Neck Pain Caused by Pillow


Today I worked with a client who had pretty severe neck pain, and his neck was also very stiff making driving difficult. To compound it, he’s an athlete and a fitness trainer, so exercise is a major portion of his day, and he wasn’t able to do many of the movements.

I started out by checking all of the muscles that impact the head and neck (specifically, levator scapulae, splenius capitis, splenius cervicis, sternocleidomastoin,and scalenes for anyone who is interested). All of the muscles were very tight, and his vertebrae were being pulled out toward the right side, putting a strain on his disks, the nerves coming out of the vertebrae, and even impinging on his spinal cord right at the base of his brain (causing headaches).

As I do with all neck pain clients, we started to talk about his pillow, and sure enough, it became clear that this was the cause of his problem. It’s interesting that most neck pain clients have pillow issues, so I thought it would be a good thing to share with you. Today I’m only going to talk about when you lie on your side since back sleepers have a different problem, and stomach sleepers are doing so many negative things to their neck, low back, and entire spine that the best advice there is to do whatever you need to do to stop sleeping on your stomach.

So, back to side-sleeping. Think of how your head sits properly on your neck and the rest of your spine when you are standing up straight. That is exactly how your head, neck, and spine should be aligned when you lie on your side. Your pillow needs to be the exact right thickness to keep your head in perfect alignment with your neck. If your pillow is too thin, your head is tilted down toward the mattress for hours. When you rest your head on your pillow the muscles aren’t in an active contraction, but they do shorten to the new length (tilted in this case) and they’re held there for hours, causing the muscles to shorten.

You then turn on your other side and your head tilts the other way, but the muscles from the first side won’t lengthen (due to muscle memory, but that’s another discussion) so they pull your vertebrae in that direction. It’s uncomfortable so without conscious awareness, you turn over to the original side again. Of course, this is happening every night. Most of the time it’s really subtle, but eventually the muscles are pulling so much that you feel stiff, and you may have bones pressing into your spinal cord which will cause a lot of problems, including sinus problems, eye pain, and ringing in your ear. BTW, if your mattress is too soft or is sagging, you are having problems all along your spine, including your low back.

What to do? First of all, if your muscles are really tight you can either go to a good massage therapist and have them released, or you can learn to self-treat your neck/shoulder muscles and release the spasms yourself. Many people head straight for the chiropractor’s office, but it’s important to release the muscle tension before you go to see a chiropractor. Some people will hurt worse after a chiropractic adjustment because the bones are being moved but the tight muscles are holding fast on the bone. The analogy I give is it’s like pulling your hair hard and then quickly, and with force, yanking your head in the opposite direction.

Many times, when you release the tension the bones go right back in line again and everything is just fine. However, if you are still in pain after you have released the muscle tension, it’s good to go to the chiropractor in case the bones were pulled out of alignment and made a slight turn as they moved.

Now it’s good to take a look at your pillow. First of all, I really don’t like those pillows that look like two hills with a valley in the middle. Many, many times, people come to see me with neck pain and headaches and this is the type of pillow they are using. Look at your head and neck in a mirror, there is a very slight indent where your skull goes down into your neck, but the pillow has a much larger “hill” so your head tilts into the “valley” and the “hill” presses up into your neck bones, pushing them in the opposite direction. I know I may get some people arguing that point, but I won’t back down on it because that’s been the case for so many of my clients, and it was the cause of chronic neck pain that I had suffered until I figured out this whole pillow situation.

If your pillow is too thin (such as a feather pillow), just put something in it to raise it up. It could be something as simple as folding a bath towel and putting it into the pillow case, on the side that faces the mattress. If you have a feather pillow you are getting almost no support at all so get another pillow and put the two of them into the pillowcase, keeping the feather pillow close to your face. If your pillow is too thick, just open it up and pull out some of the stuffing until your head can rest easily without your neck bending.

Then just lie down, snuggle into you pillow as if you were going to go to sleep, and pay attention to see if your head is tilted, even just a little bit. Fixing your pillow will make a world of difference!

Happy Sleeping,


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