The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of clinical trials
PubMed 33895703 · doi:10.1016/j.clinbiomech.2021.105353
What was done
Authors conducted a systematic review and meta-analysis searching six databases (CINAHL Complete, Cochrane Library, EMBASE, Medline, PubMed, and PsycINFO) up to September 2020. They included clinical trials evaluating pillow types on neck pain, waking symptoms, neck disability, sleep quality, and spinal alignment in adults. Methodological quality was evaluated using the PEDro scale.
What was found
Thirty-five articles met inclusion criteria, with nine high-quality studies involving 555 participants analyzed in the meta-analysis. Meta-analysis showed significant improvements favoring rubber pillows for neck pain reduction (SMD: -0.263; P < 0.001), waking pain (SMD: -0.228; P < 0.001), neck disability (SMD: -0.506; P = 0.020), and pillow satisfaction rate (SMD: 1.144; P < 0.001). Pillow designs showed no significant effect on sleep quality (SMD: 0.047; P = 0.703) in patients with chronic neck pain.
Why it matters
Selecting specific pillow materials (such as rubber or spring) offers a low-cost non-pharmacological strategy to modestly alleviate waking symptoms, neck pain, and disability in patients with chronic neck pain.
Limits
The meta-analysis is based on a modest total sample size (555 participants across 9 high-quality trials) despite 35 included articles. Effect sizes for pain reduction were small, and the abstract notes that cervical spine alignment in side-lying positions may depend on shape and height rather than material alone.
Cited by
- contradicts A pillow that tilts the head out of alignment creates muscular strain that signals the brain and prevents deep sleep.