Neck pain and pillow use: review of the evidence that is out there
Monday, January 25, 2010 at 9:35PMIn a practice where I see primarily people with neck and back pain, invariably I am asked what type of pillow I recommend. There is a relative paucity of good data on one type or shape of pillow being better than others. As a result, I often steer clear of giving a response that is very specific.
A recent study in the journal Manual Therapy recently looked specifically at the issue of “Pillow use: the behavior of cervical pain, sleep quality and pillow comfort in side sleepers.” I found the study to be informative and worth thinking more about.
Studies suggest that side sleeping position is the most prevalent position, with 71% of individuals report that they are side sleepers. What is more, research suggests that adults spend 59-73% of their sleep time in a side lying position. More importantly, there is some data to suggest a side lying position can provide some protection against waking cervical pain. [Manual Therapy. 14 (2009) 671-678]
For better or worse, this study was done in Australia with Australian brand pillows. As a result the pillows may (or may not) be hard to find in the States.
This study by Gordon et al. tested the following pillows in side sleepers (N=106):
- Polyester/synthetic pillow (regular shape)
- Foam pillow (contour shape and regular shape) (Medirest brand)
- Latex rubber pillows (Dunlopillo)
- Feather pillow (purchased at Target)
Results of the study demonstrated the following interesting findings:
- “The feather pillow was by far the most problematic pillow.”
- “The rubber pillow was the best of all pillows at ensuring that subjects who went to bed without cervical pain woke without any, whilst the feather pillow was the worst.”
- “The shape of the foam pillow appeared to make no difference to waking pain or abolition of night pain. However, the contour pillow was less comfortable and provided poorer quality sleep.”
- “The feather pillow was a consistent poor performer in all outcome measures and therefore cannot be recommended as an alternative should subjects request a pillow which is better than their own.”
- “The rubber pillow performed consistently well and was a better performer than subjects’ own pillow in all outcome measures and should be recommended as an alternative should subjects seek a better performing pillow than their own.”
There are a few take home messages from this study. First, this was a small study and thus the results should not be over interpreted. Second, the reported results apply to people that spend most of their sleep time in a side lying position. If you are not a side sleeper, then all bets are off with these recommendations.
As a matter of disclosure, I do not have any interests in pillow businesses. I am not sure where to get the Dunlopillo in the United States. This study, though, at least gives some objective information to pass along to patients when asked about specific pillow recommendations.
Below is a link to a latex foam pillow that can be found on Amazon.com:
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