The Best 7 Mattresses for Back Pain – Reviews and Buyer’s Guide

Roughly 80% of adults will experience lower back pain at some point in their lives, and for millions this is a chronic, lifelong condition. Back pain is also a leading contributor to poor health and early mortality. Choosing the right mattress is crucial for individuals with back pain issues. The right mattress can alleviate pressure and aches in the most sensitive areas, such as the neck, shoulders, hips, and lumbar region of the lower back. The wrong mattress often exacerbates the issue, and may cause pressure to develop in new areas of the back.

This guide will look at mattress qualities that benefit sleepers with back pain, such as body-contouring and support, as well as the importance of using body weight and preferred sleep position to determine which mattress is best for you and your sleep partner. First, let’s look at some common types of back pain and how they impact sleep quality and duration.

A healthy spine serves three primary functions:

• Protecting the spinal cord, which is considered the body’s communication systems, as well as nerve roots and internal organs.
• Providing structural support needed for upright posture.
• Facilitating tactile movement.

Unhealthy spines are often unable to perform some or all of these functions, and back pain is a common result. The term ‘back pain’ may refer to anything from minor aches and pains to debilitating conditions that affect other parts of the body. Back pain generally falls into two categories:

• Acute back pain, which lasts less than three months (12 weeks) and typically occurs in conjunction with an injury or accident, such as a fall or over-lifting. The acute pain often subsides as the underlying cause of the pain is treated.
• Chronic back pain, which lasts at least three months; this may occur due to an injury or accident, or due to a physiological issue like scoliosis. In either case, chronic back pain often continues after the underlying cause of the pain has been treated.

According to the Mayo Clinic, common causes of acute and/or chronic back pain include the following:

Muscle or ligament strain: Lifting objects that are too heavy or moving awkwardly are two common causes of strain in back muscles and spinal ligaments. The spasms that accompany this type of strain are often exacerbated by poor physical health.

Bulging or ruptured discs: Intervertebral discs are found between the vertebrae that form the spinal column, and form fibrocartilaginous joints that support and cushion the spinal structure much like shock absorbers. They have thick, durable exteriors and a soft, jelly-like filling. Bulging and ruptured discs create painful sensations when they come into contact with nerves, although some people with disc problems do not experience serious — if any — back pain.

Arthritis: Arthritis refers to inflammation of at least one joint in the body that leads to joint pain and stiffness. The most common forms of arthritis include:

• Osteoarthritis, or degenerative arthritis, which causes bone cartilage to deteriorate prematurely.
• Rheumatoid arthritis, which affects the synovium material that lines the joints.
• Psoriatic arthritis, which refers to joint inflammation caused by the painful skin condition known as psoriasis.
• Gout, which refers to joint inflammation in the knees, ankles, and/or feet.

Because arthritis is associated with chronic and widespread pain, people with this condition often have a difficult time falling and staying asleep.

Skeletal irregularities: Irregularities of the back and spine that can lead to pain and pressure include:

• Lordosis, a curvature of the lower spine that is abnormally pronounced.
• Scoliosis, a sideways curvature of the spine that usually forms a C or S shape.
• Kyphosis, an abnormal curvature of the upper spine.

Most people with skeletal irregularities consider back-sleeping to be the most comfortable sleeping position, while some find additional relief by sleeping on their side with towels or pillows beneath the knees and ribs. Regardless of their most comfortable sleep position, people with these irregularities may experience frequent sleep disruption due to back pain and other symptoms of their condition.

Osteoporosis: Osteoporosis is a condition characterized by skeletal degeneration that causes bones to become porous and brittle. Osteoporosis fractures often occur in areas like the hips, wrists, and spine. This condition can lead to severe back pain if any of the vertebrae fracture or collapse.

In addition to these medical conditions, doctors have identified the following risk factors for acute or chronic back pain:

• Age: Back pain affects people of all ages, but the condition is much more common in people who are 30 years or older.
• Lack of exercise: People with weak, unconditioned muscles are considered at risk for back pain symptoms.
• Obesity: Carrying extra weight — especially around the midsection — can put undue strain on the back muscles.
• Diseases: Certain medical ailments, such as cancer, have been linked to back pain symptoms.
• Excessive or incorrect lifting: Back pain is often tied to lifting-related injuries, which can occur if the individual lifts too much weight and/or lifts with their back instead of their legs.
• Mental health issues: People with depression and anxiety are more susceptible to back pain and other physical manifestations of their condition.
• Smoking: Habitually smoking cigarettes deprives the body of nutrients that are needed to nourish the disks and other areas of the back.

Sleeping on a mattress that does not provide proper spinal support can also lead to back pain. The table below lists five regions of the spine that one should consider when trying out a new mattress.

A mattress should reduce back pain by providing an even, stable surface that helps the sleeper maintain proper spinal alignment, regardless of their sleep position. However, each sleep position affects spinal alignment in different ways, and the sleeper’s body weight is also an important factor to consider. In the next section, we’ll look at ways to choose a mattress based on these two individual factors.

In terms of sleep position, most adults qualify as side-, back-, or stomach-sleepers. The table below explores these three positions in greater detail.

Additionally, experiences with different sleep positions are tied to body weight. Generally speaking, people who weigh less than 130 pounds require softer mattresses in order to enjoy body-contouring and pressure relief, while those who weigh more than 230 pounds feel more comfortable on firmer mattresses that don’t cause them to sink too deeply. Mattress firmness is illustrated using a 1-10 scale, with 1 being the least firm and 10 being the firmest; the vast majority of mattresses sold today fall between a 3 (Soft) and an 8 (Firm), and the most common firmness is a 6 to 6.5 (or Medium Firm).

The next table lists the ideal firmness settings for different weight groups in each of the three most common sleep positions. Please note that sleep experience is highly subjective, and that individual sleepers may find their comfort preferences do not correspond to the information listed in this table.

Next, let’s look at the top-rated mattresses according to side-, back-, and stomach-sleepers in different weight groups.

Mattress type is another important consideration for people with back pain. The five most common mattress types provide varying experiences for sleepers, depending on their body weight and preferred sleep position. The table below lists the differences and similarities between innerspring, foam, latex, hybrid, and airbed mattresses.

When shopping for a new mattress and comparing different brands and models, here are a few factors for sleepers with back pain to keep in mind.

What is your mattress budget? Airbeds and latex mattresses are often effective for sleepers with back pain, but these models can easily cost $2,000 or more in a Queen size. Memory foam and hybrid models tend to be somewhat cheaper, and online-only brands typically have lower price-points compared to brands with a brick-and-mortar presence.

How much do you weigh? Body weight can be used to determine the ideal firmness for a new mattress. People who weigh less than 130 pounds — particularly those who sleep on their sides — tend to feel most comfortable on mattresses that are Medium (5) or softer. Less firm surfaces allow them to experience close conforming and better pressure relief. People who weigh more than 230 pounds, on the other hand, often prefer firmer mattresses (Medium Firm or firmer) because they don’t sink too far.

What is your preferred sleep position? People who sleep on their sides may require softer mattresses that conform to their figures and help align their spine, while stomach-sleepers often prefer firmer mattresses that don’t sink too deeply below their stomachs.

Do you share your bed with another person? Sleep partners may not agree on the ideal firmness setting. In these cases, a mattress that offers dual firmness — different firmness settings on each side of the bed — may be the best option.

Does the mattress come with a sleep trial? Most mattress manufacturers offer a sleep trial, allowing customers to test out their new mattress for a certain length of time (typically 90 nights or longer); if the customer is dissatisfied with the mattress before the trial period expires, then they may return it for a refund or, in some cases, exchange it for a new model. Some sleep trials include ‘mandatory break-in periods,’ which require the purchaser to test out their mattress for at least 30 nights before returning it. However, sleep trials can save customers a substantial amount of money in the long run if they decide they are unhappy with their new purchase.

What are the warranty terms? The vast majority of mattresses sold today come with product warranties that span at least 10 years in length, but these warranties tend to vary in terms of the following two factors:

• Nonprorated coverage length: During the nonprorated phase of a warranty, mattress owners do not need to pay to have a defective mattress repaired or replaced (aside from shipping and handling costs, in some cases). During the prorated phase, customers must pay a certain percentage of the original mattress price to have their current model replaced, and charges may also apply to mattress repairs. Prorated charges can lead to major costs down the road. Purchasers should always read the fine print: some warranties spanning 15 to 20 years only offer two to three years of nonprorated coverage before prorated charges kick in.
• Indentation depth: Over time, mattress surfaces develop indentations where owners tend to sleep, usually in the middle of the bed. These issues may compromise the supportiveness of the mattress, which can in turn exacerbate back problems. Most warranties list a ‘depth’ used to differentiate between normal wear and tear and severe indentations that are considered a warrantable defect. Some warranties will cover indentations deeper than half an inch (1/2″) to three-quarters of an inch (3/4″), while others will only cover indentations that measure deeper than one and a half inches (1 1/2″). Indentations that measure one inch (1″) or deeper are considered most problematic for people with back pain, so these individuals are urged to seek out mattress warranties that cover one-inch indentations.

In addition to choosing the right mattress, people who live with back pain can further optimize their sleep environment with the following accessories and components:

Select the right pillow: Pillow loft, or thickness, is crucial for sleepers with back pain. The proper amount of loft can alleviate pain and pressure in the neck, shoulders, lumbar region, and other sensitive areas, while the incorrect amount of loft can make these issues much worse. In order to determine the best loft for you, it’s important to consider your head size, body weight, and shoulder width, as well as the firmness of the mattress you use. The table below features a detailed breakdown of the three general loft categories.

Pillow composition is also important because some materials provide more support and comfort than others. Materials like buckwheat, memory foam, and latex conform closely to the sleeper’s head and alleviate a fair amount of pressure, but these pillow types tend to be fairly expensive. Cheaper models, such as polyester and down alternative, do not conform and support as much.

If you experience chronic back pain, then supplemental pillows can be used in addition to the one beneath your head. People who sleep on their back may find relief by placing a pillow beneath their knees, while side-sleepers often feel more comfortable with pillow between their knees and beneath their ribs.

For more information about pillows, please visit our Best Pillows — Buying Guide and Information page.

Use a topper: A topper is an individual layer of cushioning that rests on top of the mattress cover. Toppers are designed to adjust the firmness of the sleep surface; most toppers make the mattress feel less firm, although some topper models may increase the firmness. Toppers can be ideal for people who are dissatisfied with their mattress firmness but are unable to return their mattress, as well as couples with differing firmness preferences. Toppers may be made from a wide range of materials, including feathers, memory foam, convoluted polyfoam, latex, or wool; price-points vary by material composition and brand, but most cost less than $150.

Topper firmness, thickness, and density are all important considerations, and the ideal settings often depends on the sleeper’s weight and preferred position. The table below features more information.

To learn more about toppers, check out our Best Mattress Toppers guide.

Invest in an adjustable bed: Adjustable beds are designed for customization. Most models can be elevated or lowered at both the head and foot of the bed to create different sleeping positions; angled surfaces can ease back pain for many sleepers. Additionally, many newer adjustable bed models offer a ‘silent massage’ function, which generates small vibrations in the sleep surface that can alleviate aches and pains. Most adjustable beds sold today have remote controls, including those can be adjusted using smartphones or tablets.

Adjustable beds can be quite expensive. The baseline cost is roughly $1,000, but most models cost at least $2,000 — and some reach $3,500 or higher. However, many sleepers with back pain find that adjustable beds are a worthwhile investment that greatly improves their sleep quality. To learn more, visit our Adjustable Bed Reviews guide.

For more information about sleep products and sleeping strategies for people with pain issues, check out the following pages on Tuck.com:

• Pain and Sleep
• Best Mattresses for Hip Pain
• Best Mattresses for People with Arthritis
• Best Mattresses for People with Scoliosis
• Best Mattresses for People with Fibromyalgia
• Best Mattress for Side Sleepers
• Best Mattress for Back Sleepers
• Best Mattresses and Pillows for Stomach Sleepers