Sleep is the cornerstone of a healthy lifestyle, yet it’s difficult for many people to get quality rest, especially if you suffer from chronic back pain. The right mattress can be an almost instant fix for many back issues. However, finding the right one for you depends on many factors, including your sleep position, what type of back pain you have, your body weight, and personal comfort level.
For over two years, our team tested more than 60 mattresses, both in our testing Lab and in our editors’ homes. We also spoke to sleep and medical experts to understand how mattresses can affect back pain and to learn more about mattress firmness (we even created our own mattress firmness scale) and other factors that can influence pain and your sleep. Finally, a doctor from our Medical Expert Board reviewed this article for medical and scientific accuracy.
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How to Shop for Mattresses for Back Pain
In general, a firm mattress provides the most support to those with back pain, according to Danielle Kelvas, MD, chief medical advisor at Sleepline. Memory foam, latex, or hybrid mattresses can evenly distribute body weight, reduce pressure points, and offer a personalized level of comfort, says Shelby Harris, PsyD, licensed clinical psychologist, clinical associate professor, and director of sleep health at Sleepopolis. It’s also important to consider a mattress compatible with your health needs, such as one with cooling properties for those with night sweats or general overheating.
Keep these factors in mind when selecting a mattress for back pain:
- Firmness: A mattress that’s too soft lacks the support needed to keep your spine aligned while you rest. Start your search with a medium-firm mattress that offers a balance of contouring, bounce, and support. In our reviews, we’ve noted the firmness of each mattress on a scale of 1 to 5 (1 is the softest; 5 is the firmest).
- Material: Foam, gel, and latex conform to your body’s shape to help relieve pressure points and encourage proper body alignment and reduce pain throughout the back.
- Temperature regulation: Mattresses with temperature-regulating properties absorb and dissipate your body’s heat so you don’t get too hot throughout the night.
- Trial period: Some manufacturers offer a trial period to test the product for 30 days up to 365 days. Keep in mind this program sometimes costs extra, so read the fine print carefully.
- Motion transfer: If you sleep with a partner, motion transfer may be of concern. Consider memory foam mattresses that absorb and isolate motion to ensure neither of you is disturbed by the other’s movements.
- Sleep position: Different mattress types and firmness levels work best for specific sleep positions.
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How We Selected the Best Mattresses for Back Pain
To find the best mattresses for back pain, we conducted extensive research to ensure our selection included various types of mattresses to cater to diverse sleeping preferences. We tested more than 60 popular models across brands and price points. Each was subjected to rigorous testing over a period of several weeks or months. During our testing, we sawed five of the picks open—including our Best Overall, the Bear Original—to take a closer look at the layers and see just how they support your back for better sleep.
During testing we focused on a variety of factors, including:
- Comfort: We analyzed whether it felt like we were sinking into the mattress or felt like we were resting on a cloud.
- Support: Mattresses that offered just the right amount of support, keeping our spine in perfect alignment were more likely to make our list.
- Sleep quality: Mattresses that caused our testers to feel refreshed upon waking or that minimized tossing and turning received higher scores.
- Value: We prioritized mattresses that offered a longterm value, that held up well during our testing period, and were made of high-quality materials.
- Unique features: We also considered whether mattresses had special features such as dual-sided designs, cooling properties, and motion isolation.
- Other factors: Finally, we took into account details like shipping and delivery options, trial periods, returns, and warranty, which significantly affect the overall customer experience.
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Health’s Firmness Scale
At Health, we have our own firmness scale, where we rate mattresses from 1 to 5, from soft to extra firm. While you might see a mattress rating out of 10 when browsing manufacturer websites, we measure out of 5 because, in practice, there’s not much difference between all 10 levels of firmness. More importantly, you won’t see many mattresses at either extreme of the 10-scale. We’ve decided to keep our scale to the middle of that scale and rate them out of 5 so you know what to expect.
Firmness Level Description Who It’s Best For 1 Soft: These mattresses offer the lowest level of support and the highest level of “sinking in” Potentially back and side sleepers; these may work for people in smaller bodies, but ultimately they won’t provide much support 2 Soft Plus: A soft sink with some added support for alignment, typically from coils Sleepers looking for a lot of pressure relief around the shoulders and hips; people in smaller bodies 3 Medium: You’ll still have some level of sink, but your spine should be in alignment and well-supported Side sleepers; will also work for most sleepers, aside from those who sleep exclusively on their stomachs 4 Firm: These offer sturdy support with very little sink People with back pain who need a little extra alignment; stomach sleepers 5 Extra Firm: The highest level of support. You’ll find little to no conforming. People with larger bodies or anyone who likes a firm sleeping surface Our Expertise
Jaylyn Pruitt is Health’s sleep editor. She’s been covering sleep products for over two years and has tested more than 50 mattresses, helped to oversee mattress testing in our lab and even toured a mattress factory to learn more about how mattresses go from raw materials to your bedroom. During her time covering sleep products, she’s interviewed several experts, including sleep medicine doctors, neurologists, spine surgeons, and sleep coaches.
For this story, she spoke with the following sleep experts to learn more about sleeping with back pain:
- Angelie Mascarinas, MD, board-certified physical medicine and rehabilitation (PM&R) doctor with fellowship training in interventional spine and musculoskeletal care, who practices at the Hospital for Special Surgery in New York City
- Kevin Lees, DC, director of chiropractic operations at The Joint Chiropractic, the nation’s largest chiropractic care provider
- Danielle Kelvas, MD, chief medical advisor at Sleepline, a sleep resource website
- Shelby Harris, PsyD, licensed clinical psychologist, clinical associate professor, and director of sleep health at Sleepopolis, an independent sleep education company
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What Type of Mattress Is Best for Back Pain?
The experts we spoke with agreed that the best mattress for back pain is one that will support and align your spine. For most, this mattress will be on the firmer side, especially if you sleep on your back or stomach or are a larger sleeper. Side sleepers may want a medium-firm mattress that will keep the hips and shoulders aligned. Some mattresses offer added lumbar support—often firmer foam or more dense springs—around the middle of the mattress for extra support.
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How Your Mattress Can Affect Back Pain
Spending so much time on your mattress means that it’s going to make a huge difference in your back pain—for better or worse. A too-soft mattress can leave you with a convex spine, causing muscles to strain around your spine and limbs, says Rahul Shah, MD, FAAOS, board-certified spine surgeon at Premier Orthopaedic Spine Associates.Firmer mattresses are generally better for back pain, but one that’s too firm can exacerbate pain in pressure points. The best mattress provides optimal support and alignment so you wake each morning feeling refreshed.
