I’m often asked by my patients, “which is the best pillow to use?” The truth is there is no one answer that works for everybody because there’s no one best pillow that works for everybody. I’ll talk about some of the different pillows and the advantages and disadvantages of those pillows in this blog post, then after talking about it with your healthcare provider, come up with a pillow or series of pillows that works best for you.

The Challenge of the Best Pillow

The main benefit of a pillow really is comfort and support.  You want to support your neck, but you also feel well rested when you wake up so it has to be comfortable. For optimum support, it is best to select a pillow that is designed to keep your spine in neutral alignment – that is in a neutral position, a straight line basically. Any cervical pillow that’s too high will cause a mal-alignment of your neck and can cause pain upon waking or even throughout the night.

The same thing applies to any pillow that is too flat or too low which allows your neck to bend in a direction towards your pillow once again leading to mal-alignment. Your pillow has to feel comfortable, you have to feel well rested, and it has to be adjustable – meaning it has to conform to various sleep positions. Most people don’t stay in one position all night long and, therefore, if you change positions the pillow has to accommodate those changes – it has to move with you.

Your Best Pillow Options

Knee pillows

simply refer to regular pillows which are placed under your knees if you are a back-sleeper and the knee flexion will actually cause a flattening out of the lumbar spine (the spine of the lower back).  This is a big help to those who sleep on their backs.

Body pillows

can also be used.  A body pillow can be an elongated pillow which allowsyou to “hug” the pillow while at the same time placing the pillow between your knees. This can also help keep your spine in a neutral and relaxed position.  Remember, your shoulders and hips have differing mass, so gravity will cause torsion in  your spine if you side sleep without a body pillow.

Contoured Neck Pillows

These are also called cervical pillows or orthopedic pillows. This is a pillow that has a deeper depression in the center than the edges, which allows for more of a natural contour of your cervical spine. This is not necessarily the be all and end all of pillows. Some people swear by them and others really can’t stand them, so they won’t always work for you. It may be something you want to try first before investing because they can be expensive.

Travel pillows

can also be useful. A travel pillow is simply a “U” shaped pillow that can be used when you are in the upright or seated position, whether it be in a car or an airplane. What it does is allows you – not necessarily to sleep better – but to rest and to stay in that seated position for an extended period of time, by taking some of the stress of the wieght of your head off your neck while traveling.  The average adult head can weigh from 12 to 14 pounds, which isn’t that different from a bowling ball!

Lumbar support pillows

or low back pillows, which are intended to be used when you are in the seated position. These pillows are placed behind the back over the lower spine – in order to help encourage the normal lordotic (forward) curve of the lumbar spine and provide support.

Donut pillows

can be appropriate for people who suffer from a specific condition, such as coccydynia which is pain of the tailbone. Sitting on a donut pillow simply takes pressure off of that area of the spine.
Proper pillow selection is more of an art than a science – it’s a process of trial and error. While there is no perfect or best pillow, I have had good success with water based pillows, specifically because they are adjustable,relatively cost effective, and meet all the criteria of contoured neck pillows. These pillows are marketed by both chiropractors and medical physicians, and are available in office, since there is no need for ordering a custom device.  Try different things. See what works. If it feels right, it’s probably right for you.

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