How to Find the Best Mattress for Back Pain

Seeking the best mattress for back pain alleviation or prevention? In this guide, we will explain the basics of mattress support, how beds relate to back pain, and factors to consider when testing and shopping for a new bed. From firmness to type to your sleeping position, see which mattress offers the best bed for a comfortable night’s sleep.

Choosing the Best Mattress for Back Pain

Choosing a comfortable mattress can seem intimidating between the wide selection and confusing information consumers often face. But, when you know how mattresses work and how the different types compare on support, you can make a more informed decision about which type would be ideal for your needs. In order to find the best mattress for back pain, the main things to consider are conformity, support, firmness, and your sleep position. Keep reading to see what each of these terms means, and how the different mattress materials compare.

Conformity

The conformity of a mattress refers to how it reacts to your body weight and shape. A mattress with high conformity will mold around your body and to your curves (think of how water or other viscous liquids will adjust to pressure). A mattress with low conformity will resist changing shape and will limit the amount that your body sinks in (think of wood and stiff materials would react to pressure).

Materials with the ability to conform can reduce pressure points and allow for more natural alignment, which can help reduce back tension and pain. A mattress with very low conformity can contribute to pressure points, and places pressure on hips and shoulders while offering little support for your lower back, distorting the natural alignment of your spine. The resulting muscle tension and poor alignment can contribute to back pain. On the other hand, a bed with that conforms too much can lack support and also contribute to pain.

Support

Support refers the mattress’s ability to keep your body in an ergonomic position. Your neck, back, hips and legs should rest at a natural angle. Some types of mattresses can cause hammocking, in which your heavier torso sinks lower than your legs, or your lumbar region bows out due to insufficient mid-back support. Both problems can contribute to back pain. The material should able to support your weight evenly and should be durable enough to maintain support throughout the expected lifespan of the product. Some types of beds are more likely to lose support over time, resulting in sagging, and sagging over 1 inch can contribute to back pain.

Firmness

Firmness refers to how the mattress feels against your body, and is often a fairly subjective measurement. Most mattress makers just use labels such as extra plush, plush, medium soft, medium, medium firm, firm, or extra firm, but there is not a standardized labeling system. The exception would be latex mattresses, which may be described in “ILD” which refers to the force required to compress a fourth of the material (higher numbers are firmer). As for which firmness range provides the best mattress for back pain, the answer is medium to firm based on existing sleep studies (but more often medium and medium-firm beds show best results). A study conducted in 2003 by the Kovacs Foundation showed that 82% of people with back pain reported improvement sleeping on a medium-firm mattress, as opposed to 68% of the firm respondents. Surveys from product review website Sleep Like The Dead assign the highest amount of pain to firm mattresses and the lowest to medium beds, with soft in between.  You should really listen to your body and your sleep position when choosing firmness, as there is one-size-fits-all recommendation.

Sleep Position

How you sleep will play a big role in figuring out which type of bed is the best mattress for back pain. Different sleep positions require different types of conformity, support and firmness, and taking these into consideration can help focus your options.

Side sleeping is the most popular position, though it puts up to 7 time more weight on pressure points like hips and shoulders. If you are a side sleeper, you want a mattress that is highly conforming, one that will accommodate the curves of your hips and shoulders rather than push them upwards. It also needs to be able to support your waist area in order to maintain a straight spine. You’ll likely feel most comfortable on a medium firmness mattress with a thicker comfort layer of high-contouring material like memory foam or softer latex. For side sleepers with back pain, an article from the Mayo Clinic suggests also placing a pillow or rolled towel between your knees to prevent your hips from twisting and straining your back.

Back sleeping is the recommended position for reducing back pain, but in order to reap the benefits, your mattress must support your lower back to allow the area to decompress and relax. Your mattress should have a moderate level of conformity that accommodates your rear and the curves of your back comfortably (no painful pressure points). On the other hand, a mattress that is too soft or too conforming may allow your hips to sink too far, which can put pressure on your back. Medium firm to firm are considered ideal comfort levels for back sleepers. If you can fit more than 2 fingers between your lower back and the bed when lying flat, it is not supportive enough. You’ll likely feel most comfortable with a medium layer of moderately contouring material, like latex, firmer memory foam, or wool. The Mayo Clinic also suggests a pillow beneath the knees to improve support.

Stomach sleeping is the least recommended position for people with back pain, as this position can place the most stress on your lower back and neck. However, if you must sleep on your stomach, you want to make sure your mattress has firm support that does not allow your stomach to bow downwards. A moderate level of contouring will likely feel most comfortable, with just enough padding to prevent pressure but not so much that your upper body sinks lower than your hips or legs. You can also place a pillow under your pelvis to prevent the sway back position and use a low pillow to keep your neck aligned with your spine, according to the Mayo Clinic.

If you and your partner have different sleep position preferences, you can either find a middle ground or opt for a mattress that has dual sides. Several latex bed companies allow customers to specify two different firmnesses, and waterbeds and air beds can also come with dual sides. If you do not consistently sleep in one position, track which one you most often wake up in, and choose your mattress based on that.

Mattress Type Comparison

Below is a chart comparing the leading types of mattresses on conformability, support, firmness options, durability, average owner satisfaction and price ranges. This information is based on data from SleepLikeTheDead.com. Keep in mind that different brands and models will vary, though this chart can offer some general guidance if you are unsure where to start. To see more in-depth brand comparisons, check out our previous articles comparing memory foam mattress brands and latex mattress brands.

So, what is the best mattress for back pain?

Based on the above information here are the mattress types that would most likely prove to be the best mattress for back pain based on sleep position. Keep in mind these are just general pointers; be sure to test out a variety of options to see which fits your body and preferences.

Side Sleeper – high conformity, medium support, medium firmness

1. Memory Foam  - choose a bed with 3-6” of medium/medium-high density memory foam (4 to 5.5lbs).
2. Talalay Latex – choose a bed with a soft or medium layer above the core, and of 8 or more inches in thickness.
3. Pocket Coil – individually pocketed coils offer more contouring. Look for a model with a durable pressure relieving comfort layer like latex or memory foam.
4. Air Bed – choose a model with a comfort layer of 2” or more to provide adequate cushioning and contouring.

Back Sleeper – medium conformity, strong support, medium to firm

1. Talalay or Dunlop Latex – choose a firmer latex mattress between 6-10” thick depending on your weight/frame size.
2. Memory Foam – choose a bed with 2-4” of medium density, firmer memory foam over a supportive core.
3. Air Bed – choose a model with a minimal comfort layer (or firmer material like latex) and with baffled chambers to provide sufficient support.
4. Pocket Coil – individually pocketed coils offer more contouring. Look for a model with a durable pressure relieving comfort layer like latex or memory foam. Make sure lumbar area is supported.
5. Softside Waterbed – choose a waveless or ultra-waveless model with lumbar support to prevent hammocking.
6. Offset Coil – offset coils are more affordable than pocketed, and can work for back sleepers since less contouring is required. They are usually supportive, but prone to sagging faster than some of the other types.

Stomach Sleeper – medium conformity, strong support, medium to firm

1. Talalay or Dunlop Latex – choose a bed of 6-10” thick with medium to firm layers. You may prefer one that has 1-2” of softer material on top with firmer lower layers.
2. Air Bed – choose a model with a minimal pillowtop and baffled chambers, and keep inflated fairly firm to prevent lower back strain.
3. Pocket Coil – choose a supportive model, possibly with a layer of latex to offer some cushioning and contouring without excessive sinking.
4. Memory Foam – Choose a firmer memory foam mattress of medium or higher density with a thinner layer of memory foam (less than 3”).

Different Couples – differing support and firmness needs

1. Dual Latex Mattress
2. Dual Memory Foam Mattress
3. Dual Air Mattress
4. Dual Softside Waterbed Mattress

If you aren’t sleeping well due to pain or struggle with back pain upon waking, there is a good chance your mattress is worn out or is not providing adequate support. Picking the right bed doesn’t have to be difficult; it essentially involves learning about the basics of support and examining your needs and how you sleep to see which types of beds offer the best match. Branch out and try a few different types of materials to see which feels most compatible, but don’t rely solely on an in-store test. Buyer’s remorse is pretty common with mattress shopping, as a bed can feel much different during a quick test than it does when you are actually sleeping. For this reason, it is important to choose a company that allows you at least 30 days to return, as it can take a few weeks for you back to adjust to a new bed, especially when going from springs to memory foam, for example. Checking out reviews online to see if people mention improved or worse back pain with a particular bed can also offer helpful insight. Using these basic guidelines as a starting point and listening to your body can help you find the best mattress for back pain relief.

Note: There is a poll embedded within this post, please visit the site to participate in this post’s poll.