Key Takeaways
- The wrong pillow height can strain your neck muscles overnight and leave you sore in the morning.
- Sleeping on an old or worn-out pillow reduces support and can quietly worsen neck pain over time.
- Your sleep position matters, and your pillow should match how you sleep, not just what feels soft.
- A pillow that is too firm or too soft can overload sensitive joints in the neck.
- Ongoing neck pain is often a sign that more than just your pillow needs attention.
Waking up with neck pain is frustrating, especially when you feel like you did nothing wrong. For many active people around Manly, North Curl Curl and Mona Vale, the issue is not training load or desk work. It is what your neck is doing for six to eight hours every night.
Your pillow plays a bigger role than most people realise. Below are five common pillow mistakes we see every week in the clinic and what you can do about them.
1. Your pillow is the wrong height
One of the biggest contributors to neck pain is a pillow that pushes your head too far up or lets it drop too low. Both positions force the neck into awkward angles for hours at a time.
If your pillow is too high, the muscles along the side of your neck stay shortened all night. Too low, and your neck is left unsupported. Either way, it is no surprise you wake up stiff or sore.
A simple check is side sleeping alignment. Your nose should line up roughly with the centre of your chest, not tilt up or down. Back sleepers should feel supported without their chin dropping towards their chest.
If you are unsure about what height suits your body and sleep habits, a physiotherapist can provide guidance. You can always book an appointment or get advice through the team at MGS Physio.
2. You are using an old pillow
Pillows do not last forever. Over time, they lose their shape and support, even if they still look fine on the bed.
We often hear people say their pillow is five or even ten years old. By that stage, it is usually doing very little to support the neck properly. Instead, it collapses overnight and leaves the muscles working harder than they should.
If you wake with neck pain that improves as the day goes on, this is a common sign your pillow is past its best. Replacing it every one to two years is a good general rule, especially if you are active or prone to neck stiffness.
If your pain is lingering or worsening, it may be time to look beyond just changing pillows. Booking a neck assessment with MGS Physio can help identify what is really driving your symptoms.
3. Your pillow does not match your sleep position
Not all pillows suit all sleepers. A pillow that works for a back sleeper often fails a side sleeper and vice versa.
Side sleepers usually need a slightly higher pillow to fill the space between their shoulder and the mattress. Back sleepers tend to do better with a lower profile pillow that supports the natural curve of the neck without pushing the head forward.
Stomach sleeping is trickier and often linked with neck pain due to prolonged rotation. In these cases, pillow choice is only part of the solution and addressing sleep position becomes important too.
If you are unsure what position you spend most of the night in, a physio can help you work this out and recommend practical changes that suit your body and lifestyle.
4. Your pillow is too soft or too firm
Comfort is important, but support matters more. A pillow that is too soft may feel nice initially, but it often flattens under the weight of your head. This leaves your neck unsupported for most of the night.
On the other hand, an overly firm pillow can hold your neck in one rigid position, irritating joints and sensitive tissues.
The goal is a pillow that supports your neck while still allowing small, natural movements. This balance helps reduce overnight muscle guarding and morning stiffness.
If you are constantly swapping pillows or folding them in half, it is a sign that the current one is not doing its job.
5. You assume neck pain is only a pillow problem
While pillow mistakes are common, ongoing neck pain is rarely caused by just one factor. Desk posture, training loads, stress, and previous injuries all play a role.
If your neck pain has been hanging around for weeks, or you notice headaches, shoulder pain, or pins and needles, it is time to get it checked properly.
At MGS Physio, we see plenty of active people who assume neck pain is normal. With the right hands-on treatment and a tailored exercise plan, most see significant improvement faster than they expect.
If you want help getting to the bottom of your neck pain, you can book a consultation at one of our northern Sydney clinics.