What is the Best Pillow for Neck Pain?

What is the best pillow for neck pain?

Being a chiropractic, massage and physiotherapy clinic, this question gets asked a lot.  The standard answer that I have always given my patients is that it is “trial and error”.  You must try one out and make note of what you are trying (whether it be feather, soft, medium, etc.) and see how you feel after a reasonable period.  Sometimes it is difficult to remember how things were feeling a few months ago so keeping a written journal can be helpful during this process.  At Burlington Sports Therapy we have always practised in an evidence-based manner, meaning our treatment and diagnostic recommendations should be grounded in some level of good scientific evidence.  This would also pertain to recommending pillows, which is why we don’t have any specific pillow recommendations, perhaps until now!

Pillow Use Study

A 2009 study published in the journal Manual Therapy endeavoured to answer this question.  They began their study through a telephone survey looking to see what most people used as a pillow and how they used it.  By far, most people were side-sleepers, and the most common types of pillows were polyester, rubber, foam contour, feather and foam regular shaped.  Following the preliminary telephone survey, the authors used 106 subjects to test out the various types of pillows over a 10-week timeframe.  Each participant tested each different pillow type as well as using their own pillow for comparison.  To be included in the study the subjects did not have any neck pain at the time of the study.  During the trial, the participants used their own pillow for one week followed by a trial pillow for a week.  Then they used their own pillow again before moving on to the next trial pillow.  This continued for the entire 10 weeks of the study and patients reported what they felt.

The results of this study were very interesting.  The shape of the pillow really didn’t affect pain levels although the contoured pillows were reported to be less comfortable.  Foam and polyester pillows seemed to sit in the middle in terms of comfort and sleep quality. Feather pillows performed poorly in all outcome measures.  In fact, the authors suggested that feather pillows should not be recommended to patients!  Perhaps the most interesting result of the study was that rubber pillows were the best.  I have never even heard of a rubber pillow!  In fact, the authors concluded that rubber pillows should be recommended to patients as their results were statistically significant in terms of the beneficial effect.

So, what does this mean?

I still believe that if you have found a pillow that works for you it is the right pillow to use.  The outcome measures used in the study were pain and sleep quality; I don’t think we need to use anything different in real life.  I think that a reasonable timeframe to test a pillow is a week although if your neck pain gets obviously worse during a “trial”, I would discontinue its use immediately (as they also did in this study).  I don’t think that feather pillows are anything to panic over.  This is one study.  If more and more studies can replicate the results then I would perhaps agree, but my recommendation will stay the same; pillows are trial and error for every patient.  The goal of the pillow when side sleeping is to achieve a spine neutral and be comfortable.  Perhaps all that will change is that I might advise patients to go through the trial and error process with rubber pillows near the top of the order.  Feather pillows will be at the bottom along with contoured pillows.  Interestingly enough, this is probably the exact opposite of the order I would have predicted before I read this paper!

Have neck pain?  Looking for advice or treatment?  Give our clinic a call, we can help!

Written by: Dr. Kevin McIntyre – Chiropractor at Burlington Sports Therapy.



Gordon SJ, Grimmer-Somers K, Trott P. Pillow use: the behaviour of cervical pain, sleep quality and pillow comfort in side sleepers. Manual Therapy 2009; 14: 671-678.