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The majority of adults experience back pain at some point or another, with symptoms ranging from mild to severe. Back pain can be caused by injuries, damage to the spine, or underlying conditions. Pain can be exacerbated by poor posture during the day and as we sleep.

In general, back pain contributes to poor sleep quality. This is often cyclical, as back pain negatively affects sleep quality and poor sleep can worsen back pain. Sleepers suffering from back pain may be wondering what role their pillow plays each night. The right pillow can help reduce pressure and tension in the neck and shoulders and keep the spine aligned. It can also provide comfort and help improve sleep quality.

A pillow can be used under the head to alleviate back pain symptoms, but it can also be placed underneath the legs or lumbar region to relieve pressure and promote spinal alignment.

Choosing the best pillow for back pain may feel overwhelming at first, especially with the sheer number of options available to shoppers. We’ll break down our top picks, explaining the construction and materials that help alleviate back pain. We’ll also take a closer look at the relationship between back pain and sleep, and how back pain sufferers can find relief.

Product Details

Best Overall

Saatva Latex Pillow

Brand Logo

Price:

$165 – $185

Fill:

Shredded Talalay latex and down alternative

Firmness:

Medium Soft

Who it’s best for:

  1. Side and back sleepers
  2. Shoppers who want responsive support
  3. Those who want to change loft levels

Highlights:

  1. Loft is highly adjustable
  2. Shredded Talalay latex core is supportive
  3. 100% organic cotton cover is breathable

Sleep Foundation Special Offer

Use this SleepFoundation.org link for the most current discount on Saatva pillows

Shoppers who want a pillow that’s both supportive and responsive will likely find the Saatva Latex Pillow a good fit. Saatva’s model features two fill materials, which combine to give sleepers a pillow that’s both plush and stable. Though it has a sticker price that’s on the high side of average, some shoppers made find this pillow’s high-quality construction and materials are worth the cost.

Those who want pressure relief without sacrificing support may find a latex pillow suitable. The Saatva’s core is made from shredded Talalay latex engineered to alleviate pressure points and provide a stable base for your neck and head. Down alternative fill wraps the core and provides a soft, plush surface. Sleepers who want to adjust the pillow’s loft can remove the down alternative layer.

Talalay latex is also well-known for its temperature regulation, which the 100% cotton cover enhances. Latex is durable and typically has a long lifespan. To ensure its longevity, sleepers should not wash the pillow’s latex core. Saatva recommends washing the down alternative layer and cover in your home washing machine.

Saatva ships the Latex Pillow for free to shoppers living in the contiguous U.S., and backs it with a 1-year warranty. A 45-day sleep trial is also included with your purchase. Refunds are not issued outside this window.

Best Value

Original Groove Pillow

Brand Logo

Price:

$60

Fill:

Bamboo charcoal-infused memory foam

Firmness:

Medium Firm

Who it’s best for:

  1. Back and side sleepers
  2. People who experience stiff necks during sleep
  3. Shoppers on a budget

Highlights:

  1. Unique ergonomic shape cradles the head and neck
  2. Memory foam closely contours to the body
  3. Removable cover is machine washable

Sleep Foundation Special Offer

Use this SleepFoundation.org link for the most current discount on Groove pillows

The Original Groove Pillow has a unique shape designed specifically to promote healthy spinal alignment, which can play a big role in relieving back pain during sleep. The pillow carries a very reasonable price-point considering its specialized construction.

The pillow is composed of memory foam that closely contours to your head and neck. This helps reduce pressure buildup and allows your head to sink into a comfortable, neutral position that aligns with your spine. The Original Groove is ergonomically designed with a dip that cradles your head and neck for enhanced spinal alignment. We found this design best suited for back and side sleepers, but stomach sleepers may prefer a flatter pillow.

The Original Groove Pillow is encased in a polyester knit cover that you can remove and wash in a household machine. If you tend to overheat on memory foam pillows, this model is infused with charcoal that’s meant to reduce heat retention.

Each pillow comes with a 100-night sleep trial. Shipping is free on orders over $150.

A picture of the Sweet Zzz Plant-Based Pillow in Sleep Foundation's test lab.

Most Comfortable

Sweet Zzz Plant-Based Pillow

Brand Logo

Price:

$135 – $150

Fill:

Plant-based down alternative fibers

Firmness:

Medium

Who it’s best for

  1. People who are allergic to real down
  2. Those who prefer not to buy or use animal-based products
  3. Sleepers who feel most comfortable on ultra-soft pillows

Highlights

  1. Fill consists of down alternative fibers derived from plant matter
  2. Shell is made from smooth, breathable cotton
  3. Entire pillow can be washed and dried using household machines

Sleep Foundation Special Offer

Use this SleepFoundation.org link for the most current discount on Sweet Zzz pillows

Most down alternative pillows contain fill made of polyester or viscose from bamboo. The Sweet Zzz Plant-Based Pillow’s fill is composed of plush clusters derived from plant matter. This material mimics the lightness and softness of real down without relying on synthetic fabrics. It is also safe for people with down allergies, and a good choice for people who would rather not buy products that use animal-based materials. Back sleepers are also good candidates for this pillow, as seen during our product tests. Mid-range loft and decent support allow back sleepers to lie comfortably without too much sinkage around the head, neck, or shoulders.

The shell is made of smooth natural cotton. This fabric is highly breathable and the fill retains very little heat, so the pillow should sleep reasonably cool in most climates. You can wash and dry the entire pillow in your household appliances. Machine wash with similar colors on a gentle cycle, then tumble dry on low heat. Avoid ironing or dry cleaning the pillow, as both can cause permanent damage. Standard and king sizes are available.

The Plant-Based Pillow is affordably priced in each size and shipping is free of charge for all customers in the contiguous U.S. Sweet Zzz also offers accessible shipping rates for orders to Alaska, Hawaii, and Canada. Each purchase is backed by a 50-night trial, during which you can return your undamaged pillow for a full refund or exchange it. You’ll also receive a manufacturer’s warranty that covers structural and material defects for up to 1 year.

A picture of the Eli & Elm Cotton Side-Sleeper Pillow in Sleep Foundation's test lab.

Best for Side Sleepers

Eli & Elm Cotton Side-Sleeper Pillow

Brand Logo

Price:

$131

Fill:

75% Latex and 25% Polyester Fiber

Firmness:

Medium, Adjustable

Who it’s best for:

  1. People who sleep on their side
  2. Hot sleepers
  3. Those who feel pain or pressure due to uneven spinal alignment

Highlights:

  1. Contoured design accommodates the shoulder while side sleeping
  2. Improves alignment and reduces pressure on the neck
  3. Latex and down alternative fill balances plushness and support

Sleep Foundation Special Offer

SleepFoundation readers get 20% off. Discount automatically applied to cart.

The ergonomic Eli & Elm Cotton Side-Sleeper Pillow is designed with an oblong shape. This allows you to rest comfortably on your side with your neck slightly elevated and your shoulders aligned with the spine, which can alleviate pain and pressure points in these areas as well as the back and hips. The pillow contains a shredded blend of latex and down alternative fibers, creating a plush yet supportive feel.

The pillow is also adjustable, as you can add or remove fill to change the loft and density. This makes the pillow suitable for any side sleeper regardless of their thickness preferences. The cover is made from a soft and breathable blend of cotton, polyester, and spandex.

One size is available for the pillow. When it needs to be cleaned, simply remove the fill and wash and dry the cover in your household machines. Eli & Elm allows customers to bundle their purchase and save money on additional products, such as sheets, mattress protectors, and other pillows.

Eli & Elm provides free ground delivery to all customers within the contiguous U.S. You may return your pillow within 45 days of the original purchase, even if you’ve slept on it or washed the cover, and you’ll also receive a five-year warranty.

A picture of the Silk & Snow Pillow in Sleep Foundation's test lab.

Best for Spinal Alignment

Silk & Snow Pillow

Brand Logo

Price:

$75 – $85

Fill:

Shredded memory foam core with down alternative microfiber outer chamber

Firmness:

Medium

Who it’s best for

  1. Shoppers who want an adjustable pillow
  2. Value seekers
  3. People looking for pressure relief

Highlights

  1. Shredded memory foam fill promotes pressure relief
  2. Customizable loft level
  3. Two-chamber construction offers heightened support

Sleep Foundation Special Offer

Use this SleepFoundation.org link for the most current discount on Silk & Snow pillows

People who experience back pain can sometimes find relief through a combination of pressure relief and robust support. The Silk & Snow Pillow’s core is made from shredded memory foam that alleviates pressure by gently cradling your head and neck. The adjustable fill ensures that any sleeper can create a comfortable loft level. This model also comes in at a below-average price-point that may be attractive to value seekers.

Surrounding the shredded memory foam core is another chamber filled with down alternative microfiber. This layer adds a bit of plushness and keeps the pillow feeling airy. Together, the foam and fiber give the pillow a medium feel that’s suitable for back and stomach sleepers, though side sleepers can opt to keep all the fill in place to get the highest loft level.

You can remove the breathable cotton cover easily and wash it in your home machine. Silk & Snow offers a lengthy 100-night sleep trial that requires you first use your pillow for 30 days before starting a return. It’s backed by a 3-year warranty that covers material and workmanship defects. Shoppers in the contiguous U.S. and Canada can expect free shipping, while those in Hawaii and Canadian territories will have an additional charge.

Image of the Tempur-Cloud Pillow in the Sleep Foundation Test Lab.

Best Pressure Relief

Tempur-Pedic TEMPUR-Cloud Pillow

Brand Logo

Price:

$79

Fill:

Solid memory foam

Firmness:

Extra Soft

Who it’s best for:

  1. Memory foam in an extra soft feel contours to the head and neck to relieve pressure
  2. 5-inch loft keeps back sleepers’ bodies in proper alignment
  3. Soft polyester knit cover

Highlights:

  1. Back sleepers
  2. People who prefer to snuggle with their pillows
  3. Frequent travelers

Sleep Foundation Special Offer

Buy 2 TEMPUR-Cloud Pillows for $119 and save $59!

People with sharp pressure points in their neck or shoulders often benefit from a pillow that cushions these areas without cranking the neck. The Tempur-Pedic TEMPUR-Cloud Pillow offers generous contouring for sore spots, while a mid-to-high loft keeps the head aligned with the rest of the body. 

The TEMPUR-Cloud Pillow is made with solid memory foam that slowly adapts to the head to relieve pressure. Solid memory foam is often more supportive than shredded foam, so your head should sink in comfortably but not excessively. The pillow is encased in a soft polyester knit cover that is removable and machine-washable for easy care. 

Our back sleepers enjoyed the pillow’s extra soft feel and 5-inch loft the most. This combination allowed close cradling for the head and neck without sacrificing support. Side sleepers weighing up to 230 pounds may also enjoy the pillow, but those weighing more than 230 pounds may prefer a firmer pillow with a thicker profile. Our testing also found the pillow quite moldable and compressible while maintaining its shape. This makes it a great choice for people who prefer to snuggle their pillow, as well as frequent travelers seeking a pillow that’s easy to pack. 

Tempur-Pedic ships free to customers in the contiguous U.S. A return trial is not available for pillow purchases, but the TEMPUR-Cloud Pillow is backed by a 5-year manufacturer’s warranty.

Product page photo of the Helix Shredded Memory Foam Pillow - Back and Stomach Sleepers

Best for Back and Stomach Sleepers

Helix Shredded Memory Foam Pillow – Back & Stomach Sleepers

Brand Logo

Price:

$119 – $129

Fill:

90% shredded memory foam, 10% gel down alternative fibers

Firmness:

Medium

Who it’s best for

  1. People who frequently wake up with neck strain
  2. Those who normally sleep hot on memory foam pillows
  3. Shoppers with limited budgets

Highlights

  1. Shredded foam and fiber fill contours closely around the head and neck
  2. Breathable Tencel cover wicks moisture away from the skin
  3. Lower-loft design specifically geared toward back and stomach sleepers

Sleep Foundation Special Offer

Use this SleepFoundation.org link for the most current discount on Helix pillows

If you primarily sleep on your back or stomach, you won’t need as much pillow loft as a side sleeper — in fact, a thicker profile can elevate your head too much and cause painful neck strain. As its name implies, the Shredded Memory Foam Pillow – Back & Stomach Sleepers from Helix is designed for people who use these positions. A lower profile coupled with squishy, adaptive fill helps ensure adequate loft and cushioning for back and stomach sleepers without lifting the head too much.

A combination of shredded memory foam and down alternative fibers make up the fill. This blend makes the pillow feel both adaptive and luxuriously soft. The cover is composed of breathable Tencel fabric that effectively offsets heat absorption from the foam to help you stay cool at night. Tencel also has moisture-wicking properties, which can be beneficial for people prone to night sweats or those who reside in exceptionally humid climates. You can remove and machine wash the cover whenever it needs to be cleaned.

During our hands-on tests, the Shredded Memory Foam Pillow – Back & Stomach Sleepers proved popular with its target audience — it earned stellar ratings from most of our team members who utilize either position, as well as our combination sleepers who use both. Some of our side sleepers also felt comfortable on the pillow, but others needed more loft. Helix also offers a slightly thicker version of this pillow intended for side sleeping. 

The Shredded Memory Foam Pillow – Back & Stomach Sleepers is reasonably priced, and standard ground shipping is free for customers in all 50 states. Your purchase includes a generous sleep trial that runs for 100 nights, giving you ample time to test out the pillow and decide whether it meets your needs. Helix also backs each order with a 1-year manufacturer’s warranty.

A picture of the Layla Kapok Pillow in Sleep Foundation's test lab.

Best Adjustable

Layla Kapok Pillow

Brand Logo

Price:

$109 – $129

Fill:

Shredded memory foam and kapok tree fiber blend

Firmness:

Medium Soft

Who it’s best for

  1. Back pain sufferers looking for a closely conforming pillow
  2. Those who tend to sleep hot
  3. Most sleeping positions and body types

Highlights

  1. Relieves pressure on the neck, shoulders and upper back
  2. Encourages spinal alignment
  3. Copper-infused cover helps maintain a comfortable sleeping temperature

Sleep Foundation Special Offer

Use this SleepFoundation.org link for the most current discount on Layla pillows

The unique blend of shredded memory foam and natural kapok fibers in the Layla Kapok Pillow relieves pressure and promotes spinal alignment. This helps ease chronic back pain and ensures ample support for sleepers, including those who toss and turn at night. The Kapok Pillow is soft enough to be used underneath or between the knees to reduce pressure on the lower back.

The breathable cover of the Layla Kapok Pillow is woven with copper fibers, which help draw heat away from the body. In addition to temperature regulation, copper is antibacterial and odor-resistant. It has also been shown to help improve circulation.

The fill of the pillow includes natural kapok fibers, harvested from the seeds of the kapok tree. The fibers have a lightweight feel that is similar to down. The fibers maintain their loft and encourage airflow throughout the pillow. In addition to kapok fibers, the Layla Kapok Pillow includes shredded memory foam. The open-cell structure of the memory foam helps dissipate heat and moisture.

The plush feel of the Kapok Pillow conforms closely and cradles the head and neck. The pillow is responsive and can be molded into the sleeper’s preferred shape. The loft of the pillow is adjustable. The pillow arrives slightly overstuffed, and fill can be removed as needed.

The Layla Kapok Pillow is highly rated for durability and includes a 5-year warranty that covers defects in materials and workmanship. Spot cleaning the pillow is recommended, as machine washing it can void the warranty.

Shoppers can choose between a queen or king size. The Layla Kapok Pillow comes with a 100-night sleep trial. Layla asks that purchasers try out the pillow for two weeks before initiating a return.

Image of the Cozy Earth Silk Pillow in the Sleep Foundation Lab.

Best Hotel-Style

Cozy Earth Silk Pillow

Brand Logo

Price:

$279 – $329

Fill:

100% long-strand mulberry silk

Firmness:

Medium soft

Who it’s best for:

  1. Sleepers who prefer exceptionally soft pillows
  2. Hot sleepers
  3. Those who want to invest in a long-lasting pillow

Highlights:

  1. Mulberry silk fill is both luxuriously soft and durable
  2. Excellent breathability thanks to steady airflow and cooling, bamboo-derived viscose cover
  3. Several care options to suit your schedule and budget

Sleep Foundation Special Offer

Use this SleepFoundation.org link for the most current discount on Cozy Earth pillows

Mulberry silk is a popular pillow fill for its exceptionally soft feel and above-average longevity, but pillows containing this material tend to be quite costly. The Cozy Earth Silk Pillow is a good compromise for shoppers with limited budgets. The price-point is fairly approachable, yet the pillow still performs at the same level as many of its more expensive competitors. The silk strands create a luxurious cushion for the head and neck, but the fill is also highly supportive and shouldn’t sink too much beneath the weight.

A cover made of breathable, moisture-wicking viscose from bamboo encases the silk. Air circulates freely throughout the interior, so the Silk Pillow should be comfortable for hot sleepers and those who frequently sweat during the night. The pillow is fully machine-washable, though Cozy Earth recommends commercial-size washers and dryers to minimize clumping. You can also spot clean or dry clean outer shell, or use a protector to safeguard the pillow against stains and smudges.

Cozy Earth offers free ground shipping to customers throughout the U.S. The company permits returns and exchanges within 100 nights of the delivery date, which also qualify for free shipping. All Silk Pillows come with 10-year warranties against structural defects such as clumping or shifting fill.

Best Cooling

I Love Pillow Contour Pillow

Brand Logo

Price:

$89 – $99

Fill:

Lightweight memory foam

Firmness:

Medium Firm

Who it’s best for:

  1. Sleepers with neck and upper back pain
  2. Side and back sleepers
  3. Allergy sufferers

Highlights:

  1. Contoured shape eases pain in the neck and upper back
  2. Lightweight memory foam sleeps cooler than average
  3. Available in a 2-pack at a discounted price

Sleep Foundation Special Offer

Use this SleepFoundation.org link for the most current discount on I Love Pillow pillows

The I Love Pillow Contour Pillow’s core is a proprietary memory foam blend. Its lightweight construction helps dissipate heat and moisture. This makes it a great choice if you typically overheat on foam pillows.

The soft microfiber cover of the Contour Pillow is removable and machine washable. It resists stains and common allergens while protecting the responsive core.

The memory foam core conforms to the shape of the head and the neck with a medium firm feel. The I Love Pillow Contour Pillow retains its shape throughout the night, ensuring consistent support for people with back pain. A shallow curve helps support the neck and relieve pressure. This eases neck and back pain for sleepers by encouraging spinal alignment. The pillow’s 5-inch loft is a good option for both back and stomach sleepers, both of whom tend to feel most comfortable on pillows with low to medium profiles.

Shoppers have their choice of a queen or king size Contour Pillow. I Love Pillow gives purchasers 100 nights to try the pillow out. Additionally, it is backed by a 3-year warranty that covers defects in materials and workmanship.

How Common is Back Pain?

Back pain is quite common, as an estimated 80 percent of the population experiences symptoms at some point in their lives. Back pain can range in severity and frequency and it often affects the working population. Workers suffering from back pain may miss days of work, or have limited mobility when they are on the job.

There are multiple factors that can cause back pain, and consulting with a doctor is an important step in determining a treatment plan and finding relief. Injuries can often lead to back pain. This includes injuries from exercising, playing sports, and lifting heavy objects. These activities may strain the muscles and ligaments in the back.

In addition to accidents and injuries, back pain can be caused by a ruptured, damaged, or herniated disk. Disks are part of the spine that sit between and cushion each vertebrae. Damage to a disk can also lead to nerve pain and muscle weakness.

Underlying issues including arthritis, osteoporosis, and fibromyalgia can contribute to back pain.  Back pain is common during pregnancy, as the additional weight puts pressure on the lower back. Back pain can also be exacerbated by poor posture.

Types of Back Pain

There are several types of back pain, and understanding the severity and location of the pain can help when it comes to finding relief.

It is important to work with a medical professional to determine the underlying cause of back pain. Being able to describe the type of back pain you are experiencing is important. Back pain can be considered acute or chronic:

  • Acute: Acute back pain typically has a sudden onset, and is often caused by an injury. This type of back pain heals as the underlying cause is resolved. This may involve a torn muscle or ligament, or damage to the tissue. Tissue damage generally takes three months to heal, so acute back pain often lasts three months or less. That said, acute back pain can turn into chronic back pain if the body does not properly heal.
  • Chronic: Chronic back pain lasts longer than three to six months. It persists even after an injury heals. In these circumstances, the nervous system continues sending pain signals to the brain. Chronic back pain can also be the result of an underlying condition. Arthritis, osteoporosis, and fibromyalgia can all cause chronic back pain.

Whether back pain is chronic or acute, it can manifest in different areas of the back. The location of back pain can often point to the underlying cause.

  • Low Back Pain: Low back pain is the most common type of back pain. It manifests in the lumbar region, specifically vertebrae L1 through L5. These five vertebrae, and the disks, ligaments, tendons, and muscles connected to them, help support the upper body. As a result, this area is at risk of injury when exercising or lifting heavy objects improperly. Weight gain and pregnancy can also strain the lower back. Using a pillow under the lumbar region can reduce pressure on the spine and help alleviate lower back pain.
  • Mid-Back Pain: Mid-back pain occurs between the lumbar region and the bottom of the rib cage. This type of back pain is less likely to be caused by heavy lifting. Mid-back pain can be connected to more serious health issues like tumors or underlying conditions. Posture can play a role in worsening or preventing mid-back pain.
  • Upper Back Pain: Upper back pain occurs in the thoracic spine, or the 12 vertebrae between the rib cage and neck. This type of back pain includes the shoulders, and is often affected by posture. Trauma or injury can also cause upper back pain. Serious conditions, including osteoporosis, arthritis, tumors, and narrowing of the spine can all lead to upper back pain. Like other types of back pain, upper back pain can also be a result of damage to the vertebrae, disks, muscles, or ligaments. Pillow choice is especially important for those with upper back pain, as the right pillow will support the upper back, shoulders, and neck.

Regardless of how severe your back pain is or where it manifests, speaking to your doctor about your symptoms is important. A medical professional can help diagnose and treat back pain.

Back Pain and Sleep

Anyone with chronic pain knows how difficult it can be to get uninterrupted sleep each night. The relationship between back pain and sleep is complex. Back pain sufferers often get caught in a vicious cycle: back pain negatively affects sleep, and poor sleep quality can worsen pain. Poor sleep and chronic pain also affect mood, physical function, and quality of life.

Restless sleep often involves waking up throughout the night due to pain and discomfort. Adults generally need at least seven hours of interrupted sleep each night, something that may feel impossible for those with back pain.

“Sleep and pain have a bidirectional relationship, and the current data suggest that the effects of sleep on pain are likely stronger than the effects of pain on sleep. Focusing on improving your sleep quality may help with your overall pain level. Common changes to sleep quality could include difficulty falling and/or staying asleep, more sleep fragmentation (i.e., more awakenings during the night), early morning awakenings, and unrefreshing/non-restorative sleep.”

Sarah Silverman, Psy.D., a licensed psychologist and holistic sleep wellness consultant who treats patients in New York and Florida.

It is important to note that your pillow and mattress play a role in sleep quality and pain management. Both affect sleep posture, which can alleviate or exacerbate back pain symptoms. The best mattress and pillow to combination should promote a neutral posture that keeps the spine aligned.

Pillows can be used to support the head, neck, and shoulders. They can also be used under the lumbar region and legs to alleviate pressure on the spine. There is plenty to consider when selecting a pillow for back pain, which we’ll break down further here.

How to Choose a Pillow for Back Pain

The pillow you use affects how much support and pressure relief you experience throughout the night. Spinal alignment is important for every sleeper, as it can help prevent and alleviate back pain. The following factors determine how well a pillow supports the head, neck, and shoulders and should be carefully considered. These include the loft, firmness, and size of the pillow. Each shopper has unique needs, which should be accommodated by the right pillow.

What to Consider When Purchasing a Pillow for Back Pain

The following considerations affect the performance and quality of a pillow, and should be kept in mind by all shoppers. There are plenty of choices on the market, and it is not uncommon for companies to overstate certain features to entice shoppers. This can be distracting.

Focusing on what is most important, namely the amount of support and comfort a pillow provides, will help shoppers narrow down their options. These factors can help shoppers filter out unnecessary marketing jargon and exaggerations and find the best pillow for them.

When evaluating the following elements, back pain sufferers should also consider their sleeping position, head and shoulder size, and type of back pain.

Loft: Loft refers to the height of the pillow, which is one of the most important considerations when choosing a pillow for back pain. It determines the angle of the head and neck and how well the spine is kept in alignment. Loft can range from low to high. Some pillows have an adjustable loft, allowing sleepers to customize the height of the pillow by adding or removing fill. Stomach sleepers often need a low loft pillow to keep the head and neck at a comfortable angle. Back sleepers tend to choose a medium loft pillow that cradles the head and neck, while side sleepers may opt for a medium to high loft to fill the gap between the neck and shoulders.

“Side sleepers tend to need a high-loft pillow for support and to fill the space beneath the head and neck to promote proper spinal alignment. Keep your head and neck in alignment at around 30 degrees with the help of a good pillow so your airway stays open during the night, allowing air to flow from your nose to your lungs without obstruction.”

Sarah Silverman, Psy.D., a licensed psychologist and holistic sleep wellness consultant who treats patients in New York and Florida.

Support: Support measures how well the spine is kept in alignment. The spine extends into the neck, so the pillow must be supportive enough to reduce pressure on the neck and shoulders. Some materials are more supportive than others, as they retain shape throughout the night and resist falling flat.

Firmness Level: The firmness of a pillow is measured on a scale of soft to firm. The best pillow firmness for back pain depends on sleeping position and weight, among other factors. The pillow should balance comfort and support. Stomach sleepers often prefer a soft pillow, while back and side sleepers may opt for a medium to firm pillow. Firmness and comfort are subjective, so shoppers should keep their personal preferences in mind.

Pressure Relief: How well the pillow conforms to the shape of the head and neck determines how much pressure relief it provides. Back pain can be worsened by undue pressure on the neck and shoulders. This is often caused by a pillow that is too firm, or one that puts the head and neck and an uncomfortable angle. A pillow that relieves pressure will cradle the head and neck and reduce tension. Pillows can also be used underneath the lumbar region to relieve pressure in the lower back.

Shape: How well the pillow retains its shape throughout the night affects the amount of support sleepers receive. A pillow that retains its shape without constant fluffing or adjusting is beneficial for back pain sufferers, as it can help them sleep without interruptions. Some sleepers prefer a pillow that can be molded into their preferred shape. The best pillows for back pain can have an even shape, or can be contoured for additional neck support.

Price: Setting a budget is an essential part of shopping for a new pillow. Polyester and down-alternative pillows are often affordable, while more expensive options may include memory foam, latex, buckwheat, or down fill. The materials and construction impact price.

Quality Materials: The quality of materials used determine the lifespan of a pillow. This is important for back pain sufferers, as quality materials will provide consistent and even support. Latex, feathers, and high-density foams all tend to be durable materials. Shoppers should note that investing in a high-quality pillow may cost more upfront, but these pillows do not need to be replaced as often.

What Pillow Materials are Best for Back Pain?

There are benefits and drawbacks to each pillow type, but memory foam pillows are often considered to be the best for back pain. Back pain can manifest in different ways, and every shopper will have different needs and preferences. Some may find that down, poly fill, or latex pillows are more comfortable. We’ll break down common pillow types here.

Memory Foam
Viscoelastic foam, or memory foam, conforms to the shape of the head and neck by responding to heat and pressure. This type of pillow offers a customized feel that reduces tension in the neck and shoulders and helps keep the spine aligned. Pillows can have a solid memory foam core, or shredded memory foam fill. There are a couple drawbacks to memory foam to keep in mind, namely that it can have an initial odor and tends to retain heat.

Buckwheat
Buckwheat pillows are filled with the outer shell of buckwheat seeds. The hulls have a naturally open shape that encourages airflow and helps dissipate heat. Buckwheat pillows often have an adjustable loft, as the hulls can be added or removed to change the firmness and height of the pillow as needed. The hulls conform to the shape of the head and neck to reduce aches and pains. That said, the buckwheat hulls may be too firm for some. They are also prone to making a rustling noise when the pillow is shifted.

Feather
Feather pillows are filled with the outer feathers of ducks or geese. This results in a lightweight fill that compresses easily and cradles the head and neck. For sleepers with back pain, this can reduce tension in the head and neck. Feather pillows are often slightly firmer than down pillows, and the loft can be adjusted by adding or removing fill.

Latex
Latex is harvested from the sap of rubber trees, which is poured into molds and processed using the Talalay or Dunlop manufacturing method. The result is a durable, breathable material that offers moderate contouring for pressure relief. Latex retains its shape. It is often used as a solid pillow core, so latex pillows are less likely to be adjustable. They also tend to be expensive.

Down
Down refers to the insulating under-feathers of ducks or geese. It is softer and lighter than feathers, as there are no quills. Like feathers, down compresses easily and fills gaps for contouring support. This type of pillow cradles the head, neck, and shoulders and can ease tension in the upper back. That said, down may be too soft for some back pain sufferers. Down-alternative is a polyester fiber designed to mimic the feel of down at a lower price point.

Polyfoam
Polyurethane-based foam, or polyfoam, offers moderate contouring but is not as responsive as memory foam. It can relieve pressure for back pain sufferers. This type of foam pillow is typically affordable, but low-density polyfoam has a shorter lifespan that can result in inconsistent support or deep impressions.

What is the Best Pillow Positioning for Back Pain?

Sleep posture can exacerbate or alleviate back pain. Sleeping on your back is often considered the best positioning for back pain. This position is most likely to encourage sleepers to maintain a neutral posture, which keeps the spine aligned and reduces pressure on the lumbar region. Sleepers can use pillows strategically to relieve back pain.

Stomach sleeping is one of the worst sleeping positions for back pain, as it puts pressure on the lower back and often leads to spinal misalignment.

The following sleeping positions, along with their potential benefits and drawbacks, should be considered:

  • Back with Pillow Beneath Knees: Sleeping on your back relieves pressure on the spine. To make this sleeping position even more beneficial, sleepers can use pillows underneath the head and knees. The pillow beneath the head should cradle the head, neck, and shoulders and keep the spine aligned. A pillow underneath the knees may help prevent pressure from building in the spine.
  • Fetal Position: The fetal position can be beneficial for some back pain sufferers, but precautions should be taken to ensure body weight is evenly distributed. Sleepers should keep both knees evenly bent and curve their upper body towards their knees to promote natural alignment.
  • Side with Pillow Between Knees: Side sleeping can be comfortable for back pain sufferers, but the mattress and pillow should be conforming and supportive. Placing a pillow between the knees squares the hips and alleviates pressure on the lumbar region. This helps keep the spine aligned.

Other Tips for Back Pain Sufferers

For back pain sufferers, pillow choice is crucial. In addition to choosing a supportive pillow, shoppers can take the following measures to help alleviate back pain and sleep comfortably.

  • Choose the Right Mattress: When selecting a mattress for back pain, shoppers should consider their sleeping position and body type. These can affect how comfortable the mattress feels. The right mattress will help alleviate back pain for those already suffering, but it can also help prevent it. A supportive mattress will help keep the spine aligned and improve overall sleep quality.
  • Engage in Physical Therapy or Stretching:Physical therapy can help with both acute and chronic back pain. Physical therapy includes exercises and stretches that improve mobility and strengthen muscles. This can reduce pain and tension throughout the body. Heat and cold therapy can also be used in physical therapy to relieve back pain. Working with a physical therapist can result in a long-term plan to manage back pain and its underlying causes.
  • Invest in a Mattress Topper: A mattress topper adjusts the firmness of a mattress by acting as an additional comfort layer. For back pain sufferers, a mattress topper can cushion pressure points. Conforming materials like foam and latex help evenly distribute body weight and keep the spine aligned. Investing in a mattress topper is often a more affordable option than purchasing a new mattress, especially if the only issue with the mattress is its current firmness level.

Frequently Asked Questions About Pillows for Back Pain

Can the wrong pillow make back pain worse?

The wrong pillow can worsen back pain, making it essential for sleepers with back pain to choose their pillows wisely. The wrong pillow will provide inadequate support, placing the head and neck at an uncomfortable angle. This can be the result of a loft that is too high or too low, or a pillow that is not the right firmness for the sleeper. Shoppers need to choose a pillow that supports their sleeping position and body type, including their head size and shoulder width.

What is the most important consideration when choosing a pillow for back pain?

One of the most important considerations when choosing a pillow for back pain is its loft. Size and shape are also essential factors, as each impacts how much pressure relief and support the pillow provides. Pillow loft is the height of the pillow, which determines the angle of the head and neck. The pillow should also be large enough to evenly distribute weight and ensure support as sleepers change positions throughout the night.

What is the worst pillow type for back pain?

The worst pillow type for back pain is one that flattens easily and does not support the head and neck. Some materials, like low-quality polyester fibers, are less likely to retain shape throughout the night, causing strain on the neck and shoulders. The pillow should maintain its loft and keep the upper body supported.

Can a body pillow help with back pain?

A body pillow can help alleviate back pain. Body pillows are long pillows that can be rectangular, U-shaped, or C-shaped. These types of pillows are often used to elevate different parts of the body, reducing pressure on the joints and muscles. This is especially beneficial for side sleepers who need to position a pillow between the knees to help with back pain. A body pillow is also commonly used throughout pregnancy.

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