Read This If You Still Wake Up With Neck Pain

A physical therapy assistant spent years treating necks twice a month — and missing the eight hours that actually mattered. Here's what he tells people to do instead.

If you're here, you probably read what I wrote about my years as a physical therapy assistant — the ten minutes I'd get with someone's neck against the fifty-six hours a week their pillow had it.

I've had more messages about that than anything I've ever said. And nearly all of them ask the same thing: okay — so what do I actually do about it?

This is the answer. It's the one I wish I could go back and give every patient who kept ending up back on my table.

The part you already know

You don't need me to convince you the problem is real — you live it every morning. So I'll just say the uncomfortable bit plainly.

It was never really your posture, or your age, or your stress. It's the eight hours a night your neck spends on a pillow that can't hold it where it needs to be. Which means the fix isn't another stretch, another adjustment, or another appointment. It's changing what's under your neck.

That's it. That's the whole thing I missed for years. So the only question worth answering is: what should be under there instead?

What I started telling people to look for

When I finally started paying attention to pillows, I noticed they nearly all fail the same handful of tests. These are the four I'd run through with anyone who asked.

It has to fill the gap. On your side, there's an open space under your neck, and the pillow has to be tall enough to fill it so your head stays level instead of dropping. Almost no ordinary pillow is.

It has to hold its shape. This is the one that catches everyone out. A soft pillow feels like it fills the gap when you first lie down — then your head's full weight presses it flat within minutes, and by 2 a.m. you're back to no support at all. It has to stay there all night, not just at lights-out.

It has to give your shoulder somewhere to go. Otherwise your shoulder gets pinned under your own body weight — and that's the numb arm.

It has to still work when you roll onto your back. Nobody holds one position till morning, so a pillow that's only right in one position just moves the problem around.

Line those four up and you start to see why nothing in the linen cupboard has ever worked. An ordinary pillow was built to look full on a bed and cost almost nothing to make. Holding a neck in line for eight hours was never part of the job. It's almost a different object that happens to be the same shape as the thing you actually need.

"But I bought a good mattress"

Before anyone emails me — yes, I know you bought a good mattress. People tell me that constantly, like it rules sleep out as the cause. It doesn't.

A mattress supports you from your hips up to your shoulders, and then it stops. The few inches above your shoulders — your neck and your head — never actually touch it. That part has been on the pillow the whole time. A mattress was never going to reach the spot that hurts.

The one I point people to now

When I went looking for a pillow that passed all four tests, I kept landing on the same one — and it's the one I now point people toward: the Original Groove® Pillow.

It's shaped, not flat, with a zone for each job:

Raised sides that fill the gap under your neck on your side, so your head stays level with your spine instead of sagging toward the mattress.

A shoulder cut-out that gives your shoulder somewhere to drop into, instead of being crushed under you all night.

A lower cradle in the centre for when you roll onto your back — your head settles in, your chin stays up.

A gentle rise behind the neck to keep your spine in a neutral line on your back.

And it's firm enough to hold all of that all night, instead of flattening out the moment your head sinks in. Roll from your side to your back at 4 a.m. and there's a zone waiting either way. Nothing to fold, stack or fight in the dark.

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This isn't a fringe idea

I'm not pointing you at something I saw scrolling late at night.

A 2021 systematic review and meta-analysis found a strong link between pillow design and neck pain — that the shape and height of your pillow genuinely affect how your neck sits overnight.¹ A second review landed on exactly what I'd seen for years: contoured pillows with higher sides for side sleepers, a lower middle for back sleepers, and a cooler surface.²

It's the same reason the Groove is now recommended by more than 1,000 chiropractors, physios and other practitioners — people who, like me, finally started asking the question.

The people sleeping on it put it better than I can:

The heat and the smell

Two questions I always get, because people have been burned by memory foam before.

Does it sleep hot? It's built with a breathable, temperature-regulating core, not the dense foam that traps heat. Does it smell? Any new foam can have a faint scent out of the box, but it airs off in a day or two — most people never mention it. If you've sworn off foam for either reason, this isn't that.

You don't have to take my word for it

I know that when you've already spent money on chairs, mattresses and appointments that didn't hold, one more pillow feels like one more gamble.

So here's the fair version. Spread over the years you'll use it, it comes out to a few pennies a night — less than the painkillers you reach for every morning. It feels strange the first few nights if you've only ever slept on something flat. But you get 100 nights to decide, and if it's not for you, you send it back for a full refund. The risk sits with them, not you.

I spent years sending people home with exercises and booking them back in for two weeks' time. If I could do it over, I'd have started every one of those appointments with a single question: what are you sleeping on?

You don't have to wait for someone to finally ask you.

See the Side-Sleeper Groove →

1. Pang JCY, Tsang SMH, Fu ACL. The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: a systematic review and meta-analysis. Clinical Biomechanics. 2021;85:105353.
2. Radwan A, Ashton N, Gates T, Kilmer A, VanFleet M. Effect of different pillow designs on promoting sleep comfort, quality, and spinal alignment: a systematic review. European Journal of Integrative Medicine. 2021;42:101269.