In this article I would like to give my point of view on a very controversial topic, which many people ask about and at some point in our lives as physiotherapists we have had to give an opinion: the pillow at bedtime.

There is much discussion about the use of the pillow, there are professionals who recommend it and those who do not. What is certain is that the pillow has become part of a “custom” since since childhood we have grown up with the belief that to sleep “you need” a pillow and since then, its use has become “indispensable”. And although there are certainly patients who deserve the use of a pillow to sleep, it does not mean that we should all use it, much less always, that it is beneficial. Next we will explain more about it.

Is a good pillow important to avoid cervical problems?

Many patients ask me this same question to find out if it is important to change the pillow to improve a cervical problem. My answer is usually: “is it good that you usually walk with a cane or a crutch?”. Patients are thoughtful, and most of them tell me something like: “Depends If I had a limp or if I had a problem with my leg, obviously a cane would be good; but if my health is good, why would I want a cane?

Just as it happens with this cane analogy, it should happen with the use of the pillow. Pillows when sleeping are not necessary for children and people with a healthy and flexible cervical spine, since the pillow is not a necessary element for the cervical spine to maintain its physiological curvature. But the reality is different: we are used to sleeping with a pillow from an early age, a habit that generates a dependency. In people with this habit, despite the fact that physiologically the pillow is not necessary, the pillow is felt as essential, many may even complain of not falling asleep or having had a bad night sleeping without a pillow.

What is the best pillow for me? Hard, soft, high, low, anatomical, latex.

Before you decide to buy an expensive or luxurious pillow, watch this video. Here we show you which is the best type of pillow to sleep, rest and take care of your cervical vertebrae and your neck.

But when is the pillow necessary?

The pillow only becomes necessary when cervical stiffness begins to set in with certain levels of osteoarthritis and with the neck and head forward. This indeed happens too often today in our modern society, partly due to stress and our postural attitudes at work. As a consequence, the use of a pillow becomes very common and even necessary, as thick as the cervical problem has evolved.

which is better: a hard pillow or a soft pillow?

The truth is that as in the case of mattresses, it is an unanswered question. It all depends again on the person, their postural characteristics, their sleeping position and even the type of pillow they have already become accustomed to.

It is important, therefore, to put everything in its place, that is, reduce cervical stiffness, reduce stress and learn the best postures to adopt at work, physical activity, activities at home, etc. If we do not restore the integrity of the cervical spine first, we can go “crazy” looking for a pillow of one type or another to improve your neck, but it does not matter which pillow we buy: none can offer us the solution to pain.

What about special ergonomic pillows?

Well, there are a large number of ergonomic pillows and products on the market, whether for work or sleep. Soft pillows, hard pillows, large pillows, small pillows, Many of these products have really been designed by ergonomic experts to provide comfort during resting hours or even while driving, or sitting in the office chair; but many others are equally only designed to produce high profits in the companies that produce them. The benefits of using these products between them (that is, whether or not they are designed by experts) do not make any difference, and they may not even solve your cervical or lumbar problem.

From Physiotherapy Online what we advise you is to consult with a physiotherapist. He will analyze your body structures, the activities you do every day and then he will be able to propose a solution to your problem, of course taking into account what can benefit your cervical spine and your sleeping preferences.

Which mattress is better for health?

To address this issue, I would give at least another full article, since it happens similar to the pillow: there is no professional who can recommend which is the ideal mattress for you or for your back, only you yourself will know when you rest on this. Mattress and pillow companies advertise all kinds of things, adding multi-year guarantees to mattresses, making them out of countless different materials, etc., and some seem to be more comfortable, better quality, or more durable than others; but the ideal mattress for you is based on your own body.

What is the best mattress for my back? Hard, soft, latex, foam, springs

Do you want to know what the ideal mattress is so that you can sleep all night while taking care of your back? In this video I am not going to explain to you which is the best mattress for your back pain and you will see why.

What is the ideal posture if I want to rest and not put my back at risk?

There are studies that affirm that the best sleeping position is on your side, with a pillow between your legs, but the truth is that answering this question with this statement would not be completely correct, since the sleeping position is extremely relative and depends on the comfort of each person.

What is the best sleeping position? Face up, face down, side.

Watch this video to find out what is the best position to sleep, something that is very subjective and relative.

We always want you to give us the recommendations of the correct posture, as well as the right pillow or mattress to sleep without damaging your back or neck. It is much better to take into account the postures you adopt during the day, so that at night you can sleep in the most comfortable way that you think.


There are repeated questions such as what type of pillow is ideal for sleeping? Or what pillow do you recommend for my cervical problem? And what is the ideal mattress for my back pain? Only you can answer all of them, because rest and comfort will only be felt by you, whether you sleep with or without a pillow (which in fact were not used in ancient times) and therefore do not follow the physiology of the body.

Whether it’s with pillows or mattresses of different types or materials, it doesn’t matter: if you attribute your poor sleep to this, you must experiment yourself and you will feel the differences in the short term.

Once you have known this information, its pros, cons and our recommendations, you will be able to discern for yourself if it is really necessary to use the pillow when sleeping or not, always remembering that the most important thing is the health and well-being of your body.

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