What makes you think early humans slept on flat surfaces with no neck support? Is this something you've studied, or are you making things up?
Here's what gorilla nests look like:
https://www.berggorilla.org/en/gorillas/general/everyday-lif...
I'm sure early humans were at least as capable at making beds, and could make something that functioned as a pillow, or at least gave some neck support, if that was comfortable.
(To be clear, I know absolutely nothing about how early humans slept. I just suspect that you don't either.)
Congrats on getting past the acclimation period, it seems obviously better for your back.
How has it affected your personal life? The last woman I dated was deeply offended by my disinterest in sharing her bed and insistence on sleeping on the floor after our first few overnights. This aspect of the practice seems the most problematic, it's had me consider moving to Japan.
The mattress-pad I use is 4mm of sponge. I use it to help with air-flow under my body. I think I'm eventually going to wean myself off it and sleep on a sheet on a wooden floor (or perhaps a tatami mat type thing).
It helps a lot that I don't have a "steady" love-life. I keep a bed in a guest-bedroom for the dalliances though. Nobody else I've met in real life so far agrees with the concept of sleeping without a mattress. Pity (for them).
Evolution is a game of trade-offs and compromises, you know.
A pain in the small of my back went away after I started sleeping on a hard floor with a thin mattress-pad underneath. The discomfort was brutal the first week though.
I still love using my big squishy pillow tho, because I like sleeping on my side.
I know that sleeping without a pillow has to be good for me... 2 million years of homo-noid evolution without pillows is all the facts I need.
However, the most I'm able to go without a pillow is 2 nights. I have such terrible sleep, that I give in and use a pillow the 3rd night.
Without a pillow I find I can't sleep on my side (which I love doing), and if I'm sleeping on my stomach then there's too much pressure on whichever face-cheek faces down, causing mild bruising.
I'd love to learn to stop using pillows though.