The Pillow Queen

Last updated: November 2022

“Do you really need that many pillows?” I don’t know how many times my husband has asked me that. In spite of being very supportive and compassionate, my husband continues to be baffled by this aspect of my rheumatoid arthritis, how RA complicates the simple process of lying down.

Finding comfort with RA pain

After all, shouldn’t lying down in and of itself be relaxing and restful? When we’re tired or hurting we lie down, and that should put us at some ease. However, when joints are aching and muscles are tight, lying down can actually be painful. My husband will lie down on the floor so our small children can climb on him like a human jungle gym. He will lie down in the grass on a sunny day and feel very relaxed. He can lie down for a nap on the couch in complete comfort.

However, rheumatoid arthritis is a game-changer when it comes to finding comfort. If I lie down on the floor or the ground, I will be stiff if I’m there for only a couple of minutes, and if I’m there longer one of my hips might lock up on me and pain will stab my sacroiliac joints, not to mention the discomfort of the cold that creeps into my joints from those low surfaces.

As for napping on the couch, the only way that is comfortable is if I use my safety net of multiple pillows, in which case I might as well head to the bedroom for a siesta. Ironically, rest is supposed to be restorative, yet for those of us with RA, even lying down can be taxing on our joints.

Comfortable pillow positions

Enter my pillows. In order to get comfortable enough for some quality rest, I require an assortment of pillows of varying sizes and thicknesses. On a good day, I have a three-pillow minimum: one for my head, another for under my arm, and a third for between my knees and ankles.

Head and neck support

The need for a pillow for my head is obvious, but for someone with RA, the choice of pillow may be more important than for some other people. If I sleep on a pillow that is too thick, too hard, or too thin, my neck and shoulders will hurt the next day.


I’m a side-sleeper when my arthritis allows (sometimes my hips, knees, and ankles are too achy to sleep on my side, in which case I lie on my back, a position in which I don’t fall asleep as quickly), and I need a pillow under my arm to rest my elbow and wrist on.

If I don’t have this pillow, a discomfort will quickly arise in my shoulder, then travel down to my elbow, and if I sleep without support for my arm all night, even my wrist will ache in the morning.

Knees, hips, and ankles

The final pillow is for between my knees and ankles. My hips immediately feel uncomfortable if I try to lie on my side without a pillow, and the top knee and ankle will protest if I stay in that position for longer than an hour. If I am lying on my back, I need the third pillow under my knees. Any attempt to lie on my back with my legs out flat quickly sends sharp pains to my hips and sacroiliac joints.

Pillow placement for joint pain

If I’m in a flare, I require even more pillows. I sometimes need two pillows under my knees in order to rest an aching hip, knee or ankle. If I’m able to sleep on my side, as is my preference, I need a pillow behind my back to support my hips. Therefore, in order to be prepared for however I might be feeling each night, our bed looks like something from a pillow commercial.

When my body hurts, all I want to do is rest. Yet, RA is so ruthless that even rest does not come easy. Luckily, now that I have established the exact type of pillow that best supports each of my trouble spots, it’s far easier for me to get comfortable enough to relax. So yes, honey, I really do need that many pillows.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The 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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