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Pillows are a popular topic of conversation with patients.  “Lola, do you recommend those expensive, memory foam pillows?”  or “should I change my pillow? If so what do you recommend?”; or even “I bought one of those expensive, funny shaped pillows and it made matters worse.”  Although I sell specialist pillows in the clinic shop, I recommend them to a small number of patients.  Most other patients are advised on how to adapt their own pillows to make sure their neck and spine are supported throughout the night.

So here is an outline of my advice.  However, my preferred approach to advising is to get patients to come into the clinic with their pillow(s) and get them to lay on the couch and I show them how to modify the pillow to suit their body shape.



Beautiful blond young woman sleepingTummy sleeper

If you are a tummy sleeper, with or without back and neck pain – I advise you to change this habit.  The tummy sleeping causes the joints in the spine to pinch together which can cause persistent pain due to joint irritation.  Please try to convert to side sleeping or back sleeping.  If you are having trouble changing,  find a pillow to hug into and follow the advice below regarding pillow for side sleeping.

Side SleeperSide sleeper

The best tip here is to find a pillow or bolster in some cases, which will fill the depth of your shoulder.  Usually the reason that orthopaedic pillows do not hit the spot is because they are not the right depth for all bodies.  If you are tempted to buy an orthopaedic pillow, get one that is depth adjustable.  If the depth is right, your neck will run in a continuous line with the rest of your spine, i.e. it will not taper into or away from your bed.  To support the pelvis, place a small folded towel of cushion between your knees.
If you have deep shoulders and a short neck, I would recommend a plump down pillow or similar, as a memory foam pillow may not offer you enough flexibility to stuff the pillow into the neck space to give support and comfort during the night.

Back SleeperBack sleeper

Again, the depth is important, but the pillow will not be as deep as if you are a side sleeper.  If the pillow is too deep, you will compress your throat and overstretch the ligaments and muscles at the back of the neck.  If the pillow is too flat then then may cause the neck to back bend, which compresses the small joints in the spine and causes joint irritation and if you are unlucky, can cause temporary but very painful and restricting muscle spasm.  This position is not very good for the delicate vertebral arteries in the upper section of the neck.  The ideal pillow depth will slight tilt the chin downwards and allow the back of the neck to lengthen.

Who would I recommend adjustable orthopaedic pillows to?

Ears, Nose, Throat (ENT) Conditions

Chronic ENT sufferers, depending on the contour of their neck and back.  The added support and improved spine and head alignment has been know to be beneficial for reducing symptoms and improving breathing at night.

Hypermobile joints in the neck

Especially if the neck is quite long.  The additional support will reduce the occurrence of neck pain flare ups.

History of severe facial or head trauma.

The best pillow to recommend would be adjustable and also be softer than the standard memory foam pillow.  These people often need support but cannot tolerate very dense foam.


Some patients have reported benefits.

I toss and turn all night – I cannot see the benefit of the above advice.insomnia-1

My theory is, from my own experience, is that if the spine and head are comfortable, the amount of tossing and turning will reduced.

Other tips for a good night sleep

  • Do not drink alcohol too close to bedtime – leave at least an hour.  the alcohol affects the cerebellum, which is intrumental for balance and sleep.
  • Drink a glass of water before bedtime.  The body does a lot of processing during sleep.  Hydration throughout the day can lead to reduced stiffness in the morning
  • Finish watching TV or looking at PC screen / devices etc before bed time.  the light interfere with the melanin hormone which signals bedtime and enable quality sleep
  • Do not sleep with the lights on.  Important message for those who are afraid the dark or fall asleep with the telly on.  If you fall into the former category, maybe have a light on in the landing.  In the case of children who are afraid of the dark, turn off the light in the room after they have fallen asleep and wean them using the little plug in lights.