The present invention relates to spinal support and a means for support and alignment for the neck in the side supine or semi prone or prone positions comprising supporting the user s head and/or neck in a first user position with a first adjustable support means adapted to locate the user s head and/or neck at a first height relative to a supporting surface for the user supporting the user s head and/or neck in a second user position with a second adjustable support means adapted to locate the user s head and/or neck at a second height relative to a supporting surface for the user wherein the first and second heights relative to the supporting surface for the user are substantially different such that substantially constant cervical spinal alignment for the user is maintained In both positions.