No Pain in the Neck

How to Choose (and Use) A Good Pillow

Real Simple TV @—March 18, 2006

You’d think with all the hours we spend on it, the humble pillow would be the subject of countless studies.

If you’re a back sleeper, pay attention to the curve at the base of your neck.  Holly Rudnick, a senior physical therapist who specializes in the spine at New York’s Hospital for Special Surgery, recommends making a personalized support system to prevent that hyperextension: “If you roll up a towel lengthwise and you put it about a quarter of the way up inside the pillowcase, you’ve built in a neck support to use while you’re lying on your back,” she says. “That way, you can play around with the thickness of it and come to a better idea of what is going to work for you. And then if you want to go out and spend money on a prefab pillow that simulates that, you can do that.”  Another trick beyond the pillow: “If you’re sleeping on your back, generally you want to make sure the spine is in a relaxed position,” says Rudnick. “We recommend people put some kind of towel roll along the small of their back. Putting a pillow underneath your knees is another way of taking up the slack in that space between your spine and the bed.”

If you’re a side sleeper, Rudnick suggests creating a cushion for the space between your neck and shoulder. “You want to have that curve taken up and supported,” she says. “Some people can do that with just a pillow.” Choose a squishable but sturdy feather variety, she suggests. “Other people need an additional support, whether it’s a towel roll or neck rolls. And there’s an abundance of neck rolls on the market.”

If you’re what Rudnick calls a “quasi” stomach sleeper, then you have a separate prescription. “A quasi stomach sleeper is half on her stomach, half on her side,” she explains, “in which case, the bottom leg is more straight and the top leg is bent. But instead of being stacked on top of the other hip, the leg is forward and half rolling into the stomach.” For proper support in this position, she says, “you’d have a pillow under the knee of the top leg. In that case, most people don’t really need the support at the waist, but they do still need support at the neck. The idea is you want to take any twisting out of the spine while you’re sleeping.”

View an Internet version of the complete Real Simple TV article.


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