Can Pillows Cause Neck Pain?

What a pillow actually influences

A pillow determines the angle at which your head and neck are held for six to nine hours. That is a long time in one position. If the angle is significantly off — head dropping toward the mattress or pushed up away from it — many people notice it in the morning.

Patterns that point toward the pillow

• Discomfort is worst on waking and eases within an hour or two of getting up.
• It started around the time you changed pillow, mattress, or where you sleep.
• It disappears when you sleep elsewhere — a hotel, a relative's house — on a different pillow.
• Your pillow is visibly collapsed, lumpy or folded under your head each morning.

Patterns that point away from the pillow

• Pain that is constant through the day, or worsening over weeks.
• Numbness, tingling, pins and needles, or weakness in an arm or hand.
• Pain following an injury, fall or collision.
• Headaches, dizziness, or symptoms beyond local neck discomfort.
• Pain that wakes you from sleep rather than being present on waking.

A checklist before you buy anything

1. Check the loft. Lie in your usual position and look at whether your head is level. See the pillow height guide.
2. Check whether it holds up. Press down: if the pillow bottoms out easily it will not survive the night. See pillow firmness.
3. Check the mattress. A sagging mattress changes alignment more than any pillow can correct.
4. Check your daytime setup. Desk height, screen position and phone use all affect how the neck feels; a pillow cannot offset a full working day.
5. Change one thing at a time, and give each change at least a week.

If you do decide to change pillow

Match the loft to your position first, then choose enough firmness to hold it. Contoured cervical pillows and neck support designs are popular for this, but a plain pillow at the correct height can work equally well. Buy where the return policy is clear.