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Best Pillow for Back Pain 2025

After researching and testing the best pillows on the market, we recommend the Layla Kapok Pillow for back pain relief.

Product Resources
  • We recommend the Layla Kapok Pillow because of its high-quality feel and excellent pain relief.
  • The pillows in this article range from $65–$165.
  • Other top picks are the Luxome LAYR pillow, the Saatva Latex pillow, the TEMPUR-Symphony Pillow, the Fox by Lagoon Pillow, and the Brooklinen Marlow Pillow.

NCOA supports everyone’s right to age well. So we take the time to research, test, and recommend products that can help you live a healthier life. We’ve spent more than 2,500 hours researching and testing mattresses and pillows to give you the most accurate product reviews. To find the best pillows, we: 

  • Consulted with sleep specialists like doctors, occupational therapists, and physical therapists for guidance on choosing the best pillow
  • Put more than 25 pillows and mattress toppers through a series of 17 different tests at our in-house lab
  • Mystery-shopped more than 20 brands
  • Surveyed more than 2,000 older adults on their sleep quality
  • Interviewed experts on the importance of good sleep for older adults
  • Worked with older adult testers to evaluate pillows and get their opinion
  • Read thousands of verified customer reviews

We’re constantly testing new pillows and sleep products to give you the most accurate and up-to-date recommendations. Read more about our pillow review methodology.

When you have back pain and are trying to get a good night’s sleep, the first thing that usually comes to mind is the type of mattress you’re sleeping on. After all, the best mattresses for back pain have the potential to help ease your back pain and relieve pressure on your back. But if you’re not in the market for a new mattress or you have one you like but are still experiencing pain, getting a new pillow can help improve your rest.1 The right pillow is important for keeping your neck, shoulders, and spine aligned, which can help reduce pressure buildup and minimize pain.

In our review, we highlight the best pillows for back pain and explain how they made our list. We also provide guidance on how to find the best pillow for your unique needs.

Our Top Pick

Layla Kapok Pillow: Best Overall

Two Layla Kapok pillows on a bed.
  • Great pressure relief and support
  • Adjustable filling
  • High-quality materials
  • Suitable for all sleeping positions

Saatva Latex Pillow: Best Luxury Pillow

A Saatva Latex pillow on a white background
  • Luxurious feel
  • Soft, but still provides good support
  • Helps ease pressure on the back

Luxome LAYR: Best Adjustable Pillow

A Luxome LAYR pillow on a grey background
  • Adjustable with three types of inserts
  • Most customization options
  • Helps ease back pressure

Best pillows for back pain in 2025

Comparing the best pillows for back pain

Comparison Features
Score (out of 10)

9.7

8.7

9.3

8.1

8.3

9.4

Best for

Overall

Luxury

Adjustable

Back Sleepers

Softness

Cooling

Fill material

Memory foam

Latex

Down alternative and memory foam

Memory foam

Memory foam

Memory foam

Adjustability and loft height (inches)

Adjustable; 7''

Not adjustable; 5–7''

Adjustable; 9.5''

Not adjustable; 6''

Adjustable; 8''

Adjustable; 5''

Free trial period (nights)

30

45

30

0

100

365

Warranty

Yes

Yes

No

Yes

Yes

Yes

What we look for in a pillow for back pain

We looked for the following features when choosing the best pillows for back pain:

Spinal alignment support

A pillow should help maintain the natural curve of the spine, especially at the neck and upper back.

Adjustability

People with back pain often benefit from fine-tuning their pillow height and firmness based on their pain level and sleep habits.

Loft (height)

Loft refers to how high the pillow is. The right loft should keep your head and neck aligned with your spine.

Firmness level

The right firmness balances comfort and structural support for your head, neck, and upper back.

Layla Kapok Pillow: Best Pillow Overall

We chose the Layla Kapok Pillow as our Best Pillow Overall because of its combination of softness and support. This pillow offers a plush sleeping experience that helps keep the spine aligned for back, side, and stomach sleepers. With its adjustable interior and affordable price, we think the Layla Kapok pillow would be a good choice for most sleepers with back pain.

Our Top Pick

Layla Kapok

Best Pillow Overall
Two Layla Kapok pillows on a bed.
  • High-quality, plush feel 
  • Adjustable filling provides a customizable sleep experience
  • Excellent choice for back, side, and stomach sleepers
  • Fill material: Shredded memory foam and kapok fibers
  • Adjustability and loft: Removable fill, 7''
  • Firmness level: Adjustable firmness
  • Free trial period: 30 nights
  • Cooling: Breathable cover
  • Shape: Traditional rectangle

Why we chose the Layla Kapok as the Best Overall Pillow for Back Pain

We chose the Layla Kapok as the Best Overall Pillow for Back Pain because it provides excellent neck support, spine alignment, and a customizable sleep experience for a reasonable price (it’s the second-least expensive pillow on this list, after the Brooklinen Marlow Pillow). It earned 4/5 and 5/5 across all our testing categories, earning it a near-perfect 9.7/10 overall. We also like that they offer a 30-day trial and a 5-year warranty (ties for the longest warranty on this list), which makes it easier to try this pillow without feeling like you’re stuck if you don’t like it.

Layla Kapok pros and cons

Pros

  • Extremely supportive
  • Adjustable loft and shape
  • Long warranty (five years)
  • High-quality feel
  • Second-lowest price on this list

Cons

  • Not very cooling
  • Pillow comes with limited information on how to contact customer service

Our testing experience with the Layla Kapok

When our testers received the Layla Kapok, they were impressed by the pillow’s feel. “This is a very well put together pillow,” one tester said. “The cover has almost a jersey sheet feel to it, and I would be comfortable sleeping on it without a pillow case on it. It has cooling and breathable properties, which I notice as soon as I put my head on the pillow.”

And once our testers lay down, they liked how the pillow conformed to their body while supporting their spines. “Even though this pillow is one of the softest I’ve tested, there is still pretty good support within it,” one tester said. “I felt really comfortable as soon as I laid down on my side, and my neck and shoulders were aligned with my spine even though you sank quite a bit into the pillow.”

Testers said lying on their back with the Layla Kapok was the best position and provided even more support. “When I was on my back the sides of the pillow came up and hugged around my neck and allowed for more support,” one tester said. “Even on my stomach, my cheek was sinking in enough that I didn't have any strain on my back or my neck.” Keeping the spine aligned is important for minimizing pressure points and relieving back pain.

A tester displays the shredded memory foam filler of the Layla Kapok pillow.

Because the Layla Kapok is adjustable (you can remove as much of the shredded memory foam inside as you want), you can customize it to your preferred firmness. That also makes the Layla Kapok a good candidate for back, side, and stomach sleepers. 

We also like that the Layla Kapok is filled with a mix of shredded memory foam and kapok fibers. Kapok is a natural fiber that resists moisture, dries quickly, and resists compression over time.2

The Layla Kapok pillow is not as cooling as other options, so you might find it uncomfortable if you are a hot sleeper. Testers also noted they would have liked to see more information on warranties, returns, and other policies with their pillow. Instead, they had to search online for this information, which they found inconvenient.

The Layla customer experience

  • Trial period: 30 nights
  • Shipping: Free
  • Warranty: 5 years
  • Financing: Yes

Customer service

You can contact Layla customer service by:

  • Phone: 855-358-1676
  • Live chat: Available via the chat icon on the website, 24/7

Payment options
Layla accepts major credit cards, Amazon Pay, and PayPal. Financing is available through Affirm.

Saatva Latex Pillow: Best Luxury Pillow

We chose the Saatva Latex Pillow as our Best Luxury Pillow because we were impressed by the plush materials and quality construction. This pillow offers a comfortable and supportive sleep experience (it had some of the highest scores for comfort and material quality), though the price is the highest of all the pillows we tested by $15.

Saatva Latex

Best Luxury Pillow
A Saatva Latex pillow on a white background
  • High-quality materials and luxe feel
  • Comes in both standard and high loft options
  • Shredded latex is washed, so you can use this pillow even with a latex allergy
  • Fill material: Cotton and shredded latex
  • Adjustability and loft: Not adjustable; standard (4–5'') or high loft (6–7'')
  • Firmness level: Medium
  • Free trial period: 45 nights
  • Cooling: Breathable latex
  • Shape: Traditional rectangle

Why we chose the Saatva Latex as the Best Luxury Pillow for Back Pain

We chose the Saatva Latex as the Best Luxury Pillow for Back Pain because we think this pillow combines excellent spine support with a luxe feel. Some people enjoy the high-quality plushness of a hotel pillow, and testers said that’s what you can expect with the Saatva Latex. 

We appreciate that Saatva uses washed latex as the pillow’s core, so even people with a latex allergy can use this pillow without worrying about a negative reaction. Plus, while this pillow isn’t adjustable, it is available in either standard or high loft to best suit your preferred sleep position.

Saatva Latex pros and cons

Pros

  • Luxe, hotel-pillow feel
  • Responsive shredded latex core
  • Supportive spine alignment for most sleepers

Cons

  • Most expensive pillow we tested
  • Average cooling
  • Not adjustable

Our testing experience with the Saatva Latex

When we tested the Saatva Latex, we were impressed by the expensive feel of the fabric. “This pillow is made with very nice materials,” one tester said. “It feels soft and cool to the touch. I would consider this feeling like a luxury pillow.”

And when our testers lay down with the pillow, they found it to be both supportive and comfortable. The right combination of strong support and plush comfort may help ease pressure on the back and relieve back pain. “I think that this pillow has a decent amount of pressure relief for being a soft, latex pillow,” one tester said. “The second layer is very plush, which gives support and comfort around my neck. It feels like the right amount of sinkage to be comfortable. I feel lifted off the bed, but not so much that my neck would begin to hurt. I think it would give a comfortable night's sleep for someone who likes a softer pillow.”

A woman sleeps on her back on a Saatva Latex pillow.

One drawback of the Saatva Latex pillow is that it tends to trap heat. When we tested the pillow after use, the temperature rose by about 14 degrees. This earned it a cooling score of 3/5. If you’re a hot sleeper, you might want a pillow that limits heat buildup better, such as the Brooklinen Marlow pillow.

And while many people enjoy luxury pillows for their hotel-like feel, they do come at a high price. At $165, the Saatva Latex pillow is the most expensive on our list. But it does come with a longer trial period (45 nights), so you can feel confident in your investment.

The Saatva customer experience

  • Trial period: 45 nights
  • Shipping: Free delivery
  • Warranty: Limited lifetime
  • Financing: Yes, through Affirm

Customer service

You can contact Saatva customer service by:

Payment options
Saatva accepts Visa, Mastercard, Discover, American Express, Google Pay, and PayPal. Financing is available through Affirm.

Saatva offers a $225 discount off purchases of $1,000 or more to adults age 65 and older, military members and their families, first responders, health care professionals, government employees, teachers, and college students. This discount cannot be combined with other offers.

Luxome LAYR: Best Adjustable Pillow for Back Pain

We chose the Luxome LAYR as our Best Adjustable Pillow for Back Pain because it comes with three different inserts that allow you to create a truly personalized firmness and loft experience. No other pillow we tested offered this level of customization.

Luxome LAYR

Best Adjustable Pillow
A Luxome LAYR pillow on a grey background
  • Adjustable feel with three types of inserts
  • Mix and match for the best sleep experience
  • Great for all types of sleepers
  • Fill material: Down alternative and memory foam
  • Adjustability and loft: Adjustable; 9.5''
  • Firmness level: Adjustable firmness
  • Free trial period: 30 nights
  • Cooling: Gel-infused foam, breathable fabric
  • Shape: Traditional rectangle

Why we chose the Luxome LAYR as the Best Adjustable Pillow for Back Pain

We chose the Luxome LAYR as the Best Adjustable Pillow for Back Pain because the three different inserts allow you to easily mix and match to find your preferred loft and firmness. Because back pain is so personal—every person has their own issues and needs—the ability to adjust a pillow to address your specific pain may help you get better sleep. The three inserts are all very different, making this the most adjustable pillow we tested.

Luxome LAYR pros and cons

Pros

  • Three customizable inserts—all different from each other
  • Comfortable and supportive

Cons

  • Some people might not like having to pack and repack their pillow
  • Traps heat (worst cooling score of any pillow we tested)

Our testing experience with the Luxome LAYR

The Luxome LAYR comes with three completely different inserts: 

  • A soft insert (down-alternative)
  • A medium insert (down-alternative and shredded memory foam)
  • Two firm inserts (one- and two-inch block of solid memory foam)

You can mix and match the three layers to find your preferred loft and firmness.

When our testers tried the Luxome LAYR, they loved how customizable the pillow was. “This is the easiest and most customizable pillow I have tested,” one tester said. “There are three different layers within the pillow, so you can keep it just plush, only memory foam or shredded memory foam.”

After some quick experimenting, testers were able to find the right combination. “I liked taking out the larger memory foam piece to lower the loft of the pillow for my neck and shoulders. You could go one step further and have it only be plush, which made it more comfortable on my stomach.”

A tester displays the shredded latex and memory foam layers of the Luxome LAYR.
Our tester displays some of the insert options of the Luxome LAYR—the shredded memory foam and two-inch block of firm memory foam.

This ability to customize makes the Luxome LAYR a great choice for back, stomach, and side sleepers. “This pillow can easily be for any kind of sleeper with the way it is customizable,” one tester said. “You will just have to find the right loft, support, and responsiveness with the different layers you have. 

Testers loved the ability to customize, but pointed out this may be a problem for combination sleepers. “If you don't switch positions a lot in the night, this is probably a great choice with the way you can adjust the pillow for being on your back, stomach, or side. I wouldn't recommend this for combination sleepers just because you may enjoy the pillow you customize on your back, but not your side, etc.”

Some people might not like having to unzip and repack their pillow to achieve a preferred feel with the Luxome LAYR. If that’s the case, you might enjoy the Layla Kapok more, which molds to support you without requiring customization. 

For those open to customizing their pillow, the biggest drawback of the Luxome LAYR is its subpar cooling performance, earning only a 2/5 rating. This is the lowest cooling score among all the pillows we tested. It’s likely not the best choice for hot sleepers. 

Luxome LAYR customer experience

  • Trial period: 30 days
  • Shipping: Free standard
  • Warranty: Limited
  • Financing: Yes

Customer service

You can contact Luxome customer service by:

Payment options
Luxome accepts all major credit cards as well as Shop Pay, AmazonPay, PayPal, and Google Pay. It offers financing through Affirm.

TEMPUR-Symphony: Best for Back Sleepers with Back Pain

We chose the TEMPUR-Symphony as the Best for Back Sleepers with Back Pain because its supportive material and loft help keep your neck and shoulders aligned while sleeping on your back. This can help minimize pressure points and relieve pain as you sleep.

TEMPUR-Symphony

Best for Back Sleepers with Back Pain
Two TEMPUR-Symphony pillows on a plaid bedspread.
  • Supportive and comfortable memory foam
  • Keeps neck and shoulders aligned while on your back
  • Long warranty (five years)
  • Fill material: Memory foam
  • Adjustability and loft: Not adjustable; 6''
  • Firmness level: Medium
  • Free trial period: None
  • Cooling: Breathable cover
  • Shape: Traditional rectangle with one arched side

Why we chose the TEMPUR-Symphony as the Best for Back Sleepers with Back Pain

We chose the TEMPUR-Symphony as the Best Pillow for Back Sleepers with Back Pain because its arched side provides excellent neck and shoulder support. We liked that the design was thoughtfully created with back sleepers in mind, and there’s also a flat side for side and stomach sleepers.

TEMPUR-Symphony pros and cons

Pros

  • Designed specifically for back sleepers
  • Comfortable and supportive

Cons

  • No free trial
  • Loft might be slightly too high for a stomach sleeper

Our testing experience with the TEMPUR-Symphony

When we tested the TEMPUR-Symphony, we were impressed by the high-quality materials and how durable it felt. Even testers who don’t prefer the feel of memory foam liked the comfort and support of the Symphony. “I don’t typically like memory foam, but this one felt really good as soon as I laid down,” one tester said. Once testers lay on their backs, they noted how supported they felt.“On my back I felt very supported in the neck area,“ one tester said. “But not that my head and neck were higher than my shoulders in a way that would be uncomfortable throughout the night.”

A weighted medicine ball measures the loft difference of the TEMPUR-Symphony pillow.
Our testers used a 10-pound weighted ball to measure the responsiveness (how quickly it pops back up) of the TEMPUR-Symphony. Testers said it was very responsive, meaning it shouldn’t prevent you from changing positions at night.

The contoured side of the TEMPUR-Symphony helps keep your neck, shoulders, and spine aligned while you’re sleeping on your back, minimizing pain and pressure points. But the fact that it also has a flat side for side and stomach sleepers means you can choose your preferred position. “This pillow would be good for someone who is a combination sleeper,” one tester said. “The pillow is very responsive, so it will mold back to its original shape as you change positions throughout the night. I felt comfortably supported on both my back and my side.”

The TEMPUR-Symphony doesn’t come with a free trial, and it’s not returnable. Every other pillow on this list offers a free trial period, so if that’s important to you, we suggest the Brooklinen Marlow pillow, which has the longest free trial period on this list (365 nights).

TEMPUR-Symphony customer experience

  • Trial period: None
  • Shipping: Free
  • Warranty: 5-year warranty
  • Financing: Yes

Customer service

You can contact TEMPUR-Symphony customer service by:

Payment options
TEMPUR-Pedic accepts all major credit cards and offers financing through its website.

The Fox by Lagoon: Best Soft Pillow for Back Pain

We chose the Fox by Lagoon as our Best Soft Pillow for Back Pain because we liked that this pillow still offered neck, spine, and shoulder support while also feeling plusher and softer than almost any pillow we tested.

The Fox by Lagoon

Best Soft Pillow for Back Pain
The Fox by Lagoon pillow on a white background.
  • Soft but supportive construction
  • Great for side and stomach sleepers
  • Removable filler
  • Fill material: Shredded memory foam
  • Adjustability and loft: Adjustable; 8''
  • Firmness level: Adjustable firmness
  • Free trial period: 100 nights
  • Cooling: Breathable fabric
  • Shape: Traditional rectangle

Why we chose the Fox by Lagoon as the Best Soft Pillow for Back Pain

We chose the Fox by Lagoon as the Best Soft Pillow for Back Pain because it offered neck, spine, and back support while providing a soft, plush sleep experience. Soft pillows are typically less supportive, but the Fox by Lagoon addresses this issue with a shredded memory foam filling that can be adjusted to your preferred firmness. Testers noted that this feature helped create a good balance of soft comfort and solid support.

Fox by Lagoon pros and cons

Pros

  • Adjustable filling
  • Supportive
  • Soft and comfortable

Cons

  • Might be too soft for back sleepers

Our testing experience with the Fox by Lagoon

When we tested the Fox by Lagoon, we were impressed by how supportive the pillow was while still being plush. “Overall, this pillow is very soft and comfortable, as it’s made with polyester and bamboo,” one tester said. Most of the other pillows we tested were either medium or firm, but the Fox lands squarely in the soft category. While this plushness typically means that a pillow lacks support, the Fox addresses this issue with removable filling that lets you choose your firmness.

A woman sleeps on her back on the Fox by Lagoon pillow.
One of our testers relaxes with the Fox by Lagoon pillow.

“I think [for] someone who enjoys a softer pillow with less firmness around the neck, this would be a good choice,” one tester said. “It would need regular fluffing/adjusting when getting comfortable. However, someone who sleeps on their stomach could really enjoy this.”

Because of the Fox’s softness, it’s better suited for stomach or side sleepers. If you only sleep on your back, you may prefer the TEMPUR-Symphony instead.

“I would recommend this pillow to someone who is a side or stomach sleeper,” one tester said. “There is not enough support in the pillow for your head and neck when sleeping on your back. Ideally, it would be for stomach sleepers only, but I sleep on my side and don't hate how this feels (I love soft pillows).”

Lagoon customer experience

  • Trial period: 100 nights
  • Shipping: Free
  • Warranty: 5-year limited
  • Financing: Yes

Customer service

You can contact Lagoon customer service by:

Payment options 

Lagoon accepts all major credit cards, Shop Pay, and GPay. It also accepts HSA/FSA Flex Pay.

Brooklinen Marlow: Best Cooling Pillow for Back Pain

We chose the Brooklinen Marlow as our Best Cooling Pillow for Back Pain because it heated up by only eight degrees after use, making it the only pillow we tested to earn a 5/5 for cooling. Not only did it limit heat buildup, but testers also said the Brooklinen Marlow provided excellent support for their backs and necks.

Brooklinen Marlow

Best Cooling Pillow for Back Pain
Brooklinen by Marlow pillow
  • Breathable and cool, earning a 5/5 cooling score
  • Adjustable firmness
  • Soft and supportive
  • Fill material: Memory foam
  • Adjustability and loft: Adjustable; 5''
  • Firmness level: Adjustable firmness
  • Free trial period: 365 nights
  • Cooling: Cooling memory foam
  • Shape: Traditional rectangle

Why we chose the Brooklinen Marlow as the Best Cooling Pillow for Back Pain

We chose the Brooklinen Marlow Pillow as the Best Cooling Pillow for Back Pain because, out of all the pillows we tested, the Marlow trapped the least amount of heat. Its temperature only rose 8 degrees after use, compared to Saatva’s 14-degree increase. The Marlow earned a 5/5 for cooling—the only pillow we tested to do so.

We also like that the Marlow has two zippers you can use to make the pillow firmer or softer. This is much more convenient than some other pillows that require you to remove and store their fillers.

Brooklinen Marlow pros and cons

Pros

  • Cooling materials make this pillow great for hot sleepers
  • Zippers for easier adjustability
  • Great mix of comfort and support

Cons

  • Spot-clean only

Our testing experience with the Brooklinen Marlow

When we tested the Brooklinen Marlow pillow, we were impressed by its plush and comfortable feel. Testers noted that it reminded them of a luxurious hotel pillow. We also appreciate that the materials used make this pillow allergy-friendly.

“I like this pillow a lot,” one tester said. “It feels like the type of pillow you'd get at a hotel—fluffy and plush.” Despite feeling plush and comfortable, testers noted that it provided great support. “Actually, this pillow is more supportive than a lot of other ‘fluffy’ pillows I've tried. I think the combination of memory foam and polyester fiber gives it a unique fill that balances support and pressure relief.” 

One of our testers, who has allergies, said they appreciate the allergy-friendly construction. “I also appreciate that it's hypoallergenic and antimicrobial, especially as someone with allergies. I think this pillow would be great for anyone seeking a medium-plush feel that's not too hard but still offers neck and head support.”

A woman sleeps on her side on the Brooklinen Marlow pillow.
One of our testers naps on the Brooklinen Marlow pillow. The verdict? An excellent, supportive, and cooling pillow.

And we especially like that the pillow uses zippers to adjust its firmness. This is a nice touch for older adults who don’t want to remove the fill, add it back, or store it in a separate place. “It's super easy to modify this pillow,” one tester said. “Both sides have a zipper that opens to reveal a mesh gusset. When both zippers are closed, it's the firmest. With only one closed, it's medium. With both zippers open, it's the softest.”

This customizability and its superior cooling make this pillow great for back, side, and stomach sleepers, as well as hot sleepers.

And while Brooklinen technically doesn’t have a free trial period, it offers a 365-day return policy, which provides the longest trial period on this list by 265 days. The Brooklinen Marlow Pillow is also the least expensive pillow on this list by $44.

Brooklinen customer experience

  • Trial period: 365-day return policy
  • Shipping: Free over $100
  • Warranty: 365-day warranty
  • Financing: Yes

Customer service

You can contact Brooklinen customer service by:

Payment options 

Brooklinen accepts all major credit cards, PayPal, ShopPay, and Venmo. It offers financing through Afterpay.

Our process testing the best pillows for back pain 

Our team has spent thousands of hours researching and testing mattresses, pillows, and other sleep accessories so you can feel confident in our reviews. We work with experts in sleep, physical therapy, and occupational therapy, so we know what features are most important when searching for the best pillows for back pain.

For this review, we personally tested 15 pillows identified through our research to ease back pain. Each pillow was put through rigorous testing by older adults with pain, to ensure we have real-world data about how they perform.

We considered these important factors when testing the best pillows for back pain:

Spinal alignment support 

Our testers laid down with the pillow on their backs, sides, and stomachs, which are the three main ways that people tend to sleep. We measured how aligned our necks, shoulders, and spines were in the different positions, making note of any pressure points or sinking sensations.

Pressure relief 

We measured for any pressure buildup in our necks, shoulders, spines, and hips. Pressure points typically mean that a part of the body is unaligned. We made sure that the pillows all helped support the body equally.

Loft retention and height adjustments

We measured how well the pillow retained its loft over several nights. If a pillow becomes squished down and doesn’t bounce back, it may not keep your body aligned.

Firmness and responsiveness

We tested the responsiveness of the pillow by evaluating how quickly it bounces back. This is particularly helpful for people who change sleep positions during the night. 

What causes back pain while sleeping?

There are many different issues that older adults face that can contribute to back pain while sleeping. Some of these are physical issues, such as arthritis, fibromyalgia, and other pain conditions that inflame your nerves or muscles. These conditions can be made worse by pressure points when lying down on a mattress. For more information, see our review of the best mattresses for back pain, best mattresses for arthritis, and the best mattresses for fibromyalgia.

If you are sleeping on a mattress that doesn’t keep your spine, neck, and shoulders aligned, you may develop pressure points and sore spots that cause pain over time.

How common is back pain? 

Back pain is one of the most common conditions. Four in five Americans will experience back pain at some point in their lives.3

In our March 2025 survey of 300 older adults who recently bought a mattress, 65% of respondents reported experiencing back pain.4

How to choose a pillow for back pain relief

When choosing the right pillow for back pain relief, it’s important to remember that every person has their own unique pain issues and needs. What might work for you may be different than what works for someone else. Consider the following topics and how they might affect your pain relief.

Sleep position considerations (back, side, stomach)

The way you sleep influences your needs for back pain relief. Someone who sleeps on their back might benefit more from a contoured pillow, while stomach sleepers might like a flatter pillow to help keep their neck and spine aligned, according to research.5

Back sleepers do best with a small, soft pillow, since it reduces pressure on the neck muscles,” said James Hook, a chiropractor at Neurogan Health in San Diego. “Throughout the night, your muscles don’t feel constricted because the soft cushions allow gentle movement of the neck, helping it stay in its natural position. For side sleepers, the right pillow should be firm and thick enough to keep the spine aligned between the ear and the shoulders. Here, the most important thing is to choose a pillow that suits your sleeping habits.”

Firmness level: soft vs. medium vs. firm

The firmness of a pillow can also make a big difference in how well your spine and neck stay aligned while sleeping. Firm pillows are less responsive, meaning they hold their shape as you shift positions. A soft pillow might collapse underneath your head, possibly creating a dip that puts your spine out of alignment. This is why we recommend pillows that have an adjustable firmness so you can find the right level of resistance for you.

Adjustability and loft

Pillows that have a high loft can either keep your neck aligned or lift your head uncomfortably. This depends on your build and how you like to sleep. Pillows with adjustable loft are helpful for tailoring the height to your specific needs.6

Materials

Pillows come in a variety of materials, and choosing the right one is typically personal preference. You might like the feel of memory foam over a down alternative, or prefer latex. Try different materials to see which suits you best, and be sure to pay attention to free trial periods so you can return ones you don’t like.

Certifications and allergen considerations

If you have certain allergies, such as those to down or latex, research the pillows you’re considering to identify any potential allergen issues. A down alternative or washed latex pillow could be a good option.

Tips for managing back pain

Back pain is one of the most common health issues among older adults, and it can negatively affect your quality of life.7 Understanding the root causes and developing strategies to manage back pain can go a long way toward minimizing its influence on your daily activities.

If you have back pain, your sleep position can make a big difference on how sore you feel when you wake up. Sleeping on your back with a pillow under your knees can help keep your neck, spine, and shoulders aligned correctly. Sleeping on your side with a pillow between your knees can accomplish the same thing.

It’s also important to speak to your doctor about possible physical therapy treatments or medications that can help. Staying active may help, but always get a new activity plan approved by your health care provider before you start.8

How much do the best pillows for back pain cost?

The pillows in this article range from $65–$165. When choosing the right pillow for your budget, consider the other costs and fees that might come with the pillow. For example, you have to spend $100 or more to receive free shipping from Brooklinen, and TEMPUR-Pedic doesn’t offer returns. 

Table 2: Cost comparison of the best pillows for back pain

Comparison Features
Price

$109

$165

$150

$129

$139

$65

Shipping costs

Free

Free

Free

Free

Free

Free over $100

Warranty

5-year

Limited

Limited

5-year

5-year

1-year

Return fees

None

None

Decided at return

No returns

None

$9.95

How to save money on pillows

The easiest way to save money on pillows is to buy them when they are on sale. Look for promotions around Memorial Day, 4th of July, Labor Day, or Black Friday. You can also save money by choosing a pillow with a free trial period and free returns, because then you can get your money back if you don’t like the pillow.

And some companies, like Lagoon, let you use your HSA/FSA fund to pay for a pillow, which can save you some money.

Frequently asked questions

What pillow is recommended by health care providers for back pain?

Health care providers we spoke with recommend a supportive pillow made of memory foam or latex for back pain.

How often should I replace my pillow for back support?

Guidance varies, but in general, you should replace your pillow for back support every two years.

Can a pillow really help lower back pain?

Yes, a pillow can help lower back pain because it helps to support your neck, shoulders, and spine and keep them aligned.

Should back sleepers use a firm or soft pillow?

Back sleepers should use a medium-firm pillow to support their head and keep it aligned.

Questions? Email us at reviewsteam@ncoa.org.

Sources

  1. Prommanon, B., et al. Effectiveness of a back care pillow as an adjuvant physical therapy for chronic non-specific low back pain treatment: a randomized controlled trial. Journal of Physical Therapy Science. July 22, 2015. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC4540812/
  2. Encyclopedia Britannica. Kapok plant fibre. Dec. 17, 2024. Found on the internet at https://www.britannica.com/topic/kapok
  3. Harvard Health Publishing. Back pain. May 3, 2022. Found on the internet at https://www.health.harvard.edu/topics/back-pain
  4. NCOA Sleep Pain and Position Survey. 300 respondents. Conducted using Pollfish. Launched March 2025
  5. Radwan, A., et al. Effect of different pillow designs on promoting sleep comfort, quality, & spinal alignment: A systematic review. European Journal of Integrative Medicine. February 2021. Found on the internet at https://www.sciencedirect.com/science/article/abs/pii/S1876382020314505
  6. Lei, J., et al. Ergonomic Consideration in Pillow Height Determinants and Evaluation. October 2021. Healthcare (Basel). Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC8544534/
  7. Angst, F., et al. Epidemiology of Back Pain in Young and Middle-Aged Adults: A Longitudinal Population Cohort Survey From Age 27–50 Years. Psychosomatics. November-December 2017. Found on the internet at https://www.sciencedirect.com/science/article/pii/S0033318217301445?via%3Dihub
  8. Mauck, M., et al. Evidence-based interventions to treat chronic low back pain: treatment selection for a personalized medicine approach. Pain Reports. Sept. 30, 2022. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC9529058/

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