The pillow is strange in appearance as it has "rolls" around the edge and a recessed middle. The rolls serve the purpose of supporting the neck while the head tips back ever so slightly. The result is to ever so gently allow the vertebrae to relax which creates less stress during the nightl on neck muscles. It really works to provide less neck pain. I was so pleased with mine after a week that I sent one to a friend who has neck problems and he also found it helpful.