Which pillow is best for back pain?#
For lower back pain, the most useful pillow is usually not the one under your head. A pillow between your knees (side sleepers) or under your knees (back sleepers) keeps your pelvis and lower spine in a neutral position and takes strain off the lower back. The head pillow still matters, mainly for upper back and shoulder pain, and it should keep your neck level with the rest of your spine.
If your back pain is new, severe, follows a fall, or comes with numbness, weakness or problems with bladder or bowel control, see a GP or call NHS 111 rather than changing your bedding.
How we chose: we test mattresses hands-on, but we have not sleep-tested these pillows. The picks below are matched to the need on this page from each retailer's published specification (fill, height, adjustability, care), checked on 14 October 2026. Prices change, so confirm on the retailer's site. We may earn a commission if you buy through these links, at no extra cost to you.
How to use pillows for back pain, by sleeping position#
| Position | Head pillow | Extra pillow | Why |
|---|---|---|---|
| Side | High and firm (about 10 to 14cm) | Between the knees | Stops the top leg pulling the pelvis and lower back into a twist |
| Back | Medium (about 7 to 10cm) | Under the knees | Bending the knees slightly lets the lower back flatten and relax |
| Stomach | Very low, or none | Thin pillow under the hips | Reduces the arch in the lower back |
The knee pillow#
For side sleepers, a pillow between the knees is the single cheapest change you can make for lower back pain. Without one, your top knee falls forward onto the mattress and pulls your hip and pelvis with it, which twists your lower back for hours. The pillow should be thick enough that your knees, hips and ankles stay roughly stacked, and firm enough not to go flat.
You do not need a special "knee pillow". An ordinary firm pillow you already own works. If it slides out in the night, a long body pillow is easier to keep in place, because you can hug the top end. Simba sells a body pillow aimed at side sleepers, and The Foam People's Core pillow is a cheap way to add a firm shredded-foam pillow for under your knees or between them.
Our head pillow picks for back pain#
The head pillow matters most for upper back and shoulder pain, where a pillow at the wrong height holds the upper spine bent. Adjustable is the safe choice:
- Simba Hybrid Pillow (£109): foam Nanocubes you add or remove to change height and firmness. The most adjustable pick here.
- Emma Adapt Cooling Pillow (£99): three removable foam layers, medium to firm, 30-night trial.
- Emma Comfort Cooling Pillow (£85): softer microfibre with a removable inner layer, so it can go low enough for back and stomach sleepers.
- The Foam People Core (about £13): shredded memory foam. Works as a head pillow, or as the extra pillow for your knees or hips.
The mattress matters more#
Pillows fine-tune your position, but your mattress decides whether your spine is straight in the first place. A mattress that sags lets your hips sink too far, and one that is too firm stops your shoulders and hips sinking in, and both leave your lower back bent. If you wake with back pain that eases once you are up and about, and your mattress is more than seven or eight years old, start there: see our best mattress for back pain and can a bad mattress cause back pain?
For neck pain specifically, see the best pillow for neck pain. For fills and loft, read our guide to choosing a pillow.
Frequently asked questions#
Can a pillow cause back pain?#
A head pillow at the wrong height can contribute to upper back and shoulder pain, because it holds the top of the spine bent. Lower back pain is more often down to the mattress and to how your hips and legs are positioned, which is why a knee pillow tends to help more than a new head pillow.
Should I put a pillow under my knees if I sleep on my back?#
If you have lower back pain, it is worth trying. A pillow under the knees bends them slightly, which lets the lower back flatten towards the mattress instead of arching. Many people find it more comfortable straight away.
What is the best sleeping position for lower back pain?#
On your side with a pillow between your knees, or on your back with a pillow under them. Stomach sleeping arches the lower back and is usually the most uncomfortable position for back pain.
Do I need a special pillow for sciatica?#
Not a special one. The same positions help: side sleeping with a pillow between the knees often eases pressure on the affected side. Sciatica that does not settle within a few weeks, or comes with weakness or numbness, needs a GP.
