Vanti C, Banchelli F, Marino C, et al. Effectiveness of a "Spring Pillow" Versus Education in Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. Phys Ther. 2019 Sep 1;99(9):1177-1188. doi: 10.1093/ptj/pzz056. (Original study)

BACKGROUND: Different types of pillows have been proposed for neck pain, but no previous randomized controlled trial has investigated the effectiveness of a "spring pillow" for adults with chronic nonspecific neck pain.

OBJECTIVE: We evaluated the effectiveness of using a pillow made from viscoelastic polyurethane and 60 independent springs compared with an educational intervention in individuals with chronic nonspecific neck pain.

DESIGN: This was a randomized controlled trial with crossover study design.

SETTING: The setting was the Occupational Medicine Unit, University Hospital, Bologna (Italy).

PARTICIPANTS: We recruited 70 adults with chronic nonspecific neck pain, of whom 64 completed the trial.

INTERVENTION: Participants were randomly assigned to 2 groups. One group used the spring pillow for 4 weeks, and the other group followed educational advice for 4 weeks while continuing to use their own pillows. After 4 weeks of treatment and 4 weeks of washout, groups were crossed over. Pain perceived in the neck, thoracic, and shoulder areas and headache were the primary outcome measures. In addition, disability, sleep quality, subjective improvement, and pillow comfort were assessed. Measures were captured at pretreatment, after 4 weeks, after the 4-week washout period, and 4 weeks after crossover. The mean differences (MD) in outcomes between groups were assessed.

RESULTS: Treatment with the spring pillow appeared to reduce neck pain (MD = -8.7; 95% confidence interval [CI] = -14.7 to -2.6), thoracic pain (MD = -8.4; 95% CI = -15.2 to -1.5), and headache (MD = -16.0; 95% CI = -23.2 to -8.7). Reductions in shoulder pain were not statistically significant between groups (MD = -6.9; 95% CI = -14.1-0.3). Neither the crossover sequence nor the period (first vs second intervention administration) significantly affected the results.

LIMITATIONS: Education may not have been the best comparator for the spring pillow; drug consumption, actual pillow use, and the implementation of the educational suggestions as prescribed were not controlled.

CONCLUSIONS: Use of the spring pillow in this study was more effective than an educational intervention for improving cervical, thoracic, and head pain. Whether a spring pillow is more effective than other ergonomic pillows remains to be tested.

Discipline Area Score
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Comments from MORE raters

Physician rater

Interesting but too early to disseminate.

Physician rater

Intriguing result. I agree with the authors of the article that the study should be replicated with a different pillow such as a simple cervical roll as the control.

Physician rater

This is an interesting and well performed study. There is only a small effect on headache, but no clinically relevant improvement of pain in neck and shoulder. A large placebo effect is likely.

Physician rater

The information contained herein is known to practitioners. I don't think you're very interested.
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