The best pillow for neck and back pain depends on your body and how you sleep.

Different people require different things. To find the right pillow or bed you must consider past injuries, current medical conditions, your fitness level, your health habits, and medical conditions, like arthritis. All of these affect the spine. Therefore, they affect how your body adapts to structural changes because bodies are unique.

X-rays offer insight into what kind of pillow someone is sleeping on. Knowing a person’s bone structure helps me recommend a better choice. It is possible to forecast someone’s response to a corrective orthopedic pillow. However, adapting to a better pillow can take time. Discomfort with a pillow or change is often an indicator of poor spinal mobility, not a sign of a bad pillow design. A supportive pillow is worth the money. It will support aging discs and maintain and correct spinal curvatures.

Cell phones and computer usage cause a position of neck strain. The world has created “tech neck.” A slang term for repetitive overuse of the neck in prolonged flexion. Flexion causes the shoulders to slump and the lower back to round. This tightens and shortens the muscles in the front of the neck, shoulders, and hips. Poor posture causes strain of the muscles, ligaments, and spinal discs. This leads to pain, early degeneration, and spinal curves that are unnatural.


When a flexed neck position becomes “familiar” to the body and the tissues adapt, the body will want to sleep that way too. It may allow comfort, but comfort and support are two different things. If your goal is comfort, that’s one kind of pillow and bed. If your goal is correction, then you want to sleep in a position that supports the bodies natural curves. Your natural curves are natural when you get the right kind of exercise or movement in the muscles of the neck and spine. A good pillow can help correct and support a natural curve. Which will help reduce neck strain, pain and premature aging.

Therefore, the search for the best pillow and sleeping positions really comes down to doing what’s best for the body. What’s best for the body might not be as easy as buying a new pillow or bed. What’s best for the body is good support, spinal mobility, exercises and stretches.


If the goal of sleeping is to support the natural curves, then sleeping on your back with a pillow that encourages the natural curves would be best. However, the spine is not always mobile enough to move in a natural way. Some people with a history of whiplash, chronic neck pain, back pain or arthritis can not physically achieve this position. These people do well with help from a professional.

Back sleeping can have its own set of problems for certain people. If someone has chronic back pain and tight hip flexors when they lie on their back they may arch too much and jam the lower back joints. Sometimes relief is provided with an additional pillow behind the knees.


Sleeping on your stomach tends to cause compression on one side of your neck, and over-stretching on the other side of the neck. Once a person is relaxed, the twisted neck gets even more exaggerated. It is not uncommon for these people to wake up with a “crook” in their neck several times in a lifetime. Furthermore, sleeping on the stomach tends to cause the lower back to bow or sag which compresses the lower back joints. Stomach sleeping may provide people with a sense of security as they protect their vital organs and emotional centers but the risks outweigh the benefits. Better to break this habit than break down the body.


Side sleeping is a good option. The spine can stay in neutral alignment with the head well supported and a pillow potentially between the knees. A sagging mattress will exaggerate the curves not support them.


Everyone wants a good night’s sleep. But sleep, like any other prolonged posture, can be even more challenging if you have other issues like shoulder pain, knee pain or even sleep apnea. There are many things to consider when making pillow, bed, and sleep recommendations. Resolution may demand a creative sleeping evaluation and plan. Pillows and beds don’t come cheap so knowing the particular issues of your body may help you make a better investment. Consider some of these ideas as you consider what might be right for you.


If you have questions about sleeping postures, pillows or beds reach out to me at 406.888.6044 for a 15-minute consultation. I have two favorite pillows for sale at The Bend.

Dr. Erika Putnam, chiropractic physician, is the owner of The Bend in Whitefish, Montana. She uses a broad and holistic approach to treat spinal and extremity conditions and other health problems with a variety of chiropractic techniques, rehabilitation, nutrition, lifestyle, and functional medicine. She has over 20 years of experience in the chiropractic field and holds a 500-hour yoga instructor certification. The Bend has a private yoga studio where Dr. Putnam helps chiropractic patients recover by engaging them in yoga or exercise instruction to prevent injuries from reoccurring and to improve overall strength and flexibility. She is a co-author in the book The Ultimate Guide for Self-Healing Techniques. She advocates for healing in a pro-active environment that includes physical, emotional, and energetic wellbeing. For more information visit