Do you feel pain and stiffness after waking up? Then, the reason behind it can be, disturbed sleep due to bad sleeping posture. Bad sleeping posture can lead to stress and tension in the neck and shoulders because of which the person wakes up with a feeling of discomfort or pain. Therefore it is important to sleep in a proper posture by using a comfortable pillow or a bed. A proper pillow supports the head, neck, and shoulders and helps the person have a sound sleep. An experienced physiotherapist can very well guide you to choose the right pillow, by taking a personalized assessment in resting spinal position and recommending the pillow that will optimize the patient’s rest. This blog can help you find out how to choose a proper pillow and when to replace it.


Physiotherapy Guide:

A proper pillow helps to maintain the alignment of the body, from the head, neck, spine, and through the spine to the chest, knees, and hips. It also helps in reducing snoring and improves breathing. Insufficient support to the neck and shoulders can put the spine and body, out of alignment, leading to strain and discomfort in the neck, shoulders, and back, resulting in sleeplessness, headaches, and neck pain.


Choosing a Proper Pillow

Several factors should be considered while choosing a proper pillow.  Pillows are available in varying sizes and shapes. Few characteristics make a pillow good for use and ensure the prevention of unnecessary strain on the neck and shoulders.


Spinal Curvature: A pillow should support the neck while resting, in such a manner that the natural curvature of the spine should maintain bone and muscle health. If the pillow is too high or too low, then it causes the neck to bend abnormally, which can strain the neck and back muscles. It can also cause difficulty in breathing, which is a sleep disturbance.


Relaxing: A pillow is used to provide rest and comfort to the person when sleeping. The pillow should be firm, soft, and comfortable, to relax the strained muscles and provide proper sleep.


Adaptable: Pillow height varies with sleeping positions, it is better to have pillows that can be adjusted according to the need and sleeping position.



A standard-size pillow is sufficiently large, that's fine, provided the sleeping posture is in alignment. There should be the right amount of thickness, thinness, firmness, and softness of the pillow so that the person can sleep with the head, neck, and shoulders aligned with the spine, as well as provide the right level of support and comfort during sleep.



Pillows are also made of various shapes, to provide support and stability for the head and neck. Cervical and contour pillows may help with neck and back pain, and contoured body pillows can provide stability, support, and relief for pressure points along the body.


Pillow Materials:

A good pillow is made from a suitable material. Latex, memory foam, and other materials are available in pillows, to provide the best comfort and support for the neck and shoulders. Memory foam pillow conforms to the individual's shape, softens and contours to the lines of the head, neck, and shoulders, and also distributes weight evenly across its surface. Down pillows are light and soft, made of different combinations of down, feathers, and other fillings, these compress around the head and neck's shape so that it is in line with the spine. Whereas latex pillows are more firm than down, but still very comfortable. Polyurethane foam pillows are suitable for all sleep positions, these pillows are responsive without having a viscous feel and have a pressure-relieving quality.



Natural, breathable fabrics should be used to cover the pillows. Pillow covers under pillowcases help to extend the life of the pillow, protecting it against stains and sweat.



While selecting a pillow, allergies and chemical sensitivities should be taken into consideration. Synthetic materials like polyester and memory foam are made through chemical processes, and many pillows are put through antimicrobial treatments.


Pillow height:

In case of neck pain, a flatter pillow is a better option. Higher pillows create more craniocervical pressure, it is the spot where the head and neck join and also creates a greater cervical angle, i.e the head isn't lined up with the spine. This results in pain and stiffness if the neck stays at this angle all night.


Sleeping position affects pillow choice:

Almost everyone keeps on changing the position of sleeping throughout the night. A backside sleeper might also spend some time during the night on the side, the stomach sleeper shifts occasionally to one side. Therefore, a pillow is chosen that works in all sleeping positions.


Side sleepers:

Side sleepers need a firm and slightly higher pillow to keep the head in line with the spine, and a pillow with a bump under the neck to support it, also putting a thin pillow between the knees can help keep the spine in line with the head and neck.


Stomach sleepers:

Stomach sleepers may need a soft pillow or no pillow at all underneath the head if used a pillow may be kept under the stomach and pelvis which helps to prevent back pain.


Back sleepers:

Back sleepers may need a flat and soft pillow, to keep the head and neck in alignment. Back sleepers should use a pillow with a cervical spine curve, i.e a bit of a roll or bump under the neck and a flatter spot for the head.



During travel, the head can be kept upright by using a U-shaped travel pillow. This pillow prevents the head from getting angled to the side when sleeping in sitting up.


When to replace the Pillow?

Over time, pillows get compressed and lose their shape. Bed pillows should be replaced after 18 months. Memory foam pillows last longer, up to 3 years. Natural pillows tend to last longer than synthetic pillows, and also higher quality pillows last longer than inexpensive ones. To check whether the pillow has life left in it or not, some simple tests can be done:

First, take off the pillowcase and over, and examine it. Does it have stains from sweat? Is it torn? Does it smell? These are various signs of a pillow that needs to be replaced. Pillow collects dead skin cells, mold, fungus, dust mites, etc. which can cause allergies, interfere with breathing during sleep, and make it harder to sleep well. The pillow should also be examined by folding it in half. If it lies there folded, rather than springing back to its original shape, then that is a dead pillow. For large, king-size pillows, fold into thirds, rather than in half. If the pillow drapes or hangs down when kept over the extended arm, then it's time to replace it.

When choosing a suitable pillow sleeping habits and personal needs should be taken into consideration as the wrong pillow can lead to headaches, and neck and shoulder pain.