What’s the Best Mattress for Back Pain?

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Best Mattress for Back Pain - image of woman relaxing on a mattress

If you suffer from back pain, a good nights’ sleep can make a world of difference.

“Sleep is when we have most of our cell growth and repair, so set yourself up for a good night’s rest and expect to wake up rejuvenated and refreshed,” says David Coppola, a chiropractor and holistic doctor in Key Largo, Fla.

A good mattress can help, of course. But not every mattress is a tonic for every sore back. Many back pain sufferers assume that they’re best off sleeping on an uncomfortably hard surface. Yet experts say that’s not the case. “That’s an old wives’ tale,” says Terry Cralle, a spokeswoman with the Better Sleep Council. Rather, say Cralle and other experts, you need to choose the mattress that best supports your particular sleep style and body type.

Here’s how to determine what’s the best mattress for back pain.

Evaluate your sleeping position to mitigate back pain

When it comes to firmness, experts say that the best mattress for back pain is one that supports your spine’s natural alignment will do the best job alleviating back pain. To a large degree, looking at the sleeping position you favor will guide you in the right direction. (If you also suffer from sleep apnea, cardiac issues, or other health problems, it’s not a bad idea to loop your doctor into your mattress decision-making process.)

One medical journal study found that when subjects switched to mattresses designed to dovetail with their preferred sleeping positions, improvements in both pain and stiffness were noticeable immediately, and progressive improvements built on that over the 12 weeks subjects were followed. “It was concluded that sleep surfaces are related to sleep discomfort and that is indeed possible to reduce pain and discomfort and to increase sleep quality in those with chronic back pain by replacing mattresses based on sleeping position,” the study noted.

So, what’s the optimal firmness for various sleeping positions?

For back sleepers: According to the latest research, back sleepers tend to do best with a medium-firm mattress, all else being equal. As reported in Harvard Health Publishing, a survey of 268 people with low back pain found that those who slept on very hard mattresses had the poorest sleep quality, while there was no difference in sleep quality between those who used medium-firm and firm mattresses.

For side sleepers: Side sleeping tends to be the position most conducive to a healthy spine. In that case, you might want a somewhat softer mattress that will let you “sink in” a bit and preserve your spine’s natural alignment. Side sleepers who spend the night on a mattress that’s too firm might experience pressure or numbness in their hip and shoulder.

For stomach sleepers: Stomach sleeping can place a lot of stress on your lower back and neck, which is why the National Sleep Foundation recommends trying to switch things up. If you’re a committed stomach-sleeper, though, a firm mattress will give you a bit more support to minimize back pain.

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Get educated about mattress types

One big factor that determines the level of support a mattress will offer for back pain is what material (or, increasingly, materials) comprise it. The “traditional” mattress—and the kind most Americans still have, according to a Consumer Reports reader survey — is a classic innerspring coil mattress. While there’s nothing wrong with sticking with the tried-and-true, back-care experts recommend learning about the wider variety of mattress types and materials out there today, including memory foam and latex, since they have different attributes that may appeal to your sleep needs. “There’s no evidence to support that one material is better than another,” Cralle says.

Regardless of material, the best mattress for back pain is one that includes firmer support zones for optimal alignment. “Your mattress should have reinforced areas for the hips and shoulders. Pay attention to the edges as well,” Coppola advises. Firmer edges are a good indication of a higher-quality product, with durable materials that will provide adequate support night after night. “The edges should not break down when you sit on them to put on your socks and shoes,” says Coppola.

If you tend to run hot when you sleep (and here’s why some people do), you may want to consider materials that will keep you cooler, since overheated sleepers tend to toss and turn, exacerbating their back pain in the process. Natural latex mattresses incorporate channels to improve airflow and avoid trapping heat, for example, while many memory foam mattresses feature special gels or heat-wicking materials to keep you cool. (Learn more about the key differences between latex and memory foam to help you decide which material is right for you.)

Don’t assume that high cost equals quality

“Mattresses do not have to be expensive. They need to be comfortable to your skin and supportive to your skeleton,” says Robert Hayden, an Atlanta area chiropractor and spokesman for the American Chiropractic Association. “If you can get that combination, that is the mattress for you.”

If you’ve always stuck to the same type of mattress, don’t be afraid to branch out and try other varieties to find the best mattress for your back pain. Ultimately, the choice is less about what the mattress costs and more about how it feels when you lie down on it. “It is very subjective, and it depends on your comfort,” Hayden says.

That said, it’s best not to base your decision on purchase price alone. If you wouldn’t cut corners when buying, say, power tools or camping gear, you should apply that same outlook when it comes to shopping for a mattress, says Cralle: “Look at them as more of a performance product.”