Pillows and Matresses: What you need to know


Is my sleeping position causing me pain?

One of the most common questions we get asked is how should I sleep or do you think my sleeping position is causing this?

One of the most common injuries we see is someone that went away on holiday and then suddenly developed raging neck pain. Why? Generally a change in bed surface, pillow surface or size of pillows causes a sudden abnormal load on our neck or back. Our bodies don’t love sudden changes.

With the question “do you think my sleep position is causing my pain?” the answer is generally no but some people do get pain when lying down or get up in the morning feeling stiff and sore.

Your goal should always be to maximize your quality sleep and get a good amount to regulate your hormones and keep your nervous system healthy.

If you do struggle to get to sleep I love this sleep routine by Podcaster and human experiment extradonaire Tim Ferriss. My slightly less over the top version is phones on flight mode before entering the room, bath with Epsom salts (one cup), fiction or non fiction (nothing educational) book, apple cider vinegar with camomile tea and a dash of honey.

Now for those that struggle with pain when they sleep I will break it into the three most common issues, neck, back and hip pain and give you couple of little hacks to try.

Remember if you are already sleeping well please don’t try and change your position and obsess on having perfect posture all night when you sleep. Just enjoy your pain free sleep!

Neck pain

I had a patient last year who was advised by her massage therapist to sleep with two pillows. The following night she developed headaches for the next 5 months followed by outside hip pain.

We traced it back to this change and went back to her original position. Miraculously her headaches had disappeared. Although I’d like to claim my Physio magically fixed her I suspect it was the change back to her original sleeping position. If it ain’t broke don’t fix it!

Having said that if you really are struggling with neck pain try the following

Change the surface you are sleeping on

Change Pillows.

The main function of the pillow is to support both the head and the neck. It should therefore fill the natural hollow of the neck keeping it in a neutral position.

Try two pillows if you are currently using one.

The goal with this is to get your neck into as neutral position as possible. All necks are different.

Change the make up of the pillow

I love a latex pillow. That is personal preference but give that a whirl if your current pillow isn’t working.

If you still aren’t winning after trying 2 versus one pillows and adjusting the thickness of the pillow, try a supportive rolled up towel around your neck. This can be great when you have acute neck pain.

Roll up a small towel and place it on the inside of your pillow to maintain the neutral position of your neck or simply wrap it around your neck for support.

What about the position I am lying in could this be the source?

Again stick to the rule if you aren’t in pain and sleeping amazingly DO NOT CHANGE.

However some people love lying on their stomach with their head jammed into rotation. If your neck is a little stiff, this can cause your upper neck joints to be taken to their extreme limits which maximally compresses them. This can cause headaches and neck pain which wears off as the day progresses.

Low back pain

Some people only have low back pain when they are sleeping or when they get out of bed in the morning. If your morning low back pain is excruciating there is likely to be a surface issue with your bed. Is that mattress celebrating its 10th anniversary?  Or could a skateboarder use it as a halfpipe? Might be time for an upgrade. Remember you spend almost half your life on this structure. Don’t be afraid to invest a bit of money. Cost per use is not that much.

If you wake up in agony and your mattress is soft consider a slightly firmer mattress. If it is rock hard and you have back pain consider a slightly softer surface. On an airbed? GET OFF!

When in a bed shop don’t just lye down for 30 seconds and go yip I’l take this one. Lye down on it for a few minutes. Take your time. Roll onto the other side. Ask about warranties.


Try a koala mattress. I LOVE my koala mattress.

They give you a 120 night trial. If you aren’t happy you call them and they pick it up and refund your purchase. It’s  a medium mattress but has really improved my morning stiffness.

If you have tried different surfaces and to no joy try a lumbar roll aka a rolled up towel.

Again this can be awesome if you are suffering from an acute episode of low back pain.

Fold the beach towel in half and roll from end to end, Wind it around your waist just above your pelvis and fasten it at the front with a safety pin. The roll should fit the natural hollow in the body contour between your pelvis and your rib cage. If you lie on your back, the roll should support your low back in a slight curve.

Another condition we see that people can dread going to sleep is outside hip pain (Gluteus Medius Tendinopathy). It generally is more common in women because your hips are shaped differently to ours and particularly those post menopausal women whose tendons have become stiffer.

If you’re really struggling with outside hip pain try the following:

1.     Sleep with 2 pillows between your legs. This stops your hip going into too much stretch which compresses the tendon against the bone. Sleeping with two pillows will really help even mild hip pain.

2.     If you really prefer sleeping on that side and it’s painful to sleep on go to Clarkes rubber and get the egg shell looking soft foam. Measure your mattress length and ask for the foam to be it cut to this length.

This has really changed many women’s lives. See the link to the egg shell foam we recommend here.

So there you have it.  A few slumber hacks for some better zzz’s.

Remember if it isn’t broken please don’t try and fix it. If your mattress is starting to sag, and you think perhaps it’s time for a replacement - our advice is to replace it. Just take your time considering whether that is the right mattress for you.

Consider surface, consider size of pillows and consider structure of pillows. Still not winning? Try the neck or lumbar towel hack.

If this has helped you I would love to hear it.

Comment below and let me know which hack worked. Thanks