If you’re waking up with a stiff neck, tight shoulders, or an achy upper back, your pillow may be the quiet culprit. Most people assume pain comes from stress or a bad mattress, but the wrong pillow can throw your entire spine out of alignment overnight. A pillow that’s too high, too flat, too soft, or simply worn out forces your neck into awkward angles — and your muscles spend the night fighting to compensate.

The right pillow should support the natural curve of your neck, keep your head aligned with your spine, and allow your muscles to fully relax. When it doesn’t, you feel it the next morning.

What to Look for in a Pillow

1. Proper Loft (Height)

• Side sleepers: need a higher loft to fill the space between shoulder and ear.
• Back sleepers: need a medium loft to keep the neck neutral.
• Stomach sleepers: need a very low loft (or no pillow at all) to avoid neck strain.

2. Firmness That Holds Its Shape

A pillow that collapses overnight forces your neck to crane. Medium-firm or supportive memory foam/latex tends to maintain alignment best.

3. Material That Supports — Not Sinks

• Memory foam: great for contouring and stability.
• Latex: supportive, buoyant, and naturally cooling.
• Down/feather: cozy but often too soft for chronic neck pain.

4. Ergonomic or Cervical Design

Contoured pillows cradle the neck and help maintain a neutral spine, especially for back and side sleepers.

5. Adjustability

Pillows with removable fill let you customize loft and firmness — ideal if you’re not sure what height you need.

3 Top Pillows for Neck & Back Support

1. Tempur-Pedic Tempur-Ergo Neck Support Pillow

A classic for a reason. Its contoured shape supports the natural curve of your neck, and the firm memory foam keeps your head aligned all night. Excellent for side and back sleepers who wake up stiff.

Best for: chronic neck pain, side/back sleepers, firm support lovers.

Amazon $129.00

2. Eli & Elm Side Sleeper Pillow

Designed specifically for side sleepers, this U-shaped pillow fills the gap between your head and shoulder, reducing neck strain. The adjustable loft and breathable materials make it supportive without feeling heavy.

Best for: side sleepers, shoulder pain, people who run warm at night.

Amazon $114.00

3. Coop Home Goods Original Adjustable Pillow

A fan favorite because it works for almost everyone. You can add or remove shredded memory foam to get the exact height and firmness your neck needs. It’s supportive, customizable, and great for combination sleepers.

Best for: all sleep positions, people unsure what loft they need, couples with different preferences.

Amazon $89.00

Also check out this article from Forbes from best pillows.

And here is Good Housekeeping’s 11 best pillows.

Sleep Posture Tips for a Pain‑Free Neck & Back

Keep Your Spine Neutral

Your ears, shoulders, and hips should line up in one straight line. If your head tilts up or drops down, your pillow is the wrong height.

For Side Sleepers

• Use a higher‑loft pillow to fill the space between your shoulder and ear.
• Place a pillow between your knees to keep hips aligned.
• Avoid curling into a tight fetal position — it strains the neck.

For Back Sleepers

• Choose a medium‑loft pillow that supports the natural curve of your neck.
• A small pillow under the knees can ease lower‑back tension.
• Avoid overly thick pillows that push your chin toward your chest.

For Stomach Sleepers

• Use a very thin pillow or none at all to prevent neck twisting.
• Place a pillow under your hips to reduce lower‑back strain.
• If possible, transition to side or back sleeping — it’s easier on the spine.

Replace Pillows Regularly

Most pillows lose support after 18–24 months. If it’s lumpy, flat, or you’re constantly folding it, it’s time for a new one.

Check Your Shoulder Position

Your shoulder should rest on the mattress, not on the pillow. If your pillow pushes your shoulder forward, it’s too big.

Watch Your Phone Use in Bed

Looking down at a screen before sleep strains the neck and makes pain worse by morning.