Neck Arthritis Pillows and Sleep

Sleep disorders in people with neck arthritis are common. In fact, sleep disturbance affects up to 10.2 million U.S. adults with arthritis, according to a 2011 study by the National Institute of Arthritis and Musculoskeletal and Skin Diseases. The study estimated that people with arthritis (or any chronic disease) are almost three times as likely to have insomnia as their healthy counterparts.*

I spoke with two New York City physical therapists to find useful tips on sleeping with neck arthritis and was pleasantly surprised to find that at least one of these tips may even save you money.

Neck arthritis pillows
Pete Barrett / Collection:DigitalVision / Getty Images

Sleep in Spinal Alignment

Hagit Rajter, a physical therapist at the Joint Mobility Center at New York's Hospital for Special Surgery, says that when you sleep, your head should be in line with your spine. She advises you to think of your head as an extension of your spine. This means you should neither excessively bend your head forward, nor extend it back. Tilting to either side is out, too.

Rajter cautions against these movements because she says they may lead to cervical radiculopathy and/or a pinched nerve. Symptoms may include pain down one or both arms, weakness, numbness or tingling. (Cervical radiculopathy could be understood as sciatica of the neck and arm area.)

Debbie Turczan, a physical therapist and yoga instructor, agrees. "When sleeping on your side, it is important to support the neck and head so that the spine remains straight," she says.

Flat pillows are less than ideal, Turczan says. (This includes feather pillows that flatten too easily.) The reason is that a pillow that is too flat will position your head lower than your spine. Remember Rajter’s suggestion (above) of keeping your head as an extension of the spine? With a flat pillow, it’s just not obtainable.

Turczan suggests rolling up a thin towel and placing it under your neck when sleeping on your side. This will help support your neck, as well as keep it in good alignment. When sleeping on your back, Turczan suggests using a smaller towel roll under your neck, for the same reasons.

Avoid Sleeping on Your Stomach

Have you ever noticed that when you lie or sleep on your stomach you have to turn your head? This is why Rajter recommends against the prone position during the night. "Imagine what it would feel like if, during the course of your workday, you were required to maintain a position in which your neck was twisted," Rajter says. "Would you be able to hold your neck like that for a full six full hours? How would it feel? That’s what sleeping in a prone position does to your neck."

Again, Turczan agrees, adding, "Stomach sleeping is not ideal because one will need to keep their neck rotated all the way to one side or the other in order to breathe. Sleeping with your neck rotated for many hours can exacerbate neck pain."

Neck Arthritis Pillows

When it comes to pillows, there’s no proven benefit to spending a lot of money.

Although some people are convinced they need to spend upwards of $150 on a therapeutic pillow, Rajter rejects this idea as unnecessary. Instead, stick with the goal of comfort and the ability to conform the pillow to your neck space, she advises.

The main points about selecting a good pillow for neck pain are:

  • It should be wide enough to support the distance between your shoulders and your neck.
  • You should be able to shape and reshape the pillow. This is to fit it into your form in a supportive way. Rajter suggests down feather pillows.
  • For side sleepers, the pillow should be tall enough to fill in the space between your mattress and your ear.

Avoid Neck Collapse With a Collar

One way to keep your neck in good alignment during the night (i.e., keeping your head as an extension of your spine and avoiding excessive tilting, bending or extending as discussed above) is to wear a soft collar.

"Soft collars worn at night may prevent your neck from collapsing," Rajter says. This may help decrease morning pain or stiffness. “The collar is particularly good if you have chronic neck pain." Speak to your healthcare provider if you think this might make a good option for you.

*This number was the estimate before any statistical adjustment to account for socioeconomic and other variables in the subject population was made.

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  • Email Interview. Turczan, Debbie, MSPT, Physical Therapist and Yoga teacher. New York City. September 2011.
  • Louie GH, Tektonidou MG, Caban-Martinez AJ, Ward MM. Sleep disturbances in adults with arthritis: prevalence, mediators, and subgroups at greatest risk. Data from the 2007 National Health Interview Survey. Arthritis Care Res (Hoboken). 2011 Feb;63(2):247-60. doi: 10.1002/acr.20362. 
  • Telephone Interview. Rajter, Hagit, PT, MSPT, Schroth Scoliosis Therapist, Cert. McKenzie Therapist, Advanced Clinician Physical Therapist, Joint Mobility Center, Hospital for Special Surgery, New York City. September 2011.

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.