Best Pillows for Neck Pain and Neck Support, by Position

This is the cervical contour pillow most others imitate. It is a single formed piece of Tempur-Pedic's slow responding TEMPUR material in what the maker calls an extra firm feel, with a raised lobe along one long edge that sits under the curve of the neck and a shallow dip behind it for the back of the head. Tempur-Pedic describes it as following the natural curve of the body to keep head, neck and shoulders aligned, for side and back sleepers. The cover is a removable, machine washable polyester knit, and the foam is CertiPUR-US certified.

Height is chosen before you buy, and that is the whole decision. The medium profile here is 20 by 12.5 by 4 inches at the neck lobe. Amazon also sells the small profile at 3.5 inches and the large at 4.75 inches, all sold by Amazon directly. A narrow frame or a back sleeper usually wants the small or medium; broad shoulders on their side want the large. Harvard Health's description of the ideal back sleeper pillow, a rounded support under the neck with a flatter area for the head, is more or less a description of this shape.

Skip it if you move between positions in the night. A contour pillow has a front and a back and only works one way up, and stomach sleepers should not use it at all. Owners with neck pain who stick with it report a week or two of adjustment before the firm ridge feels normal, and Tempur-Pedic notes that as a personal item it cannot be returned once used.

The catch. One shape, one height, one way up; choose the profile carefully, because it cannot be returned once slept on.

RejuveNite is the consumer brand of Talalay Global, the Shelton, Connecticut plant that produces Talalay latex for mattress and pillow makers, and this pillow is made there. Talalay is a particular way of making latex foam: the liquid latex is drawn into a sealed mold under vacuum, flash frozen at minus 22 degrees Fahrenheit to lock the cell structure before it is cured, then washed in five stages. The result is a more open, more even and more buoyant foam than the simpler Dunlop process gives, and it is why Talalay is the latex people mean when they say a latex pillow feels springy rather than dense.

For a neck, latex does two useful things. It pushes back, so the head does not sink through it by morning, and it recovers at once when you turn, so there is no slow dent to climb out of. It also breathes better than memory foam. This is the queen in the high profile, which the listing measures at about 7 inches unloaded; under a head it settles to a side sleeper's height. The pillow comes with a fitted liner and a 400 thread count cotton sateen cover that is machine washable, and the latex is certified to OEKO-TEX Standard 100 class 1, the strictest class, which covers products for infants.

Skip it if you sleep on your back or stomach; the high profile is too tall for either, and RejuveNite sells lower profiles. Skip it too if you want to fine tune. A solid latex pillow is one height, and this one is firm. Owners with neck pain who like it describe the feel as being held up rather than cradled.

The catch. Fixed height and firm; the high profile suits side sleepers only, and latex has a faint rubber smell for the first days.

Pacific Coast describes itself as the leading supplier of down pillows to American hotels, and this pair is its firm, gusseted pillow for side and back sleepers. A gusset is the strip of fabric sewn between the top and bottom panels that gives a pillow straight sides like a box. Without it, a feather pillow domes in the middle and tapers to nothing at the edge, which is exactly where the neck rests. With a 2 inch gusset the height carries out to the edge, and the maker says plainly that the point is to fill the space between neck and mattress and keep head, neck and spine in line.

Feathers are the fill Harvard Health suggests trying first for a neck, because they conform to its shape, and they are the fill most people already know how to sleep on. The shell is 100% organic cotton with a double layer to keep quills in, and the down and feather are certified to the Responsible Down Standard. The listing notes that black cotton seed flecks visible in the cover are natural to unbleached organic cotton, which saves a confused return.

Skip it if you want the pillow to be the same height every night. Feathers settle, the pillow needs a shake each morning, and Harvard Health's caution that feather pillows collapse over time and should be replaced every year or so is the real cost of a $49 pillow. Skip it too if feathers make you sneeze; washing and sterilizing help but do not change the fill.

The catch. Loft drops over months and the pillow needs fluffing; feathers are the shortest lived fill here.

Mediflow says it has made the water pillow for more than 30 years, and the idea has not changed. A sealed pouch in the base of the pillow is filled from the tap through a funnel; a layer of fill sits on top, here one piece of ventilated memory foam. You set low, medium or high by how much water you add, and the water does what no fiber or foam can: it flows to wherever your head is not, so the pillow stays at the same height when you roll from back to side and back again. That self leveling is why owners with neck pain who change position in the night end up here.

Mediflow cites a randomized crossover study, which it attributes to Johns Hopkins, published in the Archives of Physical Medicine and Rehabilitation in 1997. Forty one outpatients with benign neck pain slept a week on their usual pillow, then two weeks each on a roll pillow and a water based pillow. The water based pillow was associated with lower morning pain, more pain relief and better sleep quality; it did not change disability scores. It is one small study, but it is more evidence than any other pillow on this page has. Mediflow also registers the pillow as a medical device with the FDA. The maker's fiber filled version is the design in the study; this memory foam version adds a cradling top layer over the same base.

Skip it if weight matters. Filled, a water pillow weighs several pounds and does not travel. Skip it too if you want a soft, sinking pillow; the water base is firm and the foam on top is a thin layer, not a cloud. Fill it over the sink the first time, and expect a day or two to find the right amount.

The catch. Heavy once filled, firm underneath, and the water has to be topped up and the pillow kept away from anything sharp.