Effect of pillow on pain, disability and sleep quality in patients with chronic neck pain: A systematic review

Abstract

Chronic neck pain impairs physical function and sleep quality. Appropriate pillow use may support spinal alignment, reduce muscle strain, and improve sleep. This systematic review evaluated the effectiveness of various pillow characteristics in alleviating pain, disability, and sleep disturbances among individuals with chronic neck pain. A comprehensive literature search was conducted in PubMed, Scopus, PEDro, and Cochrane Library for interventional studies published from 2015 to June 2024. Following PRISMA guidelines, the methodological quality was assessed using the PEDro scale, GRADE system, risk of bias tool, and level of evidence criteria. From 29,091 screened records, five studies (239 participants) met the inclusion criteria. Outcome measures included the Visual Analogue Scale (VAS), Numerical Pain Rating Scale (NPRS), Neck Disability Index (NDI), and Pittsburgh Sleep Quality Index (PSQI). NPRS scores showed minor improvements (p > 0.05), NDI results were inconsistent, and PSQI differences were not statistically significant. High heterogeneity in study designs, outcome measures, and pillow characteristics limits definitive conclusions. However, limited evidence supports the use of specific pillows as adjunctive therapy for chronic neck pain, with no particular type (latex, foam or standard) demonstrating clear superiority. Therefore, further high-quality RCTs are needed to establish definitive clinical recommendations.