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  • PhysioLogix Physiotherapy

Pillow Science! How to choose the correct pillow and mattress for you

One of the most common questions I get in the clinic is about what pillow/mattress should be used to minimise issues with all things spine related! This article aims to summarise the do’s and don’ts of choosing the right set up for you.


The way the human is set up in an anatomical sense is that it curves slightly forward to counterbalance the weight of the head when in an upright position. If the height of the pillow causes this curve to be thrown out of balance one way or the other it places more strain on either the joints or the muscles around the area with the end result being waking up with a cracker of a headache or a stiff neck. This type of pillow setup applies for lying on the back, as well as lying on the side.

Where things can get a bit tricky is how dense the pillow that is being used is and where it is positioned when sleeping. No matter if you are a side or back sleeper, the pillow should be placed under your head and not under your shoulders. Depending on the density of the filler in the pillow it can collapse under the weight of the head, or if it is too firm, cause your head to propped up too far. Either scenario alters the normal curvature of the neck which as mentioned previously has the potential to cause issues in the morning.

The last point to cover is the number of pillows that should be used. The previously mentioned principals regarding neck posture applies but is influenced by shoulder width. If the shoulders are broad more than one pillow should be used to achieve a neutral position for the neck. Of course, the opposite applies.


When choosing a mattress to assist with neck and back issue recovery it is important to try it before buying it. A mattress needs to hold the spine in a neutral position in order to prevent placing too much strain on the joints and muscle around the area. If a mattress is too soft the body will sag into it. Alternatively if it is too hard, it will just be uncomfortable on the places of the body that is in contact with it!

In conclusion when buying a pillow or a mattress it is important that they are soft enough to be comfortable, but not cause the normal curvature in the spine to be shifted too far out of alignment. There is a reason why this article has covered side sleepers and back sleepers, and not those who sleep on their stomach. Whilst kids and teenagers might be able to get away with it, sleeping on your stomach/rotated over your side causes the neck to placed in an end range position which places a lot of stress on it which is best to be avoided!

As always if you have questions about this article get in contact with the clinic and have a chat with one of the physiotherapists there and we can walk you through in more detail.


Vincent Harvey


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