Best Mattress for Back Pain – how to choose a mattress that works for you

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dog sleeping on best mattress for back painChoosing the best mattress for back pain can be a tricky endeavour. We all know that getting a good night’s sleep can make a massive difference, though, especially when it comes to acute and chronic pain. With so many options now available, how can you be sure to choose the best mattress for back pain, without breaking the bank?

New vs. Old

It should go without saying that an old saggy mattress is unlikely to do your back any favors. So, while it can take some getting used to, a new, firmer mattress can do your spine a world of good.

Ideally, you should replace your mattress every 5-7 years if you are over the age of 40. This is because the body tolerates less pressure as we age, meaning that an unsupportive mattress can put excess strain on the spine.

In one study, new medium-firm mattresses with foam-encased springs were provided to 59 healthy people whose beds were over 5 years old. After a month of sleeping on the new mattress, every single one of the study participants said that they had less back pain and shoulder stiffness and were sleeping better than before (Jacobson et al., 2008).

What about a water bed? The options can be confusing, which is why some scientists have been trying to find out if there is a way to objectively assess the best kind of mattress. 
You can learn about mattress durability here.

So, a new mattress is a given, but which mattress should you buy? Foam or conventional coil? A combination of the two? And should it be a medium, firm, soft, or adjustable mattress? What about a water bed? The options can be confusing, which is why some scientists have been trying to find out if there is a way to objectively assess the best kind of mattress.

Spinal Torsion and Maximum Pressure

In one study, researchers looked at how well four different mattresses distributed weight and the degree of spinal torsion (twisting) the mattresses caused. What they found was that the mattress that put the least maximum pressure on both the thoracic and pelvic regions also resulted in greater spinal distortion at T1/T3 and T6/T8 (DeVocht et al., 2006).

Their conclusion? These two aims of a mattress may be contradictory. Essentially, “Design features that minimize spinal distortion may maximize maximum pressure.”

While this might cause you to throw your hands up in the air and just pick a mattress at random, this research is not the end of the story. In fact, the researchers didn’t actually look at whether either factor made any difference to health. Fortunately, some British scientists had already looked at this. In their study, they found no association between how comfortable a person rated a mattress and the maximum body contact pressures at the shoulder, elbow, hip, knee, and ankle (Buckle & Fernandes, 1998).

It seems, then, that other factors are at work when it comes to choosing the best mattress for back pain. Indeed, Korean researchers found that test subjects had an overwhelming preference for mattresses that created a similar spinal curvature to curvature when standing (Park et al., 2001). These researchers also found that people felt more comfortable when there was a narrower range of body pressure distribution, rather than simply a lower maximum pressure.

So, is a subjective feeling of comfort actually the best way to choose a new mattress? What if you are looking for the best mattress for back pain?

Choose Comfort

A number of studies do appear to confirm the idea that you, and not the salesman in the store, are the best judge of any new mattress. After all, only you can decide if a mattress feels comfortable.

One study found that sleep efficiency and the amount of deep (restorative) sleep a person experienced was higher when people slept on mattresses they felt were comfortable. These sleepers also woke up less frequently during sleep (Lee & Park, 2006).

Choose a Firmer Mattress

Perhaps the most surprising thing about mattresses is that the perception of comfort is generally higher when a mattress is firmer. A mattress is also seen as more comfortable when it is less difficult to roll around on. But, as in many cases, too much of a good thing can be undesirable.

Too firm a mattress doesn’t seem to offer any great advantages for people with existing back pain. Instead, people with chronic, non-specific low back pain have better results in terms of pain in bed and when getting up, and in disability when using a medium-firm mattress (Kovacs et al., 2003).

Furthermore, tailored mattresses also seem to offer advantages for people with low back pain and stiffness after sleeping. In one study, people using a medium-firm mattress specifically layered with foam and latex based on their prominent sleeping position had a significant improvement in back pain and stiffness. The new mattresses also led to significantly fewer days per week of poor sleep and less physical discomfort (Jacobson et al., 2010).

Choosing the Best Mattress for Back Pain

What does all this research amount to when you head to the sleep store to try to pick out the best mattress for back pain? Well, if you can afford to have a custom-made mattress layered with latex and foam according to your preferred sleeping position, plump for that. Otherwise, your mattress choice will most likely be pretty subjective.

Choosing the best mattress for back pain seems to rely mostly on judging its comfortability. There are some general guidelines that can help refine the process, however. It seems smart, for instance, to choose a medium-firm mattress, be that coil, foam, or a combination of the two. And, of course, make sure to lie down on the mattress in the same way that you would typically sleep. Try to fully relax so that you can get a real idea of how the mattress feels.

Also, try rolling around on the mattress, and if it’s hard to maneuver, consider a different option. If you have a regular sleeping partner be sure to get them to try out the mattress too. An unhappy bedfellow can ruin your sleep after all! In some cases, you may want to opt for two different mattresses that attach in the center. That way, neither of you has to compromise on comfort.

Another top tip for choosing the best mattress for back pain includes buying the mattress from a store with a money-back guarantee. That way, if after a couple of months you haven’t noticed a difference, or your back pain is worse, you can return the mattress and try a different one, until you find the right mattress for you.

And, once you have your mattress sorted, check out these 5 smartphone posture apps to help you sit up straight!


Buckle P, & Fernandes A. (1998). Mattress evaluation—assessment of contact pressure, comfort and discomfort. Appl Ergon, 29;35-39.

DeVocht JW, et al. (2006). Biomechanical evaluation of four different mattresses. Appl Ergon, 37:297-304.

Jacobson BH, et al. (2008). Grouped comparisons of sleep quality for new and personal bedding system. Appl Ergon. 2008;39;247-254.

Jacobson BH, et al. (2010). Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Appl Ergon, Dec;42(1):91-7.

Kovacs M, Abraira V, Peña A, et al. (2003). Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial. Lancet, 62:1599-1604.

Lee H, & Park S. (2006). Quantitative effects of mattress types (comfortable vs. uncomfortable) on sleep quality through polysomnography and skin temperature. Int J Ind Ergon, 36:943-949.

Park SJ, et al. (2001). Evaluation of mattress for the Koreans. Program and abstracts of the 45th Annual Meeting of the Human Factors and Ergonomics Society; October 8-12, 2001; Minneapolis, Minnesota. Pages 727-730.

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