This site has been designed to provide information to help you identify factors which may be causing you to wake with symptoms related to your neck such as neck pain or stiffness, headaches or aching between the shoulders blades or in your arm.

The research that underpins this advice was undertaken by Sue Gordon, as a PhD thesis at the University of South Australia. The research was independent and was not funded by any organisation.

I hope you find information on this website to assist you in the management of your waking symptoms.


Forty six percent of Australians wake in the morning with neck pain, neck stiffness, a headache or aching between their shoulder blades or in their arm (Gordon et al 2002).

Neck complaints annually cost Australia $160 million (Mathers & Penn 1999) and they affect the way in which we live our day to day life, decreasing our ability to enjoy social and recreational activities and our efficiency in the work place.
A neck problem can cause many different types of symptoms. The neck has seven vertebrae. The upper three levels of the neck can produce headaches, called cervicogenic headaches.

The lower levels of the neck can refer pain between the shoulder blades or into the arm. And of course all levels of the neck can cause pain or feel stiff.

There are lots of factors that can contribute to the presence of waking neck symptoms. These include our sleep position, the type of pillow we use and factors which alter our sleep quality.
I first became interested in the pillow problem when we were given a set of new pillows as a wedding present. It wasn’t long before I began to wake with neck pain and headaches.

Luckily for me a change in pillow provided relief of my waking symptoms. During over 20 years of clinical practice as a Physiotherapist I have been consistently asked by patients which type of pillow they should sleep on.
On reviewing the available literature scant information and research was found regarding pillow selection. This prompted me to commence research into the relationships between pillow type, body proportions, neck posture and the prevalence of waking neck pain and stiffness, headache and aching between the shoulder blades or in the arm.
Some of the findings of the research undertaken have been published and further publications are under review.
Gordon SJ, Trott P, Grimmer KA (2002):
Waking cervical pain and stiffness, headache, scapular or arm pain: Gender and age effects. Australian Journal of Physiotherapy 48: 9-15
Gordon SJ, Grimmer KA, Trott P (2004): Self reported versus recorded sleep position: an observational study. Internet Journal of Allied Health Sciences and Practice Vol 2:No1.
Gordon, S., Grimmer, K., Trott, P. (2007): Sleep Position, Age, Gender, Sleep Quality and Waking Cervico-Thoracic Symptoms. The Internet Journal of Allied Health Sciences and Practice. Vol 5: No1.

Gordon, S., Grimmer, K., Trott, P. (2007) Understanding Sleep Quality and Waking Cervico-Thoracic Symptoms. IJAHSP 5(2)

Conference presentations:
Pillow prescription for the prevention of waking cervico-thoracic symptoms. Australian Physiotherapy Association National Conference, Cairns 4-8 October 2007. The association been pillow use and the behaviour of cervico-thoracic spine symptoms in side sleepers. Paper presentation, World Confederation for Physical Therapy, Vancouver, Canada. 3/6/2007.

Current pillow research
A trial of pillows known to reduce waking symptoms in the general population is now being undertaken with people who have arthritis of the neck. This research is funded by Arthritis Australia. The trial will be complete in March 2009.

Previous Pillow research:

The first was a telephone survey to investigate the associations between pillow use, sleep position, and other risk factors for poor sleep quality and waking reports of neck pain and stiffness, headache and aching between the shoulder blades and in the arm.


The second then examined people in their own homes to examine their neck posture and investigate the relationship between their body proportions, pillow type and waking symptom reports as they lay on their own bed with their own pillow.


Another study was undertaken to determine if people can truly report the position in which they sleep during the night.


A further study compared waking symptom reports when using the five most commonly used pillows and the persons own pillow when people sleep on their side.


And finally a digital image study investigated, in the laboratory setting, the relationship between body proportions, neck posture and pillow type in the side sleep position.

The research now allows valid advice to be given not only regarding pillow selection but  other factors that should be addressed in order to decrease waking neck pain, neck stiffness, headache and aching between the shoulder blades and in the arm.
I hope you find some information on this website to assist in the management of your waking symptoms.

Contact Sue Gordon
Senior Lecturer, School of Rehabilitation and Exercise Science, James Cook University, Townsville, Australia
     © Susan J Gordon Pty Ltd 2005

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