Do you often wake up in the mornings with neck or back pain and stiffness? Do you constantly fluff, poke, prod and flip your pillow to help find the most comfortable position to sleep? If you have ever woken up with a sore, stiff, or painful neck, shoulder, or back, you may be suffering from improper sleep. Did you ever think that the cause if the lump of feathers that you try to lay your head on every night? How long have you had that particular pillow and how do you know if it is the right fit for your neck?
After all, you weren’t born with a pillow under your head and for the first years of your life you slept soundly without one. You lay there swaddled in your crib asleep on your back, on a cushy surface for sure, but without the propped up, forward or laterally flexed neck position that a pillow often forces you into. We all grow accustomed to our necks being in certain positions and are constantly searching for the one pillow to make the best fit.
The thought process behind the modern pillow is intended to help us in our sleep and help us feel comfortable. However, the majority of individuals are searching for that support in fluffy, thick, overly large pillows, that have been created to mimic the pillows that evolved from wealth and style and not with a conscious effort to work with our anatomy to cradle our head and neck in a neutral position. The thick pillow is not so bad if you are a side sleeper but if you sleep on your back then a thick fluffy pillow is basically the antagonist of restful sleep and a healthy spine. This is due to these ‘gigantic mounds of fluff’ pushing our head into various positions of flexion and lateral flexion, basically breaking the healthy neutral position that our head should be in to keep our neck muscles relaxed and happy.
The general consensus is that the best position to sleep in is on your back with your head held in a neutral position. In this position, a small amount of support of the neck is acceptable to help keep the normal curve of the cervical spine, with a minimal amount of cushioned support for the skull. Remember, in this sleeping position the plane of the face should be running horizontal or parallel to the ceiling. Here is where our standard pillow fails in its role as a sleep aide. It is generally too large and thick to properly cradle the head and neck without causing major forward bending at the cervical spine eventually resulting in a military or straightened cervical curve.
The second best position is on our side. In this position the pillow should be the thickness of your shoulder with enough firmness from your pillow to support the head and neck strongly in a neutral position, but with enough cushion that your arm isn’t a preferable option. In this sleeping position, your head should be neutral. You may find that your pillow is too large or too small to accommodate a completely neutral head and neck position.
After replacing your pillow with a more accurately sized one, you can recycle your old fluffy pillow by placing it between your legs in order to keep your hips and thighs in a neutral position similar to what they would be if you were standing up.
If you sleep on your stomach, then you should be actively working on sleeping on your side or on your back. Nearly any pillow in this position forces your head to be placed in intensely rotated positions, and pushes your spine into unnatural, potentially detrimental curvatures.
If you are a back sleeper who after reading this post, pulled your fluffy hunk of a pillow out from under your head and attempted to lower your head and neck to the bed behind you, only to find that there appears to be an infinite distance between your head and your bedding, then your neck is probably in need of some retraining. Our suggestion is to slowly and incrementally lower your head over the course of several months to a year. Try changing the height an inch at a time, making no immediate drastic changes, until your neck sits comfortably in a neutral position.
Dr. Brandon Siegmund is a chiropractor in Houston, Texas. You can read more about Dr. Siegmund by clicking here for his bio page.