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Written By Michael Sabatino PT, DPT
Director of Physical Therapy | Monmouth Pain & Rehabilitation

This may seem like a very mundane detail, but it is a question repeatedly asked of myself and every other therapist, “what is the best pillow for my neck?” And with that question, I always give the same answer,  “I don’t know.”

It doesn’t matter what type of pillow you sleep on – it can be a buckwheat, tempurpedic, feather,  or five dollar Target pillow. It can be anything.  You need to have enough cervical support to protect your neck throughout the night.  The most helpful advice I can give is that you cannot sleep on your stomach.  I repeat,  DO NOT sleep on your stomach. I stress to all of my patients that this is the worst possible sleeping position for your neck.

Imagine sitting at your desk all day with your head cocked to the side (some of you do!), with your shoulder twisted into internal rotation. You would understand the reasoning behind any shoulder or neck pain you get. This position violates every principle of midline stabilization ever written and produces intense stresses on your spine. This is similar to the position your head is in when sleeping on your stomach.

The cause of your neck pain when keeping your head in this specific position for long periods of time is due to the intense pressure it creates, crushing down on all your cervical joints. As a result, by closing down on your cervical joints all night, you essentially block all neural gliding and prevent those joints from reopening properly. This in turn is what causes neck discomfort, pain, and sleepless nights in many patients .

One way to help combat this targeted neck pain is to roll up a towel and slide it into your pillowcase, ensuring that the towel roll is in the area between your neck and shoulder. This will allow room for your shoulder to be in the optimal position while your neck is supported. You can even try placing a second pillow partially under the first one to provide slightly more support and block your hands from coming under your pillow.

During the first REM cycle of sleep is when all the good hormones come out to aid in the recovery of your body from what we did to ourselves the day before. Incorrect sleeping positions and the pressure on your cervical joints can block these hormones from healing your body. Proper sleep positions and prevention methods will help to fix some of those broken sleep patterns.