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Quick answer: the Coop Original Adjustable Pillow scores highest (4.4/5): you set its height yourself by adding or removing fill, and it comes with a 100-night trial and a 5-year warranty. If you prefer a firm, contoured shape designed around the neck, the TEMPUR Original SmartCool is the specialist option.
Image: © Coop Sleep GoodsCoop Original Adjustable Pillow
- Adjustable loft: add or remove the memory-foam and microfibre fill
- 100-night trial and 5-year warranty
- Pillow and cover are machine washable
A pillow’s job is to keep your head and neck in line with your spine while you sleep. The right height depends on your build and on how you sleep — back sleepers usually need less height than side sleepers, who have to fill the gap between shoulder and head. That’s why “orthopedic” pillows take very different approaches: a fixed ergonomic shape (TEMPUR), adjustable fill (Coop) or an adjustable water base (Mediflow). We compared the three on their published specifications.
A note on neck pain: a pillow can help keep your neck in a neutral position, but it isn’t a medical treatment. If you have ongoing neck pain, numbness or headaches, see a doctor or physiotherapist before relying on a pillow to fix it.
What matters when choosing a neck-support pillow
Height (loft) matters most. Too high and your neck bends upwards; too low and it drops down. A fixed-height pillow has to match you from day one, which is why TEMPUR sells the Original in several sizes. Adjustable pillows let you fine-tune the height at home.
Shape versus adjustability. Contoured pillows have a raised edge that supports the curve of the neck. They suit back and side sleepers who like a firm, structured feel, but they can feel strange at first. Traditional-shaped adjustable pillows are more forgiving and work in more positions.
The trial period is your safety net. It usually takes a couple of weeks to know whether a pillow suits you. A long trial lowers the risk of a pricey mistake.
Specifications side by side
TEMPUR Original SmartCool
Coop Original Adjustable
Mediflow Water Pillow
How we scored them
Each pillow is rated from 1 to 5 on five comparison points, based on how its published specification compares with the other two. The overall score is the average. Read our full method.
| Comparison point | TEMPUR Original SmartCool | Coop Original Adjustable | Mediflow Water Pillow |
|---|---|---|---|
| Adjustability How much you can change height and firmness after you buy it. |
3/5 | 5/5 | 5/5 |
| Neck-support shape Whether the pillow is shaped specifically to support the neck. |
5/5 | 3/5 | 3/5 |
| Sleep positions Which sleeping positions the manufacturer designs it for. |
3/5 | 5/5 | 5/5 |
| Trial & warranty Trial period and warranty length. |
3/5 | 5/5 | 3/5 |
| Price Entry price compared with the other two. |
2/5 | 4/5 | 5/5 |
| Overall score (average) | 3.2/5 | 4.4/5 | 4.2/5 |
1. Coop Original Adjustable Pillow — best overall (4.4/5)
Coop’s pillow is filled with a blend of cross-cut memory foam and microfibre that you can add or remove through the zip, and the box includes extra fill. That makes it the most flexible option for finding the right height, whether you sleep on your back, side or front. Coop says the pillow and its outer cover are machine washable, and the foam carries CertiPUR-US and GREENGUARD Gold certification.
It also has the strongest safety net in this comparison: a 100-night trial and a 5-year warranty. The trade-off is shape: the Classic version is a traditional rectangle with no built-in neck contour (Coop also sells Crescent and Cut-out shapes), and sizes are US Queen and King.
Not for you if: you want a firm, contoured neck roll, or you don’t want to experiment with the fill.
✔ Pros
- Height fully adjustable at home
- 100-night trial and 5-year warranty
- Machine-washable pillow and cover
- CertiPUR-US and GREENGUARD Gold certified
✘ Cons
- No built-in neck contour (Classic shape)
- US sizes (Queen / King)
- Takes some trial and error to set up
2. Mediflow Water Pillow — best value (4.2/5)
Mediflow’s pillow places a water pouch under a conventional fibre layer. Adding or removing water changes how high and how firm it feels, and Mediflow says the water base adjusts to the weight of your head, neck and shoulders. It has the lowest entry price in this comparison — the Original Fiber version is listed from US$74 — and comes in several fill types, including memory foam and down alternative.
Mediflow cites a study of its water pillow carried out at the Johns Hopkins University School of Medicine. We couldn’t review the study itself, so it doesn’t count towards our score. Reviewers mention that a filled pillow is heavy to flip, and the warranty isn’t stated on the product page.
Not for you if: you flip your pillow often during the night, or you’d worry about a water pouch in your bed.
✔ Pros
- Adjustable height and firmness with water
- Lowest entry price
- Several fill options
✘ Cons
- Heavier than a standard pillow when filled
- Warranty not stated on the product page
- Shorter trial than Coop
3. TEMPUR Original SmartCool — best contoured pillow (3.2/5)
The TEMPUR Original is the specialist here: a contoured pillow made from TEMPUR’s viscoelastic memory foam, with a raised edge to support the neck. Each pillow has two heights — flip it to switch — and TEMPUR sells it in Medium (10/7 cm), Large (11.5/8.5 cm) and X-Large (13/10 cm). It’s designed for back and side sleepers and has a medium-firm feel, with a SmartCool cover you can wash at 40°C.
It scores lowest overall because of what it can’t do: once you’ve picked a size, you can only choose between its two heights, it isn’t designed for stomach sleepers, and at £165 in the UK it is by far the most expensive. Reviewers describe it as divisive — people who like a firm, structured pillow tend to love it, while others find it too firm.
Not for you if: you sleep on your stomach, prefer a soft pillow, or aren’t sure which size you need.
✔ Pros
- Contoured shape designed around the neck
- Three sizes, two heights each
- Washable SmartCool cover (40°C)
✘ Cons
- Most expensive by far
- Limited adjustability once bought
- Not designed for stomach sleepers
Which one should you buy?
- You’re not sure what height you need: Coop Original Adjustable — adjust it at home, with a 100-night trial.
- You want the lowest price: Mediflow Water Pillow.
- You sleep on your back or side and like firm support: TEMPUR Original SmartCool, in the size that matches your build.
- You sleep on your stomach: Coop or Mediflow, set to a low height.
Frequently asked questions
What does “orthopedic pillow” mean?
There is no official definition. The term usually describes pillows designed to keep the head and neck aligned with the spine, either with a contoured shape or with adjustable height.
How do I know which pillow height I need?
Lie in your usual position: your nose should line up with the centre of your body, and your neck shouldn’t bend up or down. Side sleepers with broad shoulders generally need the most height; stomach sleepers need the least.
How long does it take to get used to a new pillow?
Often one to two weeks, especially when switching to a contoured or firmer pillow. That’s why the trial period is worth checking before you buy.
Is a pillow a treatment for neck pain?
No pillow is a medical treatment. A well-fitted pillow can help keep your neck in a neutral position while you sleep, but persistent pain should be checked by a doctor or physiotherapist.
Our verdict
For most people, the Coop Original Adjustable Pillow is the safest choice: you can tune its height to your body and sleeping position, and the 100-night trial and 5-year warranty protect your purchase. Choose Mediflow to spend less, or the TEMPUR Original SmartCool if you already know you like a firm, contoured pillow.
Sources
- TEMPUR UK — Original SmartCool Pillow (sizes, materials, care, warranty)
- Coop Sleep Goods — Original Adjustable Pillow (fill, certifications, trial, warranty)
- Mediflow — Water Pillow range and prices
- Woman & Home — Mediflow Water Pillow review
- Expert Reviews — TEMPUR Original SmartCool review
Specifications checked on 9 October 2026. Prices vary by country and retailer.