Pillow Placement

By Monica Y. Sengupta

2 min read

Disclaimer: I still wake up frequently and commonly experience pain and stiffness in the morning. The pillow placements I talk about below provide additional comfort but do not alleviate all my symptoms completely.

Lately, I’ve had trouble sleeping. I’m trying to lower my prednisone (corticosteroid) dose, so I’ve been experiencing more swelling and stiffness. Additionally, I have become severely anemic, and any time I lay down, my extremities go numb. These issues together equal an unpleasant night.

Good sleep hygiene, great mattress support, but poor sleep

I turn off my devices at least 30 minutes before I want to sleep, only use yellow light at night, and stagger my caffeine. Sleep hygiene, check! When I moved, I bought a wonderful mattress which was a game-changer. Good support, check!

So, what else could I do? I am no stranger to sleeping pills, but I do not want to take one in the middle of the night (like 2 or 3 am). What else? I remembered a great article from Tamara on pillow placement. If you’ve been in this community for a while, you may know it is one of my favorite articles to share. I gave it a once over and began a journey for new pillow configurations.

My favorite pillows

I have a variety of pillows, but I will name the most important ones to me.

Memory foam pillows

The first pillow is a cooling, stiff, memory foam pillow that conforms to my neck and head. This one stays behind my head most of the night. I have 2 husk pillows that have some weight to them. They are also very malleable and mold to my body. The last 2 are your average down feather pillows and nothing special. The husk pillows are my all-stars, and the down pillows are their support.

Husk pillows

I bought the husk pillows to help me with my sinus infections. I sleep with one over my eyes. It applies pressure to my eyes, sinuses, and forehead and acts as an eye mask against the light. Lately, I switched their purpose to act more as a weighted blanket. I feel the most relief when one is across my chest/shoulders and the other over my ankles or knees. Oddly, they don’t worsen the numbness, and often I don’t get any numbness with these placements.

Down pillows

I use the down feather pillows for any stray joint that needs extra support. I usually place them below my hands so my fingers can rest comfortably or under my ankles/knees. They create a supportive nest for my joint without adding height or pressure. I will also “hug” it with my hand to ensure a natural position for my wrists and fingers.

Pillow placement is an art

I do not keep the same pillow configuration when I move to my side. Often, one husk pillow goes between my knees to keep them straight, and the other stays over my ankles. I may also place the down pillow under my hip and knees that are against the bed for some support.

The issue with these suggestions is that they change from night to night and hour to hour. Pillow placement is an art I am still mastering, but it does help! I am down to try anything that will make my sleep more comfortable.

Do you have specific pillow placements that you like? LMK some of your tips in the comments!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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Effie Koliopoulos Moderator & Contributor
I once was seeing an amazing physical therapist who trained as a functional manual therapist and she taught me about pillow placements. I was laying on the exam bed in the office and she showed me how she sleeps. I literally had about ten pillows all over from head to toe. I was so comfortable and almost fell asleep! Though I asked her if you need to get up and use the restroom in the middle of the night...how is it possible to get out of this human tent. She laughed and said she just does, and sets the pillows in place. I was in awe! -Effie, team member
1. Richard Faust Community Admin
 Hi <inline-mention username="Effie Koliopoulos" user-id="3227889"/>. I wonder if in the response to your bathroom question lies the rub - she just does. Thinking that for those of you with RA this is easier said than done. Have you been able to use her method? Best, Richard (RheumatoidArthritis.net Team)
2. Effie Koliopoulos Moderator & Contributor
 <inline-mention username="Richard Faust" user-id="3227544"/> I've used parts of the method. I like using a pillow between my knees as it does help the lower back and avoid unalignment in the lower back/sacrum/knees etc. This helps my knee replacement even though I had it done 6 years ago now. I find placing a pillow under my arm to support my shoulder helps if my bicep tendon is acting up. I find it helpful to hug a pillow too. But honestly, that was a bit much of what she showed me, lol. I'm also lazy at times so doing that every night from head to toe, if I had a long day is just a no. Plus I don't even have 10 pillows available for all that! Though it's good to know overall. I wish I recorded it. Maybe one day I will and post on Youtube if I see her again.
L rick Phillips Moderator & Contributor
Oh yes I have a favorite place. I put them exactly where Sheryl leaves them. Once I moved one during the night. When i came back there was crime scene tape on my side of the bed. That is when I learned that you don't mess with perfection. Or at least pillow placement. (ever)
sgreerpitt Member
about the time I was diagnosed with RA I also had surgery on my sinuses and nose and the ENT dr. told me after the surgery to sleep propped up with a wedge pillow for several weeks afterwards. During that time I discovered that I was virtually pain free from my arthritis issues sleeping that way, and never went back to lying down. At one point in addition to the wedge pillow I had 10 regular pillows of different shapes and sizes under my arms and my knees, and it became an ordeal to get in and out of bed...about six months ago due to an injury I started sleeping in my recliner using only two small pillows under my knees, and found it so much easier that I actually got rid of my bed and only sleep in the recliner now. I literally have no joint pain during the night and sleep soundly, though still suffer from morning stiffness (though not as much). 
1. Lori Foster Community Admin
 How awesome, <inline-mention username="sgreerpitt" user-id="6216378"/>! I am glad you figured out a way to get a good night's sleep. That has to help improve your health overall. Best wishes. - Lori (Team Member)
JRBwithJRA Member
 What brand/model/whatever is your cooling memory foam pillow? I have always slept hot, but add in menopause and it’s awful. Even when my arthritis would let me sleep a while longer, I wake up because I’m sweating and then my joints, muscles, etc chime in! It is exhausting, but not so much that I can fall asleep. I also sleep with a weighted blanket to help with my restless legs and that add warmth. I keep my heat at 58° overnight in the winter and still get hot! I can’t afford to keep it that cold all year long. 
1. LVanorsdal Member
 <inline-mention username="JRBwithJRA" user-id="4276478"/> I don't have a cooling pillow but I take ice packs to bed with me when it is hot out. I don't have air conditioning in my house so in the summer when it is hot and humid, I take an ice pack and sleep with it. 😀 It works amazing! I have a couple of different kinds that I use. One is a large gel ice pack that was given to me by a chiropractor. The others are just the ice packs that come with vaccine shipments we get at the office. Those last a long time even on the really hot, humid nights. Most mornings there is still some ice in them when I wake up. I usually wrap a thin cloth around them - pillow case, t-shirt, etc. - just so it's not too cold on my skin. I will either lay it on my chest or stomach or against my side - whichever works best depending on how I'm laying. I bet with you using the weighted blanket you could probably put one down by your feet and it would help keep you cool. 
2. Lori Foster Community Admin
 How clever, <inline-mention username="LVanorsdal" user-id="4271595"/>. That must keep you good and cool. Thanks for chiming in! Best wishes. - Lori (Team Member)
Lynn Marie Witt, MSOT Moderator & Contributor
<inline-mention username="Monica Y. Sengupta" user-id="3214456"/> thanks so much for sharing this information on pillows. I use memory foam. However, I will be in the market for pillows in my near future. I had not heard of "husk" buckwheat pillows before. I just looked them up and their benefits. Love your articles Monica, I always learn so much. Wishing you many, many nights of deep restorative sleep. Just Keep Swimming...Lynn Marie, "RheumatoidArthritis.Net Team Member"
iluvdollphins Member
Wow. To each their own. For me, that's a lot of movement and repositioning of pillows = too much time awake and a fight to go back to sleep. I have a memory foam pillow that was bought from the mattress store and then a thin cheapy pillow from Walmart. My head/neck is on both. I have problem enough trying to stay asleep, messing with pillows would only add to that problem. Aside from the sleep struggle, I flop around too much during the night, mainly from pain, that any more pillows would end up on the floor. 
1. Kelly Dabel Community Admin
 <inline-mention username="iluvdollphins" user-id="4688627"/> Glad you've been able to find a setup that is working out for you. Wishing you more sleep ahead. Best, Kelly, <a href='https://rheumatoidarthritis.net' target='_blank'>Rheumatoidarthritis.net</a> Team Member
Mary Sophia Hawks Moderator & Contributor
Monica, My comment is about your anemia. I've struggled with anemia frequently over the years. The best recommendation I received was to use my cast iron cookware. As you cook in cast iron, some of the iron is deposited to your food. The longer you cook, the amount is increased exponentially. Hope this helps. Mary Sophia, moderator