When No Sleeping Position Feels Right: Is It Your Pillow or Your Neck?

You start on your back, move onto your side, turn the pillow over, swap it for another one—and somehow you still cannot get comfortable.

It is a story I hear regularly from people experiencing neck pain or stiffness. Many have already tried a firmer pillow, a softer pillow, a contoured pillow or no pillow at all. Although a pillow can influence comfort and support, repeatedly changing pillows may not address every factor contributing to a restless night.

Does your pillow matter?

Yes, your pillow matters—but there is no single pillow that suits everyone. I personally like a contoured pillow and find many of my clients do too but not all of them.

Ideally, a pillow should feel comfortable and provide enough support for your usual sleeping position. Your build, mattress, preferred position and personal comfort all influence which height and firmness may suit you. Someone who sleeps on their side may need a different amount of support from someone who sleeps predominantly on their back.

Research suggests that pillow design can influence waking neck symptoms and pillow satisfaction. However, the available research does not point to one universally “best” pillow, and individual responses vary. This is why a pillow that one person loves may feel completely wrong to someone else.

Why might every position feel uncomfortable?

When your neck is already painful or sensitive, it may be difficult to find a position that feels comfortable for long. Factors worth considering can include:

• when and how the symptoms began

• your usual sleeping positions

• your pillow and mattress setup

• how your neck is moving

• sensitivity in the surrounding joints and muscles

• recent changes in work, exercise or daily activity

• a recent injury or an underlying health condition

This does not mean that everyone who struggles to get comfortable needs treatment. An occasional restless night is common. However, if neck pain or stiffness is persistent, worsening or regularly disturbing your sleep, it may be worth having it assessed rather than continuing to buy different pillows.

What happens during a neck assessment?

An assessment begins with a conversation about your symptoms. This may include when they started, what aggravates or eases them, whether they travel into your arm, and whether you have noticed headaches, numbness, weakness or other changes.

I may then assess relevant neck movement, joints and muscles and consider how the findings relate to your symptoms. If chiropractic care is appropriate, an individual management plan may include advice, exercises, hands-on care or other techniques. If the assessment suggests that another type of care or further investigation is more suitable, I will discuss referral options with you.

The purpose is not to promise a perfect night’s sleep or insist that your pillow is irrelevant. It is to consider the wider picture and help you make more informed decisions about your neck and sleeping setup.

A few practical pillow considerations

1. Start with comfort. A pillow that feels immediately uncomfortable is unlikely to become your favourite after several restless nights.

2. Consider your usual position. Your pillow should support your head and neck without feeling excessively high or low.

3. Remember the mattress. How deeply your shoulder and body sink into the mattress changes the amount of pillow height you may need.

4. Change one thing at a time. Swapping pillows and positions repeatedly can make it difficult to work out what is helping.

5. Do not ignore persistent symptoms. A pillow is not a substitute for assessment when pain is ongoing, worsening or accompanied by other concerning symptoms.

Tired of the nightly pillow rotation?

If neck pain or stiffness is making it difficult to get comfortable, you are welcome to book an assessment using the ‘Book Now’ button. We can look at what may be relevant to your symptoms and discuss an appropriate plan based on the findings.

References

• Chun-Yiu JP, et al. The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: a systematic review and meta-analysis. Clinical Biomechanics. 2021. https://pubmed.ncbi.nlm.nih.gov/33895703/

• Gordon SJ, Grimmer-Somers K, Trott P. Pillow use: the behavior of cervical stiffness, headache and scapular/arm pain. Journal of Pain Research. 2010. https://pubmed.ncbi.nlm.nih.gov/21197317/

Why the Base of Your Skull Gets So Tight (And What You Can Do About It)

Do you ever feel like your head is “heavy” by the end of the day?

A lot of people carry tension in the small muscles at the base of the skull without even realising it. This area often becomes overloaded from:

• desk work

• stress and tension

• driving

• long hours looking at screens

• clenching or jaw tension

When these muscles stay tight, people may notice:

• neck stiffness

• tension headaches

• reduced neck movement

• discomfort turning their head

• that constant urge to rub the top of their neck

Many people instinctively try stretching by pulling on their neck, but sometimes the muscles at the base of the skull respond better to gentle pressure and movement instead.

One simple technique I often recommend at home involves using a ball at the base of the skull and slowly moving across the tight muscles.

How to try it at home

• Place a massage ball (or similar soft ball) at the base of your skull while lying on your back - see images below

• Slowly roll side to side along the muscles

• Pause and hold on any particularly tender spots

• Return to the middle

• Slightly tuck your chin and repeat to target different muscles

• Repeat on the opposite side

• You can also use your forearms on your forehead to apply extra pressure

Many people find slow, controlled movement works best here.

If any exercise reproduces dizziness, numbness or sharp pain, stop and seek professional advice.

Why this area matters

The muscles at the top of the neck work hard throughout the day helping support and stabilise the head. Poor posture isn’t the only reason these muscles tighten — stress, fatigue, jaw clenching and prolonged concentration can all contribute too.

Sometimes the muscles themselves are tight and overloaded. Other times the joints of the neck may also become stiff and restricted.

This is one reason why people often feel temporary relief from stretching or massage, but the tension keeps returning.

Chiropractic care for neck tension

Chiropractic care may help improve movement and reduce tension in the neck and upper back. Depending on the individual, treatment may include:

• gentle joint mobilisation or adjustments

• soft tissue work

• dry needling

• posture and ergonomic advice

• exercises and movement strategies

The goal isn’t just short-term relief, but helping people move and feel better day to day.

If your neck constantly feels tight, heavy or restricted, it may be worth having it assessed properly rather than just pushing through it.