![]() ![]() ![]() 55 subjects (37 hospital employees and 18 neck patients) tested all of the pillows in random order over the course of 3 weeks (3 consecutive nights per pillow). Person and Mortiz 22 tested 6 different pillows on neck pain and quality of sleep. Furthermore, the analysis appears to have utilized the mean of each post-treatment period, rather than pre-post treatment period changes, so it is not clear whether the cross-over data may not largely be the post-treatment data of the previous pillow. In this study there is no mention of a “washout period” between pillow administrations (to bring the subjects back to their base-line levels) without this, it is unclear whether there were any carryover effects between different pillows. The investigators concluded that proper selection of a pillow significantly reduces pain and improves quality of sleep, but does not significantly affect disability outcomes as measured by the Sickness Impact Profile (SIP). All the subjects were diagnosed with benign cervical pain syndromes and were selected from outpatient neurology and physiatry clinics. 7 studied 41 subjects with benign cervical pain in a randomized crossover trial comparing 3 pillows (the subjects’ usual pillow, a roll pillow and a water-based pillow) with regard to pain intensity, pain relief, quality of sleep, disability, and overall satisfaction. Because a Before-After study is not a confirmatory design, the investigators also recommended further study using the RCT design to compare the Align-Right Cylindrical pillow to other commonly used cervical pillows. The investigators concluded that the data suggest that clinically important benefits can be expected from a similar chronic neck pain population. Twenty-eight subjects participated in this Before-After trial, for a period of 6 weeks (including a 2-wk baseline). 21 evaluated the effectiveness of the Align-Right Cylindrical cervical pillow in reducing chronic neck pain severity. However, with regard to the alleviation of symptoms, not enough is revealed about how the data were collected. ![]() Jackson, 20 in a study using lateral radiographs of the cervical spine with and without exposure to regular and roll-shaped pillows, concluded that the roll-shaped pillow restores the cervical lordosis (while supporting the head and neck), and decreases neck pain and discomfort while sleeping. This bodes well for further controlled study, but the Smythe design is by no means a confirmatory one. 2Ī case series by Smythe 19 involving 91 prior Fibromyalgia patients and 60 non-prior Fibromyalgia patients, all with neck pain, found that after 18 months of using a cervical pillow, 63% and 84% respectively, achieved clinically important relief. Proper usage is likely very important in achieving clinically important benefit. The importance of this finding is clouded by the fact that the author had no way of knowing if the patients assigned to the cervical pillow used it properly. The control group of 6 patients had a mean improvement of 0.83 degrees. Of these, one group of 20 patients who received only chiropractic manipulative therapy (CMT) gained a mean improvement of 4.55 degrees while the second group of 9 patients who received both CMT and orthopaedic cervical pillow therapy improved 2.22 degrees ( p < 0.01). Recognizing this, Leach 18 radiographically evaluated the cervical curve depths (CCD) of 35 patients who presented with cervical hypolordosis or kyphosis (CH/K). 16 Gray’s Anatomy 17 states that the cervical curve is a secondary curve which first appears in intrauterine life and “is further accentuated when the child is able to hold up its head (at three to four months), and to sit upright (about nine months)”. The lordotic cervical curve has long been recognized as necessary for maintaining human bipedal posture. 8 – 15 The results of our literature search thorough MEDLINE, Index to Chiropractic Literature and MANTIS are briefly summarized below. 8 With the growing interest in the role of cervical pillows, an increasing number of studies have recently been published. Since an estimated one-third of a person’s life is spent sleeping, acute and chronic cervical pain may benefit from management strategies which include modalities such as cervical pillows. More females are affected than males, with lifetime prevalence at about 30% and 15% respectively. 3 – 4 Point prevalence is highest in the 50–59 year-old age category. It has an overall point prevalence of 9–14% and lifetime prevalence of 33% in the North American adult population. Neck pain, both chronic and acute, affects a considerable percentage of people at any given time. The first two studies were published in recent issues of JCCA, 1, 2 where the literature is discussed in detail. This is the third in a series of pilot studies involving the pre-testing of an experimental prototype cervical pillow. ![]()
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