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In Search of the Perfect Pillow

In Search of the Perfect Pillow

By Tamer Issa, PT, DPT

“Can you recommend a good pillow for sleep?” is one of the most common questions that I have heard from our clients over the years.  Let me start off by saying, there is no one perfect pillow for everyone, the best thing you can do is find the best pillow for you and your body.  Most people know that their current pillow is not doing the trick because they wake up with a stiff neck, neck pain, or a headache.

I’ve been a PT for 20 years now and I have dealt with my fair share of neck issues since my early 20’s.  So believe me when I say, that I have searched far and wide for that elusive “perfect pillow”. Over the years I have tried a cervical roll, gel pillow, air pillow, water pillow, Tempurpedic pillow, buckwheat pillow, and my current pillow (read to the end to find out which it is).

There are a ton of pillow options on the market, but unfortunately, most people take a trial and error approach until they find what they think is a suitable pillow. It helps to get a professional opinion about how to go about finding the right pillow, instead of relying on the opinion of friend or coworker who is basing their advice on what works for them and their body type.  That may not be what works for you. A few things need to be considered when it comes to figuring out if a pillow would work for you.

3 Things to Keep in Mind


When we are not moving, our joints prefer a neutral position.   A neutral position minimizes stress on certain parts of the joint and minimizes the potential for muscles surrounding the joint from becoming overloaded and tense.  Whether you sleep on your side or on your back, your head needs to be in a good alignment in relation to the rest of your spine.

If you are lying on your back and your pillow is too high, it will excessively flex (bend forward) your head in relation to the rest of your spine, which may lead to more load on your spinal discs and overstretching of ligaments and muscles in the back of the neck.  If the pillow is too low and doesn’t provide enough support for your head, it will excessively extend (bend back) your head in relation to the rest of your spine leading to overloading of the neck joints. To understand the influence of the pillow height, take a closer look at these pictures and explanations.

If you are lying on your side and your pillow is too high, it will excessively side bend your head leading to overloading of the neck joints and excessive muscle tension.  The same is true if your pillow is too low and not giving adequate support.

Quick Test: Have someone take a picture from the side at the height level of your ear and analyze as to whether your pillow is too high, too low, or just right.

Neck Support

The second important consideration when it comes to finding the right pillow is finding a pillow that will adequately support the entire contour of your neck.  As you see in the example below, the entire neck should be supported by your pillow. If it does not, it will be difficult for your neck to be fully relaxed during a full night’s sleep.  

There are many factors that contribute to whether or not a pillow is giving adequate support.  The shape of the pillow, the density of the pillow and the height of the bottom part of the pillow will be a factor.  As well as, the size and shape of a person's neck and shoulders.

Quick Test: If your hand or someone else’s hand can easily fit between your neck and the pillow, the pillow is not giving you adequate support.


Lastly, take into consideration the overall comfort of the pillow.  What is the material made of? What is the quality of the pillow? Is it noisy when you move around? Does it breathe or will it make you hot?  If you narrowed it down to 2-3 pillows, mimic your sleeping position (side, back, etc) and compare them to see which feels more comfortable. It should be clear if you are listening to your body.  

On a side note, if you are a stomach sleeper, you should try to get out of that habit because it is the one sleeping position that causes the most problems.

Quick Test: Listen to your gut.  Listen to your body and get a sense of the overall feeling you have when you have tested out a pillow or comparing between two pillows.

So as you can see there are a lot of considerations to take into account when it comes to finding the “perfect pillow” for you.  It really comes down to the size and shape of your body and finding a pillow that will contour to your body type. The closest pillow that I have found that will do this for most people is The Pillowise Pillow.  It was actually introduced to me by a client who had come across it when he was on his search for the “perfect pillow” and it’s the pillow that I use at home and when I’m traveling.  The reason why I love this pillow is that a person’s body measurements and preferred sleeping position are taken into consideration to determine the best pillow match. These pillows currently cannot be found in stores and are only found through health professionals (physical therapists and chiropractors) who carry them.

If you are waking up with a stiff neck or with neck pain,  that is probably a good sign that you don’t have the right pillow.  Keep alignment, neck support and comfort in mind when you are shopping around for pillows.  I hope this advice helps you in your search to find the “perfect” pillow for YOU!

Check out Dr. Tamer Issa's book, Freedom From Neck & Back Pain- Learn to Live an Active Life Without Fear of Pain