How to Use a Cervical Pillow Properly

How do you set up a cervical pillow in 5 steps?

You set up a cervical pillow by putting the thicker roll under your neck, your head in the dip, and your shoulders off the pillow. This is for back and side sleepers.

Step 1: Find the right side up

The contoured side with the dip faces up, and the thicker roll goes toward your neck. Many pillows have a higher and a lower edge, so check the label. For the Derila Ergo, the maker says to keep it right side up, facing you.

Step 2: Place the neck roll under your neck

The roll fills the gap between your neck and the mattress. That gap is what the pillow is for. It is not meant to go under your shoulders.

Step 3: Settle your head in the dip

Let your head rest in the central dip. It may feel firm or odd at first, which is normal for a shaped pillow.

Step 4: Check chin and shoulders

Keep your chin level, not pressed to your chest and not pointing up. Your shoulders should sit on the mattress, just below the pillow.

Step 5: Add support under knees or arm

A small pillow under your knees (back) or between them (side) helps you stay put. Hugging a pillow can steady your top arm.

How should you lie on your back or side?

On your back, the lower roll goes under your neck. On your side, use the higher edge against your neck. Pick the position that fits how you sleep.

Back sleeping

Lie with the back of your neck on the roll and your head toward the centre. Put a pillow under your knees if your lower back feels tense.

Side sleeping

Use the higher edge so your nose lines up with the middle of your chest. Keep the pillow snug against your neck. Example: a side sleeper with wide shoulders often needs the taller edge. See pillow height for side sleepers for more.

Stomach sleeping

Stomach sleeping is hard on the neck because your head stays turned. Try a flat, thin pillow or none, or ease toward your side with a body pillow. The maker of Derila Ergo says it suits stomach sleepers too, with a cut-out for your arm and the cheek in the central curve.

Is my cervical pillow too high?

Your pillow is too high if your head is pushed forward or tilted sideways when you lie down. One study of ten healthy adults found that raising pillow height increased pressure under the head and neck and changed the neck’s curve. A review also notes that the best height for back and side positions isn’t settled, so go by fit.

The 4-point height check

Ask a helper to take a photo from the side, or use a mirror.

1. Your chin isn’t pushed toward your chest.
2. Your head isn’t tilting sideways.
3. Your shoulders aren’t hunched up.
4. Your ears sit roughly in line with your shoulders and your nose is level.

Waking with a stiff neck is another hint.

What to change if it is too high or too low

For a pillow that’s too high, flip to the lower side, take out an insert layer if it has one, or choose a different loft (height). Too low looks like your head tipping back or sagging toward the mattress. Then add a thin folded towel under the pillow’s neck end to raise it a little.

The Derila Ergo is a contoured memory foam pillow with front support wings and a cooling cover, measuring 54 x 36 x 12 cm, and it’s one example you could set up this way.

Check the pillow’s size and return terms before you buy, so you can adjust the fit.

See Derila Ergo on the official site60-day money-back guarantee

How long does it take to get used to it?

Plan on about 1 to 2 weeks to adjust. Start with a few hours, such as a nap or the first part of the night, and build up.

Stop and see a doctor if you get new pain, tingling or numbness. MedlinePlus lists pain that doesn’t improve in a week, or numbness, tingling or weakness in an arm or hand, as reasons to get checked.

Common mistakes:

• Putting the pillow under your shoulders
• Stacking it on another pillow
• Using a worn-out pillow

Does a cervical pillow actually work?

A cervical pillow is a support for comfort, not a cure for neck pain. Research is mixed and small, so fit matters most.

What it can and cannot do

A review of trials found pillow use was linked to less neck pain and better satisfaction in people with chronic neck pain. A newer review found limited evidence, and no pillow material was clearly better. The maker hasn’t published a study of Derila Ergo itself.

Which pillows do chiropractors recommend?

Chiropractors usually stress fit for your sleeping position over any one brand. Pain that lasts needs a chiropractic evaluation or another professional check.

How do you look after it, and when should you replace it?

Wash the cover by its label and air out the foam core, never machine-wash it. The Derila Ergo cover is removable and, the maker says, machine washable on warm. See how to clean pillows for other fills.

Replace it when it stays flat or stops supporting you, often every 1 to 3 years. When travelling, pack it in a bag. In a shared bed, keep it on your side.

Cervical pillow setup checklist

This checklist covers the whole setup in one place.

1. The side with the dip faces up.
2. The thicker roll sits under your neck.
3. Your shoulders rest on the mattress, off the pillow.
4. Your chin is level, not tucked or tilted up.
5. On your side, your ear sits roughly over your shoulder (a photo from behind helps).
6. A pillow under your knees (on your back) or between them (on your side).
7. The pillow isn’t stacked on another one.
8. Stop if you get new numbness or tingling.
9. Review the setup after a couple of weeks.

Where to go next

If you’re still choosing, see our best cervical pillow comparison, or read what is a cervical pillow. For the wider picture, try healthy sleep pillows. You can also read our ergo memory foam pillow review. Links may earn us a commission.