Customize Your Pillow For Pain Relief

By: Karl Zarse, MD

One of the most frequent questions I get regarding neck and back pain is, what is the best pillow to use? Soft or hard? Foam or Feather? With so many options it is hard to know what is best. 

There are many causes of neck pain. Some people have arthritis of the spine, others have disc issues. Regardless of your underlying neck issue, the same strategy should be utilized by everyone. And that is, the neck likes to be in a neutral position. Any extreme-forward tilt, backward bend, or side tilt can set off underlying issues and cause problems. 

Here is an uncomplicated way to find the best pillow for you. Sit upright in a neutral position with your head looking forward. Make a mental note of where your head is in space. It is not tilting forward or backward, nor is it side to side, and you should feel most comfortable in this position. 

Now assess your pillow lying flat and on your side. With each position, the pillow should cradle your head in that neutral position. If you have wide shoulders, you may need to fold it in half or use the thicker side of the foam pillows. Let your head settle until you are firmly in place and then make your assessment. There should be no steep forward head tilt, extension, or sag to the side. If your head is perfectly neutral in all positions, you have found yourself a winner. 

The structure and size of the pillow do not matter if you have fitted the pillow properly to your body in a way that achieves what I described above. Some foam pillows do last longer than fiber, but if it does not fit your body as I have described, then do not buy them. It is better to use a pillow that wears out in 6 months but fits you perfectly than to have one that lasts a long time but is a bad fit. 

Follow this advice and you will see a dramatic improvement in your sleep as well as your neck and back pain.


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