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Can Pillows Cause Neck Pain?

If you’re waking up most mornings with neck pain, it can be tempting to pass it off as one of those normal parts of getting older that you’ll just have to deal with. While occasionally waking up with neck pain may be explainable by stress, bad sleep posture, or an injury, regular neck pain is not something you should just have to deal with. In fact, it may point to a problem that, luckily, is quite simple to deal with – your pillow.

If you’re sleeping on a pillow that is not supportive enough, or it’s too low or too high, this may be the reason behind your neck pain. In this article, we’ll explain in more detail how a pillow might cause neck pain and share the type of pillow you should get to help prevent it.

How Do I Know If My Neck Hurts from a Pillow?

Neck pain is one of the most common musculoskeletal issues among adults. Research experts say that approximately 1 in 3 people1 is affected by neck pain once a year. Causes of neck pain2 can range from stress and arthritis to mental health and autoimmune disorders, but sometimes the issue is much simpler.

A good way to tell if it’s your pillow and not something more serious is by assessing how your neck feels during the afternoon and before you go to sleep. How does it feel in the morning when you wake up? If you feel alright during the day and night before, and you wake up with neck pain, it could be your pillow.

While you’re sleeping, it’s important to maintain proper spinal alignment. This means your spine should be in a neutral, comfortable position, much like if you were standing up straight. The University of Rochester Medical Center has a good tip for thinking about this: When you lie down, no matter what position you’re in, your ears, shoulders, and hips should be aligned3. The pillow beneath your head should support the natural curve of your neck; a pillow that is either too low or too high will put undue strain on your back, neck, and shoulders2.

Of course, the position you sleep in can also play a role in your neck pain and may determine which pillow is best for you.

If you are having trouble with neck pain, we recommend you to take a look at our list of best pillows for neck pain.

How Your Sleep Position Can Affect Neck Pain

If you are sleeping with the wrong pillow, it won’t matter if you’re lying on your back, side, or stomach; any one of these positions can cause neck pain with a pillow that isn’t supporting your spine correctly.

That said, there is one position in particular that will be hardest on your neck, no matter the pillow: stomach sleeping. When sleeping on your stomach, the neck has to turn to the right or the left side, which can lead to waking up with a stiff neck. According to Mayo Clinic4, this puts pressure on your spine along your back and can also create neck strain – especially if you’re using a pillow that is too high.

Using a pillow that is too high can also be a problem for back sleepers since it can cause an unnatural curve in the spine, whereas using a pillow that is too low is most often a problem for side sleepers. As mentioned, your pillow should help keep your ears, shoulders, and hips in a straight line, no matter what position you’re in.

Read More: Best Bed for Neck Pain

What’s the Best Pillow to Avoid Neck Pain?

Side Sleeping

Harvard Health5 recommends either sleeping on your side or back for neck pain. The issues tend to come in when you’re using a pillow that is too low for sleeping in these positions.

Think about it this way: when you’re lying on your side, your shoulder is pressing into the mattress. You’ll need a pillow that is thick enough to keep your spine and neck straight while your shoulder creates a gap between your neck and mattress. Many pillows that are too low will have your neck bent downward toward the bed and your head too low.

Instead, side sleepers should opt for a higher-loft pillow than back and stomach sleepers. You can also choose one that is designed specifically for side sleeping.

Helpful Finds: Our favorite pillows for side sleepers

Back Sleeping

Back sleeping has long been touted as the best position6 for back and neck pain. However, it can get uncomfortable when you’re either sleeping on the wrong mattress or using the wrong pillow.

A pillow that is too high will bend your neck uncomfortably so that your head is too far forward and your spine is out of alignment. Conversely, a pillow that is too low won’t support the natural curve of your spine and may feel just as uncomfortable for back sleepers. Generally, we recommend medium-loft pillows for back sleepers.

Discover our best pillows for back sleepers

Stomach Sleeping

Even though stomach sleeping is not the most recommended sleeping position, some people simply can’t get comfortable otherwise. Luckily, choosing the right pillow can help prevent you from cricking your neck or putting undue pressure on your spine in this position.

The key for stomach sleepers is choosing a low loft or adjustable pillow. A low loft just means that it’s a flat, thin pillow. Even though your neck will be turned to one side while sleeping on your stomach, a thinner pillow will at least prevent it from being lifted up too high.

Stomach sleepers can also consider adding a pillow beneath the pelvis to support the hips, which tend to dip down into the mattress in this position4. With a thin pillow beneath the head, and possibly hips as well, the spine should be in comfortable alignment. That being said, if your current mattress allows your hips to dip significantly, we recommend looking into a firmer, more supportive mattress for stomach sleeping as this will help prevent that uncomfortable curvature in the lower back.

Check out our picks for the best pillows for stomach sleepers

Our Final Thoughts

Unless you’ve recently sustained an injury, are living with arthritis, or have some other underlying issue, neck pain should not be a part of your regular life, and if it is, your pillow might be to blame.

Remember, your ears, shoulders, and hips should be in a straight line, no matter what position you’re lying in. In general, side sleepers need higher pillows, back sleepers need medium-loft pillows, and stomach sleepers need low pillows. Try swapping out your pillow for one that is better suited for your favorite sleep position and see how it impacts your neck pain.

Natalie Grigson

Natalie Grigson


About Author

Natalie is a content writer for Sleep Advisor with a deep passion for all things health and a fascination with the mysterious activity that is sleep. Outside of writing about sleep, she is a bestselling author, improviser, and creative writing teacher based out of Austin.

Combination Sleeper


  1. “Neck pain: Overview”. National Library of Medicine. Last modified February 14, 2019. 
  2. Kazeminasab, Somaye., Nejadghaderi, Seyed., et. al. “Neck pain: global epidemiology, trends and risk factors”. National Library of Medicine. 2022.
  3. “Good Sleeping Posture Helps Your Back”. University of Rochester Medical Center. Webpage accessed June 7, 2024. 
  4. “Slide show: Sleeping positions that reduce back pain”. Mayo Clinic. Last modified May 5, 2022. 
  5. “Say “good night” to neck pain”. Harvard Health Publishing. 2022.
  6. King, Heidi Tyline. “The Best — and Worst — Sleep Positions for Back Pain”. Keck Medicine of USC. Last modified August 12, 2022.