Waking up with back pain is a part of daily life for millions of Americans. Grimacing through morning routines to loosen muscles only to have them stiffen back up during work hours begets a dangerous cycle of poor spinal health. There are many ways to help address the presence of back pain such as chiropractic work, physical therapy, lifestyle alterations, and even strengthening exercise such as yoga. Mattresses are among some of the most holistic approaches for addressing back pain but low quality products could just make things worse. Finding the best mattress for back pain is a tough task but learning what to look for and why it’s important can the challenge surmountable.
Chronic back pain is no joke—it affects tens of millions of Americans each year. Low quality mattresses contribute to this epidemic in two unique ways. Sleeping on a mattress that doesn’t support proper spinal alignment can create low back pain, and also make worse existing back pain. That means that if the positions your sleeping in each night aren’t conducive to proper spinal alignment—your back pain might never fully resolve. Ensuring you have proper lumbar support and that your neck is properly supported are both excellent actions to take.
Having a quality mattress that supports a healthy spinal alignment can help provide a holistic fix for your chronic back pain
Using a pillow underneath your lower back, and ensuring the pillow you use for your head is high quality, can both help tremendously. Still, managing the strategic alignment of pillows each night, and each time your wake up during the night, can be annoying at best—not feasible at worst. Having a quality mattress that supports a healthy spinal alignment can help provide a holistic fix for your chronic back pain. This article is all about considerations to take in mind when selecting a mattress for back pain specifically. Before we talk about mattresses though, let’s take a closer look at spinal health and why supporting it is important.
Spinal alignment falls into a broader category of health concerns regarded as body alignment. This field of study looks at a range of different activities and physical approaches for conducting them. These types of activities may range from doing squats in the gym to simply sitting upright in a chair while reading. Following general best-practices for physical positions can help not only help support your spine but also your entire musculoskeletal system. When it comes to finding a mattress for back pain you need to be concerned about two things; horizontal support and vertical support. When you’re laying on your stomach or back it’s important the contour of your body is supported in such a way that promotes proper spinal alignment. The same is said for when you’re laying on your side. This might sound simple enough but finding a mattress that can provide proper spinal support for both side sleepers and back sleepers is easier said than done.
Your back can become injured in many ways during the day that has nothing to do with your mattress. Lifting heavy objects improperly, making awkward twists, or even falling can all hurt your back. While we sleep our bodies undergo a great many maintenance type process to help heal us from the previous day and get us ready for the next. If you aren’t getting quality sleep then you won’t be able to give your back the support it needs to repair itself properly. Even worse; if your mattress isn’t supporting the curvature of your back properly you could be making the damage worse! A general guideline is that you want to have the upper part of your spine, the middle part of your spine, and the lower part of your spine all supported in ways that contribute to their proper alignment. Finding a mattress that can support your spine can be difficult and depends on several factors. If you are a side sleeper you’ll likely want a softer mattress to allow a deeper contour. On the other hand, if you sleep on your back or side too much compression could cause stress on your spinal alignment.
Everyone is different and you should never feel overly persuaded by the experience of others—especially when picking out a mattress. Nonetheless; taking a quick survey of some mattress, chronic back pain, and sleep quality research can help get a better understanding of what you should look for when shopping for a mattress. Before we do so, let’s agree on a few perspectives from which we’ll evaluate the researcher’s findings.
This is a factor in nearly every comparative study conducted, professional or non-professional, that we’ve come across. The firmness of a mattress is often the single most noticeable attribute and also one of the most impactful towards spinal health. The firmness of a mattress dictates how much, or how little, your body will sink into the mattress immediately. The firmer the mattress the less you’ll compress the material. Softer mattresses are generally preferred by those sleeping on their side as a means to offer better compression in the hips and shoulder area.
Mattress support is similar to firmness but it differs in that it is measured throughout the night. The firmness of a mattress is measured immediately upon laying down while the support of a mattress is measured by how closely it holds form. Many cheap mattresses tend to compress more throughout the night due to weakening materials. The causes the initial position you’ve fallen asleep in to become uncomfortable and no longer supportive of proper spinal alignment. At the very least, this can cause sleep disturbances necessitating a position change; at the worst—it can be a root cause of lower back pain.
The thermal properties of mattresses aren’t directly related to spinal health—not as much as mattress firmness anyway—but contribute to overall sleep quality. As we mentioned before, if you aren’t sleeping well in general your body isn’t going to be able to repair itself at a maximum rate. This effect contributes to chronic back pain and can be summarized by causing a general unrest during sleep. Memory foam mattresses are among the most notorious mattresses for heat retention. If you decide on a memory foam mattress make sure you’ve ensured the type of foam they’ve used is one designed to help remove heat.
In a double-blind, placebo-controlled study published in the Lancet in 2003, researchers designed assessed the impact of different mattress types on 313 adults with chronic back pain. Researchers then randomly assigned participants in test groups either a firm mattress or a medium-firm mattress. To get a better idea of the differences between mattress types; on a scale of 0-10, with 10 being the softest, the firm mattresses were a 1-2 rating and medium-firm mattresses were 5-6. During the evaluation period, researchers found that those sleeping on a medium firm mattress had less back pain while in bed, less back pain while rising, and less disability due to back pain. Overall, this research is a strong vote for a medium-firm mattress if you suffer from back pain. 
Researchers found that those sleeping on a medium firm mattress had less back pain while in bed, less back pain while rising, and less disability due to back pain
In another study published in 2014 researchers compared memory foam mattresses to waterbeds to firm mattresses. These different types of mattresses were given to study participants exhibiting chronic back pain who were then evaluated over a 30 day period for impact on lower back pain, leg pain, numbers of hours slept each night and the impact on daily activity.  This study found that the firm mattress caused greater back pain, lessened ability to perform daily activities, greater leg pain, and also resulted in fewer hours slept. The medium-firm mattresses helped reduce back pain, helped support daily activities, and helped get more hours of sleep each night. Interestingly enough, the researchers found that waterbeds offered about the same level of benefits as the medium-firm mattress. Overall, this seems to be another strong vote for medium-firm mattresses being the best mattress for back pain.
Trying to find the best mattress can be an arduous task riddled with over-zealous marketers and confusing discounts. There are a few general rules to follow that can help keep you in the green zone when trying to navigate your way through the market. Knowing where to buy mattresses online will save you a lot of money, buying mattresses with solid warranties will help you save money in the long term, and buying a mattress with an in-home trial period will help you be sure you’ve chosen wisely. Below you’ll find quick rundown of the best medium-firm mattresses for back pain.
Nectar Sleep has positioned themselves well within the mattress market in recent years. The Nectar Sleep memory foam mattress rarely gets considered the best mattress—but often gets considered to be one of the best-priced mattresses. This mattress is a layered foam design with a thick base layer for continued support throughout the night. It has a medium-firmness and comes with a forever warranty and 365-night in-home trial.
The Zinus Green Tea mattress is a layered foam mattress made of CertiPur materials and is priced at an astoundingly-low range of around $200. This mattress isn’t a luxury mattress by any means, though it is a likely candidate for best-in-class for mattresses under $300. The Green Tea Memory Foam mattress is a quick fix for those suffering from really bad mattresses and just need to get something in place quickly. It’s got a medium firmness and a 100-night in-home trial.
Tomorrow Sleep is a company backed by the Serta-Simmons sleep company and have recently launched their new hybrid memory foam mattress. These products are designed from the ground-up to offer total support and cooling throughout the night. Their topmost layers of memory foam are supported by deeper layers of microcoils which provide excellent breathability. This mattress comes in either medium-firm or medium-soft, is backed by a 10-year warranty, and has a 100-night in-home trial.
Chronic back pain is no laughing matter and gone unchecked it can begin to snowball into much larger problems. Ensuring you have a mattress designed to help support your natural spinal alignment is an important first step in working to address chronic pain. Research suggests that mattress of medium firmness offer the greatest potential for reducing symptoms associated with chronic back pain as well as helping to increase overall hours slept each night. Your health is the most valuable thing you have in this world and doing everything in your power to support it will help you lead a happier and longer life. Finding the best mattress for back pain is just one step along a long road of maintaining a healthy lifestyle. Fortunately, modern mattress brands have made the process of finding and buying a new mattress much less painful than in the past!
- Kovacs FM, Abraira V, Peña A, et al. Effect of firmness of mattress on chronic non-specific low-back pain: randomized, double-blind, controlled, multicentre trial. Lancet. 2003;362(9396):1599-604. Available at: https://doi.org/1016/S0140-6736(03)14792-7
- Mattresses for Chronic Back or Neck Pain: A Review of the Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2014 May 14. APPENDIX 6, Summary of Findings of the Included RCT. Available from: https://www.ncbi.nlm.nih.gov/books/NBK263374/