Waking up with neck pain could be a sign of poor posture in bed. Drazen Zigic/Freepik The softer and "fluffier", the more comfortable a pillow appears to be. But the pleasant sensation when lying down does not always mean that it is good for your spine. According to orthopedists, the most important thing is not the softness itself, but the ability to keep the head aligned with the rest of the body during sleep. However, the ideal height is not the same for everyone and depends mainly on the position in which the person usually sleeps. The general recommendation is that the pillow keeps the head aligned with the rest of the spine, without tilting it up or down. Infographic shows how to identify whether your spine is aligned based on the height of the pillow. Caroline Inoue/g1 📺 Want to buy better? Receive tests and tips from the Buying Guide in your email. When this doesn't happen, pain and discomfort can arise which, over time, can lead to back problems. According to the Brazilian Society of Orthopedics and Traumatology (SBOT), around 80% of people will have back pain throughout their lives. Of course, you can't just blame the pillow every time you feel pain, but getting it right when you choose it certainly helps to avoid the problem. 🛏️ Is there an ideal pillow height? There is no exact number or calculation that can be done to find the appropriate height. It varies according to the position in which the person sleeps. "Those who sleep on their back need to have a lower pillow and those who sleep on their side need a higher pillow", says Alexandre Fogaça, president of the SBOT Spine Committee. The explanation is simple: the pillow must fill the space between the head and the mattress without causing excessive tilting of the neck, whether due to lack of height or excess. On its website, SBOT itself states that the best sleeping position is on the side, keeping the head aligned with the rest of the spine. 📏 How do you know if the pillow is at the right height? According to Fogaça, the best way to assess is to observe the alignment of the spine during sleep. "Visually, someone needs to look at your position and check whether the spine is straight," says the doctor. This is ideal, but if you can't count on someone else's help to look at your posture, you'll have to do it through trial and error, evaluating your own feeling of comfort. But “comfort” is not the same thing as softness. "If the pillow sinks too much, it is necessary to assess whether it still keeps the spine straight when the person sleeps on their side", adds Fogaça. Therefore, different people may prefer higher or lower pillows. ⚠️ Is sleeping without a pillow bad? According to the orthopedist, the absence of a pillow can force the cervical spine into an inadequate position. "What happens if someone sleeps without a pillow? The person's spine becomes hyperextended, which can cause pain. Repeatedly can lead to premature wear and tear on the joints (arthrosis) and herniated discs", warns Fogaça. If you've ever tried to resolve neck pain by sleeping without a pillow, you may have felt a sense of relief at first, but over time it could become a problem. "Anyone who wakes up with neck pain may be using an inappropriate pillow and have to change it. But a doctor will never recommend sleeping without a pillow", highlights the specialist. But not every improvement or worsening of symptoms is related exclusively to the pillow. "It is not a preponderant factor, it is a supporting factor", says the orthopedist. "The most important thing is to observe the set of habits related to spinal health: good posture, good nutrition, adequate physical activity, work ergonomics, chair posture." 🔄 When to change the pillow? Another possible cause of pain is the condition of the pillow. The recommendation is to change according to the manufacturer's instructions for the product. “Pillows also have an expiration date”, says Fogaça. Not all back or neck pain requires testing, but if certain symptoms appear, it may be time to see a doctor. "There are some warning signs: night pain, weight loss, leg pain. All of this should be taken to a doctor", recommends the orthopedist. Treatment must consider all of the patient's routine habits. Below, see pillow options of varying heights for R$70 to R$550. Prices were consulted in June. Plumax Home Style Pillow Luuna Comfort Flip Pillow Emma Comfort Pillow Sonos Marine Tall Pillow 100% cotton Ortobom pillow kit Plumax Percal Fibrasca Pillow This report was produced with total editorial independence by our team of specialized journalists and collaborators. 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