Twenty Years of Pillow Research: a Brief Summary
Over 100 scientific research papers have been written about the potential benefits of a pillow for optimal spinal positioning, spanning over 20 years of research from universities and clinics from around the world. In consideration of these observations, the MUTU pillow was designed to address the key findings found within this growing research space.
Exploring the definition of neck pain, its global prevalence and causation, we discuss how pillows have been found to be a simple, but inexpensive means of therapy.
The Need for the Perfect Pillow
Amongst it’s variety of causes, neck pain has been aggravated by poor sleeping posture due to its long-term overnight strain of the surrounding cervical ligaments and muscular matrix of the neck.
If not a cause on its own, physical therapists and physiotherapist can often suggest for patients to update their pillows as a means to encourage healing through correct alignment of the spine during sleep and minimize chronic non-specific neck pain .
Success of the treatment however is highly dependent on finding a pillow that can provide suitable height and support for each patient. Pillows that fail to provide proper cervical alignment for such patients can lead to further strain on the ligaments supporting it, and ultimately cause amplified muscle stiffness, tension headaches, and chronic neck pain upon waking [7-8].
Luckily for patients suffering from non-specific chronic pain, there is no shortage of possible pillow choices. With so many choices however, comes an expensive exercise of trial and error; spending hundreds of dollars before finding the right pillow.
It was through this premise, that the MUTU was born.
A pillow that could be tailored to each persons unique support and anthropometric needs, and remove the need to trial multiple different types of pillows before finding the perfect one.
A pillow that could be used by side sleepers and back sleepers alike, to ensure that their cervical spine may be supported in every position.
but ultimately, the comfortable, clean and cool pillow in the market.
The Global Epidemic of Neck Pain
Neck pain is defined by the World Health Organisation as pain in the neck with or without pain referred into one or both upper limbs that lasts for at least 1 day. Due to the variety of causes of musculoskeletal neck pain, the rates of recurrence and chronicity of neck pain are typically high due to improper care and treatment  .
Neck pain is one of the most common conditions treated by physiotherapists across the world, with prevalence likely to increase over the coming decades with increasing ageing populations seen throughout the world, especially in low- income and middle-income countries . It's known that approximately half of all individuals will experience an episode of clinically significant neck pain over the course of their lifetime. 
Within Australia alone, 10-15% of the population experience neck pain and require conservative therapy for relief of symptoms .
The Burden of Neck Pain
Under the chronic, debilitating symptoms of neck pain, patients have been known to experience significant professional and social implications as a consequence from the disorder.
Simple, but integral movements of the rotation and extension of the head are essential for vision and spatial awareness and as a consequence, its limitation has shown to hinder daily tasks such as driving and working on a computer. In addition to personal disability, neck pain has demonstrated significant consequences towards work productivity and work absence with neck pain is known to be the second largest cause of time-off work under lower back pain.
Under these observations that the the World Health Organisation conducted a six-year Global Burden of Disease Study in 2010, concluding that neck pain lied 4th highest disabling disorder, against 291 other conditions .
The Search for the Right Pillow
Due to the growing prevalence of non-specific, chronic neck pain, the need for a supportive and height adjustable sleeping pillow is growing more and more significant as a method of conservative treatment.
Lying as a critical factor influencing spinal alignment during sleep, it is highly recommended that chronic sufferers find a pillow that is capable of supporting a neutral alignment for their particular body shape, size and sleeping position. However, this is almost impossible due to the variety of models that are currently commercially available. In order to simply the purchasing process, the 'perfect pillow' has been defined based on its satisfaction of three criteria; filler type (support) , pillow height and sleeping style (alignment).
A pillow expected to relieve waking neck pain however must satisfy all three key criteria, as the fulfillment of one alone will not be able to provide significant effects, as found below.
1. FILLER TYPE
Although the correlation between head support and waking neck pain and comfort is significant [4,6-11], multiple studies have attempted to compare the efficacy of different types of pillow structures and fillers (feather, foam, rubber etc.), against outcomes of waking pain and sleep quality. The results of these studies however have been contradicting and highly varied , with pillows who have performed superior in one study, performing poorly in another, under a different sample population. This is unsurprising as each study tested different pillow models, each with a different levels of support, albeit containing the same filler. It is therefore unwise to choose a pillow based on filler type alone.
2. PILLOW HEIGHT
Regardless of filler type, what is clear amongst these studies however is the observation between pillow height and sleeping quality, being identified as one of the critical factors influencing spinal alignment [12-15]. Despite this, almost all pillows marketed towards cervical pain management are manufactured in one height for one sleeping position. In reality, each individual contains unique structural measurements and proportions that requires tailored support for effective waking pain management and therapy. In saying this, there are online guidelines available which can provide you with an ideal pillow height based on your gender and body height which you can use in your purchasing decision. This however relies on pillow manufacturers delivering a pillow that matches exactly to the height that you require.