Pillow Talk

Do you sometimes suffer headaches or wake up feeling fatigued? It could be that the very place you look forward to resting your head at night is causing the problem.

Your choice of sleeping support is important for reducing muscle and joint aches and pains, especially if you are mainly affected on waking. Selecting the right pillow will help ensure you sleep well, and wake up feeling rested, without pain or stiffness.

Sleeping on a pillow that is the wrong shape, size or density can cause neck pain and headaches due to uncomfortable spinal posture, which can be a major contributor to poor quality sleep. A poor choice in pillow can be like a poor choice in shoes – if you stand around in uncomfortable shoes for 8 hours a day you are bound to end up with muscle tension and soreness.

What to consider

One of the most important things to think about is whether the pillow that you are currently using is the correct height for you. Pillow height may vary depending on whether you sleep on your back or side or change frequently from one to the other. The spine is designed to follow a particular path from the base of the skull to the pelvis. Maintaining this curvature is often difficult.

As the body ages, the shoulders and pelvis tend to round and tilt forward, exaggerating the thoracic and lumbar curvature. The head also drifts forward, causing strain in the cervical and upper thoracic vertebrae.

Having your neck in a neutral position when sleeping means that your head is neither pushed too far forwards or backwards, when lying on your back, nor tilts too high or low when lying sideways.

Preferred sleeping position

If you are lying on your back your head should be nicely level and maintaining what we refer to as the cervical lordosis. This will minimize any abnormal stress on the joints and muscles of the neck, thoracic spine and shoulders.

Sleeping on your stomach is not recommended – it places your spine in an awkward position. The lumbar curve is exaggerated putting increased pressure in the low back.

When sleeping on your stomach, the neck has to be rotated almost 90 degrees to the right or left and side flexed on a pillow placing the neck in an extreme position of torsion and compression for a prolonged period of time.The arms usually go above the head for this position further compromising the neck and increasing the possibility of nerve impingement. For those who cannot refrain from this position at least place a pillow under your hips or purchase a body or stomach pillow.

Types of pillows and their problems

A flat foam pillow can be too stiff causing your head to be thrust forward compressing the upper cervical vertebrae.

A pure feather pillow can compress too quickly causing your head to sink too far into it – again aggravating the joints in the neck.

Contour pillows may be good for many people and for those who change position regularly from side to back. An inexpensive way to see if a contour pillow will help is to use your pillow and roll up a towel to the thickness of about one and a half to two inches thick and place it under your neck for support. This will give your neck the support it needs and if you have the level correct, it will also have your neck placed in a neutral position.

Finding the right pillow can be a frustrating and daunting process, it can take a bit of searching and experimenting before you get it right

The Australian Physiotherapy Association recommends:

These basic principles to help select the right pillow:

1. Seek advice from your physiotherapist

The ideal pillow for you will depend on many factors, particularly preferred sleeping position. If you have a neck or shoulder condition, you may need to discuss pillow options with your physiotherapist.

2. Consider your sleeping habits

If you sleep on your back, you may benefit from something that “fills the curve” in the back of your neck: a flatter pillow with a small contour, for example.

If you sleep on your side, your shoulders are wider than your neck and head, so you may need something higher.

3. Try before you buy

Here are a few handy hints to help you in your search:

  • Look for a pillow that holds it’s shape
  • Don’t go for anything too expensive if you’re not sure it’s the right one for you – remember you might need to try a few to find the right one.
  • Remember that it might take a week or two to adjust to a new pillow, so if it ticks all the boxes and it’s comfortable most of the time, hang in there and give it a week to a fortnight for your body to adjust
  • Always try out the pillow in the shop – most places will have a display bed you can test your pillow on. ( or Borrow one of our selection)
  • Don’t throw away your past selection of pillows- there may be a time in the future that they will suit your neck better.
  • Side sleepers – your new pillow should fill up the space between your ear and your shoulder without any collapsing or folding through your shoulder joint. Your neck should also remain quite neutral which means your head shouldn’t be side flexed towards either shoulder – your neck should be at a right angle from your shoulders.
  • Back sleepers – choose a medium height pillow that keeps your head and neck quite neutral e.g. not so high it tilts your head too far forward but not so low that it extends your neck and tilts your chin up.

We are passionate about healthy sleep and well being

To aid in the correct choice of pillows we offer our patients who are currently having physiotherapy treatment with us the opportunity to trial any of our pillows free of charge in their own beds.

We have three choices of pillow we recommend. Two Flexi contour pillows-, and our feather APA endorsed Natural comfort Pillows.So please speak with our Physios if you are interested in a free trial.

Remember if you are still having pain when you wake up you may need to address other factors that may be aggravating your neck and the most common reason for neck pain and neck related headache is poor sustained posture.

Check out our e- books, blogs and Community PDFS for advice, exercises and help with managing your neck and by all means make an appointment with one of our Physios to get some manual therapy treatment for pain and stiffness

Neckpain and sleeping posture are often connected- you're welcome to download our Patient Resource on Managing Neck Pain here: https://edu.hindmarshphysio.com.au/neckpainguide

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