have a basic curve or quite intricate designs with cut-outs for your shoulder and ear. Visco-elastic pillows also have different densities, which will suit different people. Some designs are simply better at supporting your neck and others might suit a particular group of neck pain patients. For instance, if you have degenerative changes in your cervical spine (neck), too hard and large a support curve will push your neck into extension. This narrows the spaces where nerves come out between the vertebrae and can lead to more pain. A softer visco-elastic, water or feather  pillow is usually better. If using a water or visco-elastic pillow, a lower curve profile is usually more helpful in this group of patients.

A change in pillow on its own may not be enough to improve your neck pain. Some studies have shown that a new visco-elastic pillow in conjunction with manual therapy seems to be more helpful that a change in pillow or manual therapy on its own. The use of the visco-elastic pillow appears to amplify the effect of manual therapy improvements.

 

Good Visco-Elastic and Water Pillow Providers in the UK

A good producer of visco-elastic pillows in the UK is Putnams. Their range of pillows have varying thicknesses:

Royal – 13cm thick and King-  15cm thick ( https://putnams.co.uk/products/putnam-pillow ) or adjustable thickness ( https://putnams.co.uk/products/putnam-self-adjusting-pillow?variant=42349827143 ) so you can choose one that suits your head neck and shoulder size, or whether you sleep on your side or back. Their pillows are foam, visco-elastic or wool based. https://putnams.co.uk/collections/pillows

Water based pillows have been shown to help neck pain in some studies. Water pillows use a core of water, which helps it to conform to your individial neck size and shape, and a casing of synthetic fibres including standard, soft or memory foam. The brand with evidence of its effectiveness in neck pain is Mediflow. You can read more about or purchase these pillows here: https://uk.mediflow.com/

If you don’t have an allergy to feathers, some people prefer a feather pillow as it can be moulded to your neck. They have varying densities and thicknesses, allowing you to choose one that suits your head, neck and shoulder size and your preference for supportiveness.

Unfortunately, you are likely to end up purchasing a number of different types of pillows to find the one that suits your neck. This isn’t necessarily a waste of money. A bit of variey in the pillows that you use can be helpful if you are prone to a painful neck. You may find that on different nights, a different pillow is more comfortable, allowing your neck muscles to relax. Having mulpitle pillows allows you to experiment with this and find the best one for that night. To decidee which one is best for you, focus on which pillow makes your neck feel the most relaxed. Much like sitting in the same, static posture during the day can give you neck pain, having your neck in the same position, held by a supportive pillow, can aggravate neck pain at night.

 

Research Evidence 

Chun-Yiu JP, Man-Ha ST, Chak-Lun AF. 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. Clin Biomech (Bristol). 2021 May;85:105353. doi: 10.1016/j.clinbiomech.2021.105353. Epub 2021 Apr 19. PMID: 33895703.

Fazli F, Farahmand B, Azadinia F, Amiri A. Ergonomic Latex Pillows as a Part of a Multimodal Intervention or as an Adjunct to Rehabilitation Programs in Cervical Spondylosis: Are They Useful?: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2019 Jul;98(7):600-607. doi: 10.1097/PHM.0000000000001157. PMID: 30741761.

Gordon SJ, Grimmer KA, Buttner P. Pillow preferences of people with neck pain and known spinal degeneration: a pilot randomized controlled trial. Eur J Phys Rehabil Med. 2019 Dec;55(6):783-791. doi: 10.23736/S1973-9087.19.05263-8. Epub 2019 Sep 4. PMID: 31489809.

Helewa A, Goldsmith CH, Smythe HA, Lee P, Obright K, Stitt L. Effect of therapeutic exercise and sleeping neck support on patients with chronic neck pain: a randomized clinical trial. J Rheumatol. 2007 Jan;34(1):151-8. PMID: 17216683.

Lavin RA, Pappagallo M, Kuhlemeier KV. Cervical pain: a comparison of three pillows. Arch Phys Med Rehabil. 1997 Feb;78(2):193-8. doi: 10.1016/s0003-9993(97)90263-x. PMID: 9041902.

Shields N, Capper J, Polak T, et al. Are cervical pillows effective in reducing neck pain? 2006. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK73379/
Soal LJ, Bester CM, Shaw BS, Yelverton C. Changes in chronic neck pain following the introduction of a visco-elastic polyurethane foam pillow and/or chiropractic treatment. Health SA. 2019 Oct 9;24:1099. doi: 10.4102/hsag.v24i0.1099. PMID: 31934412; PMCID: PMC6917418.