Recently one of my patients attended exhausted and frustrated with her worsening neck pain and headaches. She looked at me and declared, “we need to have THE TALK”. The pillow talk is what she was referring to, as surely a new pillow would ease her pain.
On September 20, 2017, Statistics Canada released a report indicating that up to 1/3 of Canadians are not sleeping well, or long enough. The reasons leading to poor sleep can be complex and multi-factorial – but sometimes it is because of pain.
In our physiotherapy clinic, we often find ourselves talking about the “Pain in the Neck” that continues through the night and interferes with quality and duration of sleep. Many of our patients have historically slept very well and they arrive at our office pretty motivated to find a solution to their night time neck pain and restore their restful sleep! Lack of sleep makes us tired and grumpy and our brains simply don’t function as well the next day. Not to mention that sleep deprivation is known to increase pain sensitivity.
The causes of neck pain vary. Neck pain can appear suddenly, such as a whiplash after a car accident or develop gradually in response to poor posture and long hours at the computer. As a result, treatment programs and recommendations need to be specific to the diagnosis. However, everyone with neck pain needs to find that restful pain free position when they go to bed so they can achieve the coveted goals of falling asleep, staying asleep and waking refreshed.
This can be a challenge when nothing seems to work and there is no position to ease the neck pain for sleep. We are often asked “Will a new pillow fix my neck pain?” or, “What is the best pillow to buy?” These tough questions do not have simple answers that are one size fits all. After all, every “body” is different and a new or different pillow may or may not be the answer.
Before heading out to the new pillow store looking for a quick fix, I ask my patients to think about 3 things:
In our modern day life we spend a lot of hours in the day doing activities, or lack of activities that cause our bodies to be stiff by the end of the day. Bending, lifting, driving, sitting, hunching and on goes the list. Once evening comes and we are tired, stiff and sore, we tend to sit some more – in front of the TV or our computers. Off to bed we go, and those stiff spines may not be able to relax into a neutral position that allows for pain free sleep.
Solution: try light stretching before bed. Keep a yoga mat or Styrofoam roller in your TV room and wind down before bed on the floor with some stretches rather than slumped on the couch.
Not only will stretches ease the built up tension in your spine, shoulders and neck, but it enhances good breathing patterns, which in turn enhances sleep.
Do you go to bed with your laptop? iPad? Phone?
Solution: stop doing that. There just is no good way to work in bed, and eliminating this habit is a big step towards a healthier neck.
Do you sleep on your stomach?
If you are a stomach sleeper and have neck pain during the night or in the morning, chances are you will feel better if you can change this habit. It can be tough to change a sleep habit, but be persistent and you can train your body to be comfortable on your side or back.
Back and side sleeping positions are generally considered the best to keep the head, neck and spine in neutral alignment and facilitate a pain free sleep.
When lying on your back, a thinner pillow is required so that the head is in line with the body and not lifted above chest height by the pillow thickness. Side lying requires a pillow that keeps the head in line with the spine and also gives support to the “hollow” between the shoulder and the neck. This is where choosing the right pillow can get tricky and patience is needed to figure out what material, size, thickness and density works best for you.
If you go to bed with neck pain, but gradually get comfortable, sleep through the night and wake up feeling less pain – chances are you do not need to change your pillow or your sleep positions. Your priority should be to work on lessening your neck pain before you go to bed.
But if you can’t get to sleep, or wake up with pain, it is worth looking at the pillow, in conjunction with the back or side sleeping positions. Most people have numerous pillows in their homes and I suggest bringing a selection of pillows to your bedside. Take a few days to rotate through the pillows and note which pillow results in a more restful sleep and less pain or headache on waking. It may be that you have the right fit already in your home.
Is it time to go shopping? If you don’t have the right pillow, you can still benefit from evaluating your existing pillows. The exercise will help identify which qualities in a pillow will and will not be good for you. Note the thickness, height, firmness, shape, material of each pillow that you tried. Eliminate the features of pillows that resulted in your worst nights and focus on the features of the pillows that provided you with some improvement. Looking at the research, there is some evidence to suggest that latex pillows are best to control neck, shoulder blade and arm pain upon waking.
So, will a new pillow help neck pain? Maybe! Use thoughtful analysis of your existing pillow, consider a latex pillow if purchasing new and make sure your position on the pillow is ideal. Consider stretching before bed – your physiotherapist can help design a routine that is specific to your needs!