10 Best Pillows for Upper Back Pain
Finding the best pillows for upper back pain starts with understanding how poor support affects your sleep posture. When the head and shoulders aren’t properly aligned, tension can build between the shoulder blades, leading to stiffness and discomfort.
Our top pick, the Derila Ergo Pillow, combines a contoured ergonomic shape with firm memory foam to help maintain upper spine alignment. It’s especially well-suited for side and back sleepers who need structured support.
In this article, we’ll take a closer look at the top pillows for upper back pain, designed to improve alignment and reduce strain across the shoulders and upper spine—helping you sleep more comfortably and wake up with less tension.
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What Type of Pillow Is Best for Upper Back Pain?
Upper back pain often stems from poor sleep posture, lack of support, or built-up muscle tension between the shoulder blades. The best pillows for upper back pain are designed to support the natural curve of your spine, promote proper alignment, and reduce pressure on key areas like the neck, shoulders, and upper back.
If you frequently wake up with tightness or discomfort in your upper body, switching to a supportive, well-structured pillow can make a noticeable difference in your sleep quality.
Below are the top 10 pillows that provide targeted support for the upper back and help you rest more comfortably through the night.
Top 10 Pillows for Upper Back Pain in 2025
1. Derila Ergo Memory Foam Pillow
The Derila Ergo Pillow’s butterfly-shaped contour supports not just your neck, but also your shoulders — helping to keep the upper spine in a more neutral position throughout the night.
The firmer memory foam offers consistent support without flattening, so you’re not waking up trying to “reset” your posture every few hours.
Key Features:
- Shoulder-cradling side wings: Help reduce pressure around the upper back by keeping your posture steady
- Firm memory foam core: Maintains loft and support through the night — no sinking or slumping
- Contours for stability: The central dip helps hold your head in place, which can reduce repositioning and strain on your upper spine
Best for: Sleepers who switch between side and back positions and wake up sore between the shoulders.
Check Price of the Derila Ergo
2. Tempur-Pedic TEMPUR-Neck Pillow
The contoured shape of the Tempur-Pedic TEMPUR-Neck Pillow is designed to cradle your neck’s natural curve while keeping your spine in better alignment.
It’s made from Tempur-Pedic’s signature pressure-relieving material that adapts to your body heat and weight over time. While it may take some getting used to, many people find the consistent support helps them wake up feeling less stiff.
Key Features:
- Ergonomic contour design: The curved shape naturally supports your neck without gaps
- Pressure-responsive material: Softens where you need it most while maintaining overall structure
- 2 size options: Available in different heights to match your body type and sleep position
Best for: Back and side sleepers who prefer consistent, structured support.
3. Coop Home Goods Eden Cool+ Adjustable Pillow
The Coop Home Goods Eden Cool+ Adjustable Pillow combines the customization benefits of adjustable fill with cooling gel-infused memory foam to address both support and temperature issues.
The mix of shredded memory foam and microfiber gives you flexibility in how firm or soft you want it, while the cooling properties help prevent the tossing and turning that can worsen neck and shoulder tension.
Key Features:
- Dual-fill system: Memory foam and microfiber blend lets you fine-tune the pillow’s height and density makes it an excellent choice for those whose upper back pain may vary from night to night
- Cooling gel infusion: Helps dissipate heat for more comfortable sleep
- Hypoallergenic materials: Good choice for people with sensitivities
Best for: Hot sleepers and side sleepers who want adjustable support.
4. Purple DreamLayer Pillow
The DreamLayer Pillow combines Purple’s GelFlex Grid technology with MicroAir Foam to create a surface that’s both supportive and cooling.
The top layer of gel grid provides targeted pressure relief with airflow, while the foam core underneath offers conforming comfort. Two removable booster layers let you customize the height to match your sleep position and body type.
Key Features:
- GelFlex Grid top layer: Provides pressure relief and cooling airflow while maintaining support
- MicroAir Foam core: Soft, conforming base that adapts to your head and neck shape
- Adjustable height system: Two removable booster layers create three different loft options
Best for: Combination sleepers who want cooling comfort with customizable height to provide adequate support to their upper back area.
5. Mediflow Water Pillow
The Mediflow Water Pillow uses water as its primary support system, which creates a completely different feel from traditional foam or fiber fills.
You can adjust the water level to control firmness, and the water layer provides consistent support that doesn’t compress over time. It’s particularly popular with people who have tried multiple pillows without finding the right balance of support and comfort.
Key Features:
- Water-based support: Offers consistent resistance that doesn’t break down or flatten
- Fully adjustable firmness: Add or remove water to find your ideal support level
- Thermal insulation: Prevents the water from affecting your body temperature
Best for: Sleepers who want precise control over firmness and consistent support
6. Avocado Green Pillow
Made with organic latex and kapok fibers, the Avocado Green Pillow offers a natural alternative to synthetic materials while still providing great support and adjustability.
The latex gives it responsive bounce, while the kapok fibers add softness and breathability. It’s handmade in the USA and uses certified organic materials, making it ideal for environmentally conscious sleepers.
Key Features:
- Organic materials: GOLS-certified latex and GOTS-certified kapok fibers
- Adjustable natural fill: You can remove or add filling to customize the loft
- Breathable construction: Natural fibers allow good airflow for temperature regulation
- Hypoallergenic materials: The organic components are naturally resistant to dust mites and allergens, making it a great option for sensitive sleepers
Best for: Eco-conscious sleepers looking for natural materials and gentle, responsive support that promotes healthy alignment and supports upper back comfort.
7. SpineAlign Pillow
Designed by a chiropractor, the SpineAlign Pillow features a unique three-chamber system that lets you adjust the support for your head, neck, and shoulders independently.
It has different sides optimized for back and side sleeping, and the ability to customize each section makes it particularly appealing for people dealing with specific alignment issues.
Key Features:
- Three adjustable chambers: Customize support for head, neck, and shoulders separately
- Dual-sided design: Different configurations for back and side sleeping
- Professional design: Created by a chiropractor with spinal alignment in mind
Best for: Sleepers who want targeted, customizable support for specific areas.
8. Layla Kapok Pillow
The Layla Kapok Pillow blends memory foam with kapok fibers to create a surface that’s both contouring and breathable. The copper-infused cover adds cooling properties and antimicrobial benefits, while the adjustable fill lets you customize the feel. It has a nice balance between the support of memory foam and the airiness of natural fibers.
Key Features:
- Memory foam and kapok blend: Combines contouring support with natural breathability
- Copper-infused cover: Provides cooling and antimicrobial properties
- Adjustable fill: Remove or add material to find your preferred loft and firmness
Best for: Sleepers who want the supportive benefits of memory foam alongside better breathability.
9. Therapeutica Sleeping Pillow
This orthopedic pillow has an unusual shape with a center cavity for back sleeping and raised edges for side sleeping. It comes in three different sizes based on body measurements, ensuring a proper fit for your shoulder width and neck length. While it looks unconventional, the design is specifically engineered to maintain proper spinal alignment.
Key Features:
- Orthopedic design: Center cavity and raised edges support different sleep positions
- 3 size options: Sized based on body measurements for proper fit
- Shape-retaining foam: Maintains its structure and support over time
Best for: Sleepers with upper back pain who want orthopedic-grade support and proper sizing.
10. Hullo Buckwheat Pillow
Filled with buckwheat hulls, the Hullo Buckwheat Pillow offers a completely different experience from foam or fiber alternatives.
The hulls shift and mold to support your head and neck while allowing excellent airflow. You can adjust the fill level by removing hulls, and the natural materials provide a firm yet flexible surface that many people find surprisingly comfortable.
Key Features:
- Buckwheat hull filling: Molds to your shape while maintaining support and airflow
- Adjustable fill level: Remove hulls to decrease height or change the feel
- Excellent breathability: Natural air channels keep you cool throughout the night
Best for: Sleepers who prefer firm, natural materials for upper back support with excellent airflow.
What to Look for in a Pillow for Upper Back Support
When selecting a pillow to reduce upper back pain, consider these key factors:
Sleep position
Different sleep positions need different levels of support. Side sleepers typically need a higher loft pillow to keep their spine aligned, while back sleepers may prefer a medium loft. Stomach sleepers often benefit from a thinner pillow to prevent neck strain.
Body type
Your height, weight, and shoulder width can affect which pillow works best for you. Larger people may need firmer pillows with higher lofts, while smaller people might find softer, lower-profile pillows more comfortable.
Pillow material
Memory foam, latex, down, and choice materials each have unique properties. Memory foam conforms to your shape but may keep heat, while latex offers bounce and breathability.
Down is soft and moldable but may not provide enough support for some.
Adjustability
Pillows with removable fill allow for customization, which can be particularly helpful if your pain levels or sleep preferences change over time.
Temperature regulation
If you sleep hot, look for pillows with cooling properties such as gel-infused memory foam or breathable natural materials like bamboo or kapok fibers.
Remember that finding the right pillow may involve some trial and error. Many companies offer sleep trials, allowing you to test the pillow before committing to it long-term.
Don’t be discouraged if the first pillow you try isn’t perfect – it may take some experimentation to find the ideal match for your needs.
Complementary Strategies for Upper Back Pain Relief
While a supportive pillow is crucial, combining it with other strategies can enhance your pain relief efforts:
Maintain good posture during the day
Be mindful of your posture while sitting, standing, and walking. Engage your core muscles and keep your shoulders back to reduce strain on your upper back.
If you work at a desk, ensure your workspace is ergonomically set up to promote good posture throughout the day.
Practice regular stretching and strengthening exercises
Incorporate exercises that target your upper back, neck, and shoulders into your daily routine. Yoga and Pilates can be particularly useful for improving posture and reducing pain. Simple exercises like shoulder blade squeezes, chin tucks, and gentle neck rotations can help reduce tension and strengthen the muscles supporting your upper back.
Use heat or cold therapy before bed
Applying heat can help relax tense muscles, while cold therapy can reduce inflammation (we recommend FlexiKold for this – pick it up from Amazon here). Experiment with both to see which provides more relief for your specific condition.
A warm shower or bath before bed can also help relax your muscles and prepare your body for sleep.
Invest in a supportive mattress
A good pillow can only do so much if your mattress isn’t providing adequate support. Consider upgrading to a mattress that aligns with your body type and sleep preferences.
Look for options that offer good support for your spine and pressure relief for your shoulders and hips.
Consider using a body pillow for extra support
A body pillow can help maintain proper alignment, especially for side sleepers. It can reduce pressure on your upper back and shoulders by providing support between your knees and arms.
This can help distribute your weight more evenly and reduce strain on your upper back.
Practice good sleep hygiene
Establish a consistent sleep schedule, create a relaxing bedtime routine, and ensure your sleep environment is dark, quiet, and cool. Avoid screens for at least an hour before bed, as the blue light can interfere with your body’s natural sleep-wake cycle.
Try gentle massage or self-massage techniques
Using a foam roller or massage ball on your upper back can help release tension and improve circulation before bed. You can also try gentle self-massage techniques, focusing on the areas where you feel the most tension. This can help relax your muscles and prepare your body for a more restful sleep.
By addressing upper back pain holistically, you’re more likely to find lasting relief and improve your overall sleep quality. Remember that consistency is key – it may take some time for your body to adjust to new sleep habits and postures.
Conclusion: Finding Your Perfect Pillow for Upper Back Pain Relief
Upper back pain doesn’t have to interfere with your sleep. The right pillow can provide the support your body needs for a more comfortable and restful night.
When choosing a pillow for upper back pain, it’s important to consider your sleep position, body type, and how much support you need across the neck and shoulders. Pillows with adjustable loft, ergonomic contours, or firmer core materials often do a better job of maintaining alignment and reducing pressure through the upper spine.
Whether you’re dealing with chronic tightness or occasional discomfort between the shoulder blades, upgrading your pillow can make a meaningful difference. Each option in this guide was selected to help improve posture and support healthier sleep—so you can wake up feeling refreshed, not stiff or sore.
And as always, if you’re dealing with ongoing pain or sleep issues, speak with your healthcare provider to rule out any underlying conditions and determine the best approach for your needs.
People Also Asked
What type of pillow is best for upper back pain?
Memory foam or latex pillows with ergonomic designs often provide excellent support for upper back pain. Adjustable pillows that allow you to customize the loft and firmness can also be beneficial.
Can a pillow really help with upper back pain?
Yes, a properly supportive pillow can help reduce upper back pain by promoting proper spinal alignment and reducing pressure on the neck and shoulders during sleep.
How often should I replace my pillow to prevent back pain?
Generally, pillows should be replaced every 1-2 years. However, if you notice your pillow losing its shape or support, it may be time to replace it sooner.
Are firm or soft pillows better for upper back pain?
The ideal firmness depends on your sleep position and personal preference. Side sleepers often benefit from firmer pillows, while back sleepers may prefer medium firmness.
Can sleeping without a pillow help upper back pain?
While some people find relief sleeping without a pillow, most benefit from proper support. Sleeping without a pillow can potentially strain your neck and upper back.
Is a cervical pillow good for upper back pain?
Cervical pillows, designed to support the natural curve of your neck, can be useful for some people with upper back pain. However, they may take some time to get used to.
How should I sleep to relieve upper back pain?
Sleeping on your back with a pillow supporting your neck’s natural curve, or on your side with a pillow that keeps your spine aligned, are often recommended positions for upper back pain relief.
Can a water pillow help with upper back pain?
Water pillows, like the Mediflow mentioned in this article, can provide customizable support and have been shown in some studies to help reduce neck and upper back pain.
Are buckwheat pillows good for upper back pain?
Buckwheat pillows, such as the Hullo pillow mentioned above, can be useful for upper back pain because of their ability to conform to your head and neck shape while providing firm support.
How does pillow height affect upper back pain?
The ideal pillow height depends on your sleep position and body type. A pillow that’s too high or too low can strain your neck and upper back, potentially causing or exacerbating pain.
Key Takeaways
- Choosing the right pillow is crucial for alleviating upper back pain and improving sleep quality.
- Consider factors like sleep position, body type, and personal preferences when selecting a pillow.
- Adjustable pillows offer versatility and can be customized to your specific needs.
- Complementary strategies like maintaining good posture and practicing regular stretching can enhance pain relief efforts.
- Consistency is key – it may take time for your body to adjust to a new pillow or sleep routine.