© 2019 by Spinal Symmetry Pty Ltd


How to choose the perfect pillow for You!

August 16, 2016

One of the regular questions we receive at the clinic is about pillows. Which is the best pillow? How do I sleep on a pillow correctly? How much should I spend on a pillow? All of which are really good questions.

However, the issue is that every body is different. We have different neck alignment, sleep in a different positions, use different mattresses, we are different sizes and so on.


You need a pillow, which is perfect for YOU! This article is going to go through all the different aspects so you can pick the perfect one.


We spend a third of our lives sleeping and hence that time is spent on a pillow. An incorrect pillow can exacerbate many of the underlying problems that can causing headaches, neck pain, shoulder and arm discomfort, numbness and can even effect breathing and be a factor in snoring.


The goal of using a pillow is to keep your head in a ‘neutral alignment’, meaning your head should sit squarely on your shoulders without bending back or forward.




So when should you change your pillow? There are 4 main factors that affect when you should change your pillow. They are time, support of the pillow has, how you feel on the pillow and the health of the pillow.

  • Time: You need to change your pillow at least every 18-24 months.

  • Support of the pillow: A pillow needs to be able to do its job the whole time you have it. To test this you can do the fold test and the lump test.

  • Fold test: If your pillow is made from natural material, fold the pillow in half and then let go, it should slowly regain its normal shape. For synthetic materials, the pillow should spring back quickly and with at least a little force. In memory foam pillows it may be harder but if you place your hand in the middle of your pillow, it should give, but not all the way to the bottom. When you remove your hand the pillow should return to its normal shape.

  • Lump test: Place your pillow on a flat and even surface and see if there are any lumps throughout the pillow. If your pillow fails either of these tests its time for new pillow.



  • How you feel on the pillow: Do you have to wake during the night to rearrange or move your pillow? Do you wake feeling refreshed and pain free, or are you waking fatigued and tight in the neck and back. If so its time for a new pillow.

  • Health of the pillow: Are there any signs of odour, mildew, dust mite infestation or bacteria. If there is its time for a new pillow because these can lead to allergies or respiratory issues.












When you go to buy a new pillow the most important factor in deciding the type of pillow is the style of sleeper you are. The height of the pillow needs to be different for every style to maintain a neutral alignment.




So which sleeping style do you have?

  • Sleep on your back (back sleeper):  A thinner pillow is required than the other positions so your head is not positioned too far forward. You can also look for a pillow with extra lift in the bottom third to cradle your neck and follow the curve of your spine. Most people will need a low to medium thickness pillow.

  • Sleep on your side (side sleeper): A firmer pillow to fill in the distance between your ear and the outside shoulder. Most people will need a medium to high thickness depending on your body size; you should also try to put a low-density pillow between your knees, which helps to align your hips.

  • Sleep on your front (tummy sleeper): A very thin, almost flat pillow. This position is the least ideal position to sleep in as it places the most pressure on your spinal alignment. To try and relieve this pressure you can place a pillow under your stomach. This not only takes the pressure off your spine, but you can slowly increase the size and amount of pillows under your body in an attempt to break the habit and become a side sleeper.

  • Mixture of all or some of these (mixed sleeper): choose a medium thickness pillow and one that is easily moldable to your head and neck as you change positions through the night.



So now knowing which type of sleeper you are, and the thickness and height the pillow you need should be. What type of filling should your pillow have?


  • Foam:  The higher the density the less breakdown and the more support you will have.


  • Memory Foam: Reduce pressure points by continuously molding and adjusting to the shape of your body. They are usually firmer and higher then other types of pillows so may not be for everyone. They can also have a smell to begin with and they are not very good for ventilation so can retain body heat and be hot.




  • Latex: Firmest type of pillow, which also resists mold and dust mites. Cooler and more airy than memory foam so good for hot people. Due to being the firmest they are also the heaviest and fixed in shape, so if you change positions it is not the best. You need to ensure you use the right height for you.





  • Wool/cotton: hypoallergenic and are quite firm. Depending on the quality of the pillow they can clump together and form lumps.






  • Down/feather: Its soft yet firm enough to give you support and you can move the stuffing around to mold to your head. They don’t usually offer enough support for side sleepers however. They also need to be regularly fluffed and shaken to get the pillow back into its correct shape. Also not good for allergy sufferers. They do feel the softest and most luxurious out of all the pillows, however poor quality pillows won’t last.






  • Synthetic: Are relatively cheap, lightweight and good for people with allergies. They are easy to bend and scrunch to get in the position in which you are most comfortable, however they do flatten quiet quickly and the filling can clump together and get out of shape.






Cost is an important factor, although avoid very cheap pillows because they will not last they will loose their support quickly and will need to be replaced quicker. Also the top end pillows are not always the best either. As you can see you need a pillow that suits YOU! So don’t just buy the most expensive, you need to try all the different priced pillows.


The best way to feel how the pillow is for you is to actually try it out in the store. If there are mattress in the store lie on the bed and get into the position you sleep with the different pillows and see how they feel. If there aren’t mattresses take the pillows to a wall and lean against the wall like a vertical mattress, again in your sleep style and again feel how it is. You can also have someone look at your neck and head and see if they are in aligned.





In February 2011, the website ‘Choice’ surveyed more than 1000 Choice members who had bought a pillow in the past five years, they found that people who tried out the pillow in the store were more likely to be satisfied with their purchase then those who didn’t (1). If neither of these options for testing the pillow is suitable ask the shop what their refund policy on pillows is. You may find that many stores will allow you to take the pillow home and try it in your bed if you keep the plastic on the pillow to protect it.


These tips and matching the perfect pillow to your body type and sleeping type will not only save you money and time but it will also save your neck and head from many strains and aches that can occur from a bad pillow.


So what about when you are undertaking Dynamic Therapy before you go to sleep in bed? As we have just seen if you lie on your back you need a certain style of pillow and if you lie on your side you need a different style. While you are using the Dynamic Therapy strap you need to be on your back for at least 30 minutes. So in this position you should have a pillow that can support your head and neck and not place too much strain on the body. Then once the 30 minutes is over you take off the strap and get into your most comfortable position to sleep. If this is on your side you may need to swap pillows to a higher pillow to fully support your neck.

Some things not to do while you’re undertaking Dynamic Therapy:

  • Sit up in bed as this places too much pressure on your pelvis and won’t be achieving the results we are after.

  • Lie with a large or multiple pillows under neck, which lifts your head into a forward flexion position (nodding). This places a lot of strain to the back of your neck and also closes your airways.



A better way to be able to either read a book or watch TV while using the Dynamic Therapy strap is to use multiple pillows to create a wedge like effect, place one under shoulder and then one on the top third of that pillow to support your neck. This will lift your head and shoulders together forward so you can see in front of you and not place too much load on the neck or the pelvis.






    If you need a slight angle under you knees while your using the Dynamic Therapy strap use a thin pillow instead of a large one. This same pillow then can be used to be placed between your knees if you sleep on your side once the Dynamic Therapy session is over.



The take home message is to think about your body when looking for a pillow. You’re the one who will be sleeping on it every night and you need to get the support and comfort you need. By following these tips, they will help you in getting the rest you need at night and waking up refreshed and ready to go.

If you are unsure as to what is best for you, you can always talk to one of the practitioners at Spinal Symmetry and they will be happy to help.




  1. https://www.choice.com.au/home-and-living/bedroom/pillows/articles/satisfaction-survey E McCluskey. 28th Feb 2011. “Which pillow should I buy?”








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