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Chronic pain doesn’t just affect us physically, it can also negatively impact our mental health. Unfortunately, back pain is a common issue and affects 75%–85% of U.S. adults at some point in their lives. While it’s always best to speak to a doctor for back pain treatment, our sleep environment can impact how well we sleep and whether or not we’re comfortable. For instance, the correct pillow can improve sleep quality by providing essential support to promote proper spinal alignment and reduce strain on the back and neck.
“The most important thing to keep in mind when sleeping with back pain is maintaining a neutral spine,” said Chris Peloquin, a physical therapist at Luna Physical Therapy in Denver. “Pillows can be used to make slight alterations in your spinal alignment no matter what position you sleep in.”
This review highlights the top five pillows for people with back pain, considering factors like support, adjustability, and affordability. Read on to find the right one for you.
Check out the video below to learn more about the best sleep positions for back pain with Nicole Hernandez, DPT. As a licensed physical therapist and NCOA reviewer, Hernandez explains how different sleep positions can ease or worsen back pain and offers expert advice on achieving optimal spinal alignment for a pain-free night’s sleep.
Research shows that the proper pillow height and support can help ease back pain and enhance sleep quality. The customizable design of the Luxome LAYR allows you to mix and match the inserts to tailor the pillow’s firmness and to meet your specific needs. If other modifications are needed, you can adjust the inserts by removing some of the material (except for the two solid memory foam layers).
We counted eight total pieces while unboxing the Luxome LAYR: the main zip-up pillowcase, two memory foam layers, one down alternative layer, one down alternative and shredded memory foam layer, and three zipper bags for storing unused layers. Our testers found the pillow feels plush yet supportive, with a loft between 5–11 inches, depending on the combination of layers used. The stitching is high-quality, and the case features a thick finish on the edges with Luxome-brand zippers.
The Luxome LAYR pillow offers four adjustable inserts to customize your firmness and loft levels. Here’s how you can use them:
Mixing and matching these inserts lets you tailor the pillow’s firmness and loft to your specific needs, ensuring proper spinal alignment and reducing back pain. Combination sleepers ⓘ People who sleep in more than one position throughout the night can configure it so one side is softer while the other is firmer, then flip it as you switch positions during the night. This level of customization makes the Luxome LAYR a good option for anyone looking for personalized comfort and support.
While this pillow features a cooling bamboo viscose cover and gel-infused memory foam, our testers noted that the LAYR did not heat up significantly during use, scoring it an “average” cooling rating.
The pillow’s multiple layers and materials make it heavier and bulkier. With so many parts and customization options, it may take some people longer to find the right setup.
While the Luxome LAYR is the priciest option in our review, we feel its benefits for back pain relief and sleep quality justify the investment.
“I love how easy it is to customize this pillow. Anyone can make it meet their needs.”
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The Brooklinen Marlow pillow has unique zippable side gussets to modify the pillow’s firmness level to three different options. You can achieve a softer feel by unzipping both zippers, a medium feel by unzipping one side, and a firmer feel by zipping both sides. While this method of adjusting firmness is more convenient and less messy than removing stuffing or inserts, it limits customization to three firmness levels (compared to unlimited levels), and the zipper can get stuck.
Our testers deem the Marlow pillow most effective for side sleepers of all body types because it provides the softest feel and highest loft when unzipped, offering good cervical alignment and a cushiony feel. Our back-sleeping testers also found the pillow comfortable in all three loft settings. We don’t recommend this pillow for stomach sleepers since the loft is too high in all settings, with our testers noting that the lift on the upper body puts pressure on the lower back.
The Marlow pillow received performance ratings of three out of five for temperature, due to its gel memory foam fill and aerated mesh on the sides, but it’s warmer than some latex pillows. It scored four out five for support, providing excellent support in all three loft settings. Comfort was rated at five out of five, with testers praising the pillow for its great neck support and cushion.
While the Brooklinen Marlow is a budget-friendly option, its firmness adjustments are limited compared to other customizable pillows, and some users may find it too soft. It also requires periodic fluffing to maintain its shape and support. Despite these minor drawbacks, the Marlow pillow offers great value and good support to prevent back pain.
“I love the neck support, and with both sides unzipped, my head just sinks into the cushion.”
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The TEMPUR-Cloud Adjustable Pillow is designed with a blend of three types of shredded foam so you can adjust the fill to achieve a balance of support and comfort. We think this feature is particularly beneficial for side and back sleepers because it helps maintain proper spinal alignment and reduces pressure points. Our testers said the pillow provided excellent neck support and contouring, making it a standout choice for back pain relief.
That said, the pillow is not ideal for stomach sleepers because it tends to provide too much lift, even with adjustments, which may cause neck and lower back strain. The cooling cover and shredded foam fill help with airflow, but it still retains some heat, which is typical of memory foam products.
The TEMPUR-Cloud Adjustable pillow earned a perfect score in our support category because it provided natural alignment without excessive lift. It also scored well in durability and comfort for being a shredded foam pillow (solid foam options are usually more durable). The pillow had no noticeable off-gassingⓘ The chemical odor given off from a new mattress; the smell is harmless and is usually gone within the first few days , and while the cover is removable and washable, Tempur-Pedic does not list any certifications for allergen resistance, which could be a drawback for some people. The pillow comes with a five-year limited warranty but does not offer a sleep trial.
This back pain pillow is moderately priced for this category. It only comes in queen or king sizes, so those who prefer a standard size will have to look elsewhere. This pillow is heavier and bulkier than a down or down alternative pillow, but its customizable design and adaptive support make it a good option for managing back pain and enhancing sleep quality.
“The foam blend contours to my body, and even though it’s a heavier material, it feels fluffy.”
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The Fox by Lagoon pillow features a shredded memory foam and polyester-blend adjustable fill, which allows you to customize the loft and firmness to your specific needs. This adjustability is particularly beneficial for back and stomach sleepers because it helps maintain proper spinal alignment and reduces pressure on the back. Our testers found that the pillow provided good neck support and cushioning. While The Fox received a four out of five for support, the pillow may require additional fill to be suitable for average weight (130–250 pounds) and higher weight (more than 250 pounds) side sleepers.
The pillow is hypoallergenic, with CertiPUR-USⓘ This is a certification given to foam bedding materials that have been tested and confirmed to be environmentally friendly memory foam and an OEKO-TEXⓘ This means it was certified as having passed safety tests for the presence of harmful substances cover. The breathable bamboo-blend cover and gel-shredded memory foam fill both enhance airflow, but the pillow does not feel cool to the touch. That said, our testers detected no noticeable heat buildup during testing.
Durability also scored four out of five, which we attribute to its thick cover and shredded memory foam. The fill may settle a bit over time, so it’s important not to lose the extra fill provided.
Off-gassing was minimal. In fact, the pillow emitted a fresh scent—versus the typical chemical odor—that went away quickly. Both the cover and inner pillow are washable, though the inner portion should only be washed once a year. The pillow comes with a 100-night sleep trial and a five-year warranty, which is longer than most pillow brands we’ve reviewed.
The Fox Pillow is priced higher than other memory foam options, but we think its benefits for sleep quality justify the investment.
“I like how the adjustable fill and flat loft provide softness while also supporting the head and neck.”
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The Sutera Dream Deep pillow features a unique butterfly wing design that helps mold to your body. This design makes it suitable for various sleep positions and helps ensure proper spinal alignment. It provides targeted support and comfort to help prevent back pain.
For side sleepers, the pillow offers good alignment through the neck support, and the butterfly wing design allows a place to comfortably rest your arms. When used on the back, our testers said the pillow feels like a cervical neck pillow used at a spa. But some lighter-weight back sleepers might find it too firm. Stomach sleepers may not experience the benefits of the neck support features, but they should appreciate a better way to rest their arms using the butterfly wing design.
The Sutera Dream Deep pillow received high ratings in our support and comfort performance categories, providing good alignment to back and side sleepers with great neck support and cushioning. The pillow has a CertiPUR-US certified foam interior, and the cover is washable.
The pillow’s high-density memory foam may retain some heat, despite its breathable cover. The foam also makes it heavier and bulkier than some other pillows on this list, so keep that in mind when you travel. This firmer pillow is not adjustable, and it’s on the pricier side, but we think its design and great support make it a good option for managing back pain and enhancing sleep quality.
“The neck support on this provides great alignment, and I love that the butterfly wing design gives side sleepers a place to put their arms.”
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Who may want to avoid it
Our Reviews Team recommends products and services we believe provide value to the lives of our readers. As we perform our in-depth research, we interview industry experts to provide the most accurate review possible.
We evaluate each pillow’s suitability for back pain by testing for firmness, support, and pressure relief. Pillows that keep the spine in alignment with lower back support will score the highest.
Firmness
Firmness is crucial in determining how well a pillow can support the neck and head, which directly affects spinal alignment. Adjustable pillows can help sleepers of all types align their spines, so we included several adjustable models in this article.
We evaluate the firmness by:
Firm mattresses can also help with symptoms associated with sciatica. Here are our best mattresses for a herniated disc.
Support
Support is a key factor in preventing and reducing back pain. A supportive pillow ensures that the head, neck, and spine remain in proper alignment throughout the night. Foam is a particularly supportive material, so you will see many pillows with foam construction in this review. We assess support by:
Pressure Relief
Pressure relief is essential for reducing strain on the neck and spine, which can contribute to back pain. We test pressure relief by:
To learn more about our testing, review our sleep methodology.
We continuously test new pillows each month to ensure we provide you with the most up-to-date information possible. Check back for regular updates.
The firmness of a pillow plays a key role in supporting your head and neck, which in turn affects your spinal alignment. If you have back pain, it’s important to find the right balance of firmness and softness. A pillow that is too soft may cause your head to sink too deeply and misalign your spine. A pillow that is too firm can create pressure and discomfort. Generally, a medium-firm pillow balances spine support and comfort best.
Pillow height, or loft, refers to the thickness of the pillow. The right loft ensures your head and neck are aligned with your spine to help prevent and lessen back pain. A pillow with too high a loft can push your head up too much, while a pillow with low loft can cause your head to drop, both leading to misalignment and strain on your spine. The ideal loft depends on your sleep position and personal preferences. Adjustable pillows offer the flexibility to find the perfect height for your neck and back. Here are the best pillows for neck pain.
When choosing the right pillow for your back pain, consider these factors for your sleeping position:
The material of a pillow affects its support, comfort, and breathability. Memory foam pillows can offer good support and pressure relief. But they can retain heat, so look for options with cooling features, like gel infusion or breathable covers.
Latex pillows provide good support and are naturally hypoallergenic, breathable, and suitable for hot sleepers and those with allergies.
Down or down-alternative pillows offer a soft feel but may not provide enough support for severe back pain, though they may be ideal for those who want comfort and adjustability.
A high-quality pillow should last between one to three years, with specialized pillows for back pain potentially lasting longer due to high-quality materials and construction. Memory foam and latex pillows generally have a longer lifespan maintaining their shape and support over time. It’s important to replace your pillow when it starts to lose its shape, becomes lumpy, or no longer provides the necessary support to keep your spine aligned.
By understanding proper pillow placement, combining pillows for extra support, and adjusting pillows for different sleep positions, you may be able to prevent or reduce back pain and improve your overall sleep quality.
The placement of your pillow can impact your spinal alignment and overall comfort. For back sleepers, the pillow should support the natural curve of your neck without pushing your head too far forward. Side sleepers should place the pillow between their ear and shoulder to keep the neck aligned with the spine. Stomach sleepers should use a very thin pillow or no pillow under their head to avoid neck strain.
Using more than one pillow can provide additional support and enhance comfort, especially if you experience back pain. Peloquin recommends side sleepers place an additional pillow between their knees to reduce tension on the spine. He also recommends back sleepers place an extra pillow under their knees, while stomach sleepers can place an extra pillow under their stomach or pelvic region to reduce tension in the lower back. Combining pillows in this way helps distribute your weight more evenly and maintains proper spinal alignment.
| Pillow type | Shredded foam and down alternative | Shredded foam and polyester | Shredded foam blend | Shredded foam and polyester | Solid memory foam |
| Cost | $120 for standard, $150 for king | $49 for standard, $69 for king | $69 for queen, $89 for king | $120 for queen, $140 for king | $99.98 |
| Firmness | Adjustable | Adjustable | Adjustable | Adjustable | Medium |
| Warranty | None | Two years | Five years | Five years | None |
Weigh factors like cost, firmness levels, trial periods, and your preferred sleeping position when shopping for the best pillow for back pain. We think the Luxome LAYR is the best pillow for back pain overall, but the other brands on this list each stand out for their own reasons. All the pillows on this list have been tested by our Reviews Team, so you can make an informed decision about which one is right for you.
The best pillow for back pain is one that offers adequate support and promotes proper spinal alignment. Memory foam pillows, adjustable pillows, and ergonomic pillows with a medium-firm level of firmness are often recommended. These types provide the necessary support to keep your neck and spine aligned, reducing strain and alleviating back pain. We chose the Luxome LAYR as our pick for the best pillow for back pain.
Yes, the wrong pillow can cause or worsen back pain. A pillow that is too soft or too firm, or one that does not provide adequate support, can lead to poor spinal alignment. This misalignment can strain your back and neck muscles, leading to discomfort and pain.
A lumbar (lower back) support pillow for sleeping is designed to maintain the natural curve of your lower spine, providing support to the lower back region. It helps to keep your spine in a neutral position, reducing pressure on the lower back and preventing slouching. This type of pillow is particularly beneficial for those who sit for extended periods or experience lower back pain.
To use a lumbar support pillow in bed, place it behind your lower back while lying on your back. This helps maintain proper spinal alignment, reduces strain on the lower back, and can ease discomfort during sleep.
When looking for a pillow to ease back pain, consider the following features:
Have questions about this review? Email us at reviewsteam@ncoa.org.
