Which pillow is right for me?

Using a traditional pillow either between the knees (when sleeping on the side) or below the knees (when sleeping on the back) is important to alleviate strain on the lower back.

For sleeping on the side

When sleeping on the side, bending the knees and placing a pillow between the knees prevents the knees from coming together and keeps the spine in the neutral position. When there is no support between the legs, the upper leg rotates downward, pulling the pelvis, and distorting the natural line of the spine (this is a useful tip for those that get pelvis pain and can really help during pregnancy). Adding support between the knees can prevent back pain induced by these types of forces and allow the back to heal and properly rest while sleeping. Usually, a firm pillow between the knees works better than a softer pillow because it serves somewhat as a kickstand to keep the upper leg from rotating over the lower leg.

For sleeping on the back

When sleeping on the back, placing a pillow underneath the back of the knees helps reduce the load on the lower back. Some people even prefer to have two pillows to elevate their knees higher. With two or more pillows underneath the knees, the lumbar spine is flattened, putting less force on the pain sensitive facet joints of the spine. This position is the best overall to help the back rest comfortably, and many people find that this is the only way they can sleep during a severe bout of back pain or while recovering from spine surgery.

Body Pillows

A pillow that is as long as the body can serve several functions for people who prefer to sleep on their side, as the top portion can be used to support the head and neck, while the bottom portion supports the knees and legs. Some people find this more comfortable than using separate pillows for the head and knees. In particular, women who are pregnant may find that a body pillow that provides added support for the abdominal area helps them rest comfortably. Throwing the top leg over the body pillow while side sleeping should be avoided, as this places torque (twisting force) on the lower thoracic and lumbar spine.

Lower Back Support Pillows

A lower back support pillow helps provide support for the inward curve in the lumbar spine. Sitting for extended periods of time without any lower back support can create muscle tension and pain in the lower back and legs (e.g. sciatica). Used when in a seated position, a lumbar support pillow fills the natural gap that is created between the lower spine and the chair. Lumbar back support is also helpful when sitting in a car. When the lumbar curve is supported, the downward forces of gravity and driving are absorbed much like a coiled spring, as opposed to a non-supported straight or slouched lumbar spine.

Summary of Pillow Support and Comfort

Use of a variety of pillows for both comfort and support can make a big difference in alleviating or avoiding back pain and getting a good night’s sleep. For people with spinal disorders, the right type of support can be especially important in helping the spine rest comfortably. For example, most down or feather pillows offer very little structural support compared to pillows filled with firmer materials. People who suffer from moderate or severe spinal disc degeneration, spinal stenosis, myofascial pain, or trauma often seem to experience a more restful night’s sleep with a firmer pillow.