As an individual with fibromyalgia, I've chronic pain everywhere. I've a straight neck, and arthritis in my neck. My head has always been sensitive to pillows due to my neck/headaches. Typically, the flat pillows are more comfortable for me. I've tried memory foam, it was too firm and it would increase neck pain/headaches. Years later here I am researching again. I read the reviews for this and I liked what I read. I took a chance and bought it. To me, it feels like it's helping. It's comfortable. No headaches. No neck pain. The only thing that's irritating is where you put your arms when side sleeping. I'm not used to having my arm in this position, but am forcing myself to use this pillow correctly so it helps me. I use a regular standard pillow case as this does not come with a pillow case.