Best Pillows for Back Pain

Back pain is, unfortunately, quite common among adults and children. Causes of back pain may include anything from muscle strains and arthritis to skeletal irregularities such as scoliosis. The right pillow can mitigate some of the pressure and discomfort associated with back pain — and by the same token, choosing the wrong pillow can have the opposite effect. Sleepers with back pain should consider factors like pillow size, shape, loft (thickness), and material composition when deciding which pillow will best meet their needs.

This guide explores the causes and symptoms of conditions that can lead to back pain, as well as tips for pillow buyers and our picks for the best pillows for back pain.

Causes and Symptoms of Back Pain

According to the Mayo Clinic, common sources of back pain include the following conditions:

  • Strained muscles and/or ligaments: Many people strain their back muscles or spinal ligaments through strenuous activities like heavy or improper lifting, as well as awkward movements. Individuals who are in poor physical shape are more susceptible to muscle and ligament strain, as well.
  • Bulging or ruptured disks: The disks are fibrous, ring-shaped pads that cushion each vertebra in the spine. Bulging or ruptured disks may press against nerves in the lower back, which can cause shooting pains. However, this condition may not lead to any back pain whatsoever.
  • Arthritis: Arthritis is a condition affecting joints, and the condition known as ‘osteoarthritis’ specifically targets joints in the lower back. Arthritis can also cause the spinal column to become narrower, which may lead to a condition known as spinal stenosis that commonly exacerbates back pain symptoms.
  • Osteoporosis: Osteoporosis causes pores to form in bones, making them brittle and more susceptible to deterioration. If osteoporosis spreads to spinal vertebrae, then people usually experience some level of back pain.
  • Skeletal irregularities: The most common skeletal irregularity that causes back pain is scoliosis, a degenerative condition that causes the spine to be C-shaped or S-shaped. Scoliosis patients often experience back pain, especially if their curvature is more pronounced.

Symptoms of chronic back pain may include the following:

  • Chronic muscle aches
  • Shooting or stabbing pains
  • Pain that travels down one or both legs
  • Limited range of motion and reduced flexibility

Back pain may not necessitate medical care, but the Mayo Clinic urges patients to meet with their physician if they experience the following symptoms:

  • Bowel or bladder issues
  • A fever
  • Above-average pain that occurs due to physical trauma, such as a fall

Pillow Positioning Options for People with Back Pain

Individuals who experience back pain can adjust or reposition their pillows in order to alleviate their discomfort. According to Healthline, the following methods may be suitable for different sleepers:

  • Side sleeping with a pillow between the knees. You should ensure your body makes contact with the mattress between your shoulder and buttocks. The pillow should be placed in a position where it won’t slip out; this will help the hips and pelvis align with the spine, which can reduce pain and discomfort. If a gap forms between your side and the mattress, then a smaller pillow may be used to fill that space.
  • Fetal position with both knees tucked. To achieve this position, lie down on your back and then roll onto one side with both knees bent and tucked toward your chest. Bend your upper body toward the knees; this will help expand the spine and alleviate pressure on the disks. Be sure to rotate to the other side if you begin to experience discomfort.
  • Stomach sleeping with a pillow beneath the pelvis. Although stomach sleeping can exacerbate back pain symptoms, a pillow placed under the pelvis can relieve stress on the neck and back disks. Some sleepers in this position are more comfortable without a pillow beneath their head.
  • Back sleeping with a pillow beneath the knees. Lay flat on your back and place a pillow beneath both knees. This helps straighten out the spine and alleviates pressure points between the neck and hips. If you find this is insufficient, consider placing a rolled-up towel under your lower back.

Understanding Pillow Size, Shape, and Loft

There are six standard sizes for pillows, as well as smaller specialty sizes normally associated with specific pillow types (such as orthopedic memory foam pillows). The following table breaks down the width and length dimensions of these seven sizes, as well as suitable pillowcase measurements.

Pillow SizeDimensionsPillow Case Size and DimensionsNotes
Small20W” x 12L”Specialty sizesNormally found with orthopedic/cervical pillows (see below)
Standard20W” x 26L”Standard (20-21W” x 30-32″L)The most common pillow size, as well as the most compact and usually the least expensive
Super Standard20W” x 28L”Standard (20-21W” x 30-32″L)Slightly longer than the Standard, but uses Standard-size pillowcases
Queen20W” x 30L”Standard (20-21W” x 30-32″L)
Queen (20-22W” x 30-34L”)
The second most common pillow size, and suitable for most people who toss and turn
King20W” x 36L”King (20-21W” x 36-41″L)Good for people who toss and turn, and also makes good headrests and backrests
Euro26W” x 26L”
24W” x 24L”
22W” x 22L”
20W” x 20L”
18W” x 18L”
16W” x 16L”
Euro (dimensions vary)The only standard pillow size that is square-shaped, and not normally used for primary sleeping pillows
Body Pillow54W” x 20L”
48W” x 20L”
Body pillow (dimensions vary)The longest pillow size, mostly suitable for side sleepers and pregnant women

Pillow shape is also important for people with back pain. Although a wide selection of pillow shapes are available, pillows generally fall into one of these two categories:

  • Even: These pillows have an even, non-contoured surface. They may not be as suitable for sleepers with back pain, but pillows made from certain materials (such as shredded memory foam or feathers) conform beneath the head and neck for targeted pain and pressure relief.
  • Curved: Also known as cervical or orthopedic pillows, curved pillows are usually made from foam and have a contoured surface. The neck is raised with the area for the head dips down, which can provide better support for people with neck pain — but some sleepers claim that these pillows are more comfortable when they are placed upside down on the mattress.

Lastly, let’s discuss pillow loft, a term that refers to how thick a pillow is when not bearing weight. Specific loft measurements vary by model, but there are three general loft categories:

  • Low-loft: Less than three inches thick.
  • Medium-loft: Three to five inches thick.
  • High-loft: More than five inches thick.

The loft will help determine how supportive and comfortable the pillow feels, and whether it is suitable for people with back pain. However, there are several factors to take into account when selecting a pillow based on loft. These include:

Sleep position: Choosing the right pillow based on loft depends on whether the sleeper prefers the back, side, or stomach position.

  • Back-sleepers are usually most comfortable with medium-loft pillows because they find the right balance between thickness and softness.
  • Side-sleepers often prefer medium- or high-loft pillows because this position can cause large gaps to form between their head/neck and the pillow.
  • Stomach-sleepers tend to prefer low-loft pillows because higher-loft models elevate the neck too much, causing the spine to become uneven; this can lead to aches and pains throughout the body. Some stomach sleepers find that not using a pillow at all is most comfortable.

Pillow position: People who sleep with a pillow completely beneath often prefer medium-loft pillows because there is less space. For those who sleep with a pillow partially beneath their head, then a medium- or high-loft pillow may be needed to fill the larger gap.

Mattress type: Certain mattresses, such as all-foam and latex models, are designed to sink deeply beneath the sleeper’s body. A low-loft pillow may be most suitable for these mattresses because there is less space between the neck and the mattress surface. Other mattresses, such as innersprings and hybrids, are less responsive and will not sink as much. A medium- or high-loft pillow can help fill the extra space and provide more support.

Body weight: People with above-average weights (more than 230 pounds) may sink deeper into their mattress than lighter individuals, and thus prefer a low- or medium-loft pillow that won’t elevate their heads too much. People with below-average weights (less than 130 pounds) may prefer medium- or high-loft pillows because they don’t sink as much.

Head size: People with larger-than-average heads are more likely to feel comfortable on a high-loft pillow that won’t sink too deeply. Low- or medium-loft pillows may be the best option for those with small or average-size heads

Shoulder width: People with wider shoulder spans experience larger gaps between their head/neck and their pillow, and may need a higher-loft pillow to compensate for the space. Those with narrower shoulders usually feel more comfortable with low- or medium-loft pillows.

It’s important to note that many pillows offer adjustable loft. The owner simply unzips the pillow cover and adds or removes the fill material to increase or decrease the loft. Adjustable-loft pillows may be the best option for people whose loft preferences tend to vary from night to night.

Best Pillow Materials for People with Back Pain

Pillows come in a wide selection of fill materials, each with unique benefits and drawbacks for sleepers with back pain. The table below lists pros, cons, and back pain ratings for the seven most common pillow materials.

Pillow MaterialDescriptionProsConsNeck Pain Rating
BuckwheatThe pillows are filled with five to 10 pounds of buckwheat hulls, or outer shellsAdjustable loft
Sleeps cool
Good support

 

High price
Too firm for some
Heavy and difficult to move
Good
Buckwheat pillows offer adjustable loft and sleep fairly cool, but many people with back pain find they are too firm
DownThe pillows contain the soft inner plumage of ducks or geese, and may also be padded with outer feathersAdjustable loft
Lightweight
Sleeps cool
High price
Flatten easily
Too soft for some
Fair
Most down pillows are not suitable for sleepers with back pain because they are excessively soft and will lose their shape quickly
Down AlternativeThe pillows are filled with polyester fibers that mimic the softness of real down

 

Adjustable loft
Lightweight
Low price

 

Short lifespan
Flatten easily
Too soft for some
Poor
Most sleepers with back pain do not feel comfortable on down alternative pillows because they are too soft and will become flat rather quickly
FeatherPillows are filled with outer feathers of ducks or geese (as opposed to down, or inner plumage)Adjustable loft
Lightweight
Long lifespan
High cost
Flatten easily

 

Very Good
Feather pillows tend to be firmer than down pillows, making them more suitable for people with back pain
LatexPillows contain solid latex, a substance extracted from the sap of rubber treesClose conforming
Long lifespan
Retain full shape without flattening
Non-adjustable loft
High cost
Dense and heavy
Good
Latex pillows offer even support, but the loft is not adjustable
Memory FoamPillows may contain shredded or solid pieces of memory foam, which softens when it comes into contact with body heatClose conforming
Adjustable loft if shredded
Lightweight
High cost
Sleeps hot

 

Very Good
Memory foam pillows conform closely and alleviate a high amount of pressure; most orthopedic pillows are made from memory foam
PolyesterPillows contain shredded polyfoam, which has a similar feel to memory foam, or interlocking polyester fibers that give the pillow a fuller shapeLow cost
Adjustable loft when shredded
Short lifespan
Flattens easily
Sleeps hot

 

Good
Memory foam pillows provide more pain and pressure relief, but polyfoam pillows can be a low-cost alternative for people with back pain

Additionally, some pillows contain interior water chambers that can be filled or drained to adjust the loft. The chambers are usually padded with foam to make the pillow more comfortable. Many sleepers with back pain claim that water chamber pillows alleviate pain and pressure to a noticeable extent.

Best Pillows for Back Pain: Brands and Models

Now, let’s look at the top-rated pillows for back pain. The following six pillows have earned the highest satisfaction ratings from customers and owners. To learn more about these products, visit the links in the second-to-last row of the table.

BrandCoop Home GoodsMediflowNest BeddingSnuggle-PedicTempur-PedicWonderSleep
ModelEdenThe Water Pillow (Gel Memory Foam)Easy Breather PillowUltra Luxury Bamboo Combination PillowSymphonyShredded Memory Foam Pillow
Cost (est.)$70 to $90$70$100 to $130$50 to $70$100$70 (2-pack)
Available SizesStandard
Queen
King
StandardStandard
Queen
King
Standard
Queen
King
StandardQueen
LoftAdjustableAdjustableAdjustableAdjustableMediumAdjustable
MaterialShredded memory foamGel memory foam with inner water chamberShredded memory foamShredded memory foamSolid memory foamShredded memory foam
Trial Period100 nights30 nightsLifetime
Fees apply after 100 nights
120 nightsNone (no returns accepted)None
Warranty5 years3 yearsLifetime20 years5 years1 year
AvailableAmazonAmazonNest BeddingSnuggle-PedicTempur-PedicAmazon
Tuck Customer Satisfaction Rating78% (14,214 customer reviews)87% (289 customer reviews)90% (517 customer reviews)90% (3,642 customer reviews)81% (542 customer reviews)92% (977 customer reviews)

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