Choosing The Best Pillow For You
- Dr Mark Uren
- 3 days ago
- 4 min read
Julie and I get asked this a lot. There is no single pillow that suits everyone. Studies comparing different pillow types do not show one clear winner for neck pain or sleep quality. Your fit matters more than the label on the box.
Think of a pillow as a tool that supports your neck so your spine stays neutral while you sleep. If the tool does not match your body or sleep style, you wake sore or stiff.
What matters most?
Focus on three things:
1. Shape and material that feel supportive for you
Research and clinical surveys show many chiropractors lean toward contoured cervical pillows, then memory foam, adjustable fill, and water based designs. The trend is toward pillows that support the neck curve and adapt to the sleeper. Pick a pillow that feels stable under your neck, not one that collapses or forces your head forward.
2. Height affects neck muscle load
In lab studies, a mid range height around 10 cm produced lower neck muscle activity and higher comfort than low or high pillows. Too low or too high raised muscle activity. Aim for a height that fills the gap between your head and mattress, so your neck does not side bend or extend.
3. Your sleep position and body build
Your best height depends on how you sleep and your shoulder and neck size. Biomechanics research suggests pillow height should match body dimensions for neutral alignment, so side sleepers need more height than back sleepers. Stomach sleepers need less height.
How to choose based on position
Side sleeping
Goal: Keep your nose lined up with the centre of your chest.
A pillow with enough height to fill the shoulder gap.
Firmer support so the pillow holds shape through the night.
A small pillow between knees if your low back feels twisted.
If your head drops toward the mattress, your pillow is too low. If your head tilts up, it is too high.
Back sleeping
Goal: Support the neck curve without pushing the head forward.
What helps:
Medium height.
A shape that cradles the neck.
A small rolled towel under the neck if you need extra curve support.
If you wake with a chin forward posture or upper neck tightness, your pillow is too high.
Stomach sleeping
This position loads the neck due to long rotation. Many neck flare ups start here. If you sleep this way now, shift over time.
Try a half prone position:
Start on your side. Place a firm pillow or body pillow in front of your chest. Lean into it so you feel the comfort of prone sleeping without the full neck twist.
How to test pillow fit at home
Use this 60 second check.
Step 1. Lie in your usual sleep position.
Step 2. Relax your shoulders.
Step 3. Ask someone to look from behind, or take a photo.
What you want:
Side sleeping. Ear, shoulder, and hip form one line.
Back sleeping. Your chin sits level, not tipped toward chest or ceiling.
If you do not get that line, adjust height or try a different shape.
Signs your pillow is not right
Watch for these morning clues:
Neck stiffness that fades after one to two hours.
Headaches on waking.
Tingling in arms that settles once you move.
You fold, bunch, or punch the pillow to get comfortable.
You wake often to change position.
When those show up, the pillow is part of the problem more often than people think.
How long pillows last
Pillows wear out. They lose shape and support. Most clinicians advise replacement when the pillow no longer holds loft or you start waking sore again. Lifespan depends on material. Softer fills compress sooner, structured or adjustable pillows last longer. Do not follow the calendar alone.
Follow your symptoms.
Simple care tips
Fluff and rotate weekly
Keep it dry.
Replace once it stays flat or lumpy.
What we look for in clinic
When you ask about pillows, we check:
Your main sleep position.
Shoulder width and neck curve.
Where you feel pain on waking.
Mattress firmness.
Any arm numbness or headaches.
Then we match you to a shape and height, and we ask you to trial it for two to three weeks. Pillow selection works like shoe selection. Comfort plus support wins.
Bottom line
No universal pillow exists. Your best pillow:
Supports your neck curve.
Fills the gap created by your sleep position.
Holds shape through the night.
Leaves you waking looser, not tighter.
For more detail on how to find your best pillow fit follow the link below:
Dr Mark has a special interest in helping recreational athletes of all ages perform better and prevent injury. Correct breathing and postural alignment are critical for top performance and injury prevention and is an integral part of “The Over 40 Athlete System” that Mark has developed.
Dr Julie has a special interest in helping mothers and “mothers to be”. Her Post Graduate qualifications in Paediatric Chiropractic and as an ex-midwife give her a unique ability to help pregnant women, new mums and their young children.
Yours in Health,
Dr's Mark & Julie
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