Alex Simotas, MD

Hospital for Special Surgery
Board Certified Physiatrist
Specializing In Spine & Sports Medicine

Home > Wellness & Exercise > Behavioral Strategies > Pillows & Your Neck

Pillows & Your Neck

Trying to sleep with neck pain is difficult. Usually keeping your head and neck, and shoulders in a “neutral” position is best and most comfortable. Generally this maintains the best and most relaxed alignment of your neck.

Most of the customized pillows and cushions are designed for back sleepers. If you sleep on your side, pick a pillow that just fills the space between your ear and your mattress without tilting your head, or consider using a cervical collar during periods of more acute pain. Here are a few other comments about these pillows and sleep.

  • A rolled up towel: This is the simplest solution. Take a towel and roll it up. Place it under the nap of your neck with or without a pillow. Make the roll of sufficient size to make it comfortable but not excessive.
  • Cervical (or “orthopedic”) pillows: These are contoured pillows designed to fit into the contour of your neck and thereby by maintaining the natural shape of your head and neck while you sleep. The problem is that everyone’s body shape—including their muscle bulk, fat, shoulder size, and natural cervical alignment—is quite different. So no one pillow will be good for everyone.
  • Feather or other basic pillows: A feather pillow may be adequate. Also feather pillows can be molded to fit the shape of your head and offer less resistance than foam.
  • Memory foam pillows: This type of pillow conforms to the contour of your head and neck. Some cervical pillows are also made with memory foam. Although manufacturers of memory-foam pillows claim they improve proper spinal alignment, there is no real evidence that this is the case.
  • Water-filled pillows: Water pillows supports your neck by absorbing and redistributing weight. One advantage of the water pillow is that you can customize the amount of support it provides: the more water you add, the firmer the support, and vice versa.


  • Avoid sleeping in a position keeps the neck flexed overnight. This can result in morning pain and stiffness.
  • When you are riding a plane, train or car for a long trip consider a horseshoe-shaped pillow or a cervical soft collar.