Best mattresses for back pain

No single brand or model, and be wary of any that claims to be. What the evidence supports is a firmness: a Lancet trial of 313 chronic low back pain patients found medium-firm mattresses beat firm ones for pain and disability over 90 days. So a doctor recommended mattress for back pain in practice means medium-firm, with enough support to keep the hips level and enough give to cushion the shoulders, tried for at least a month before you judge it.

Any of them, if the firmness and support are right. Memory foam and hybrid mattresses are recommended most because they pair a supportive core with a pressure-relieving top layer. A hybrid's pocketed coils give firmer, more even support for heavier sleepers and back sleepers, while all-foam contours more closely for side sleepers, a trade-off our hybrid vs memory foam guide goes into. Latex is supportive but expensive, and an innerspring with a thin pad is usually the worst choice, since it supports without relieving pressure.

Rarely. An extra firm mattress for back pain suits a narrow group, mainly heavier stomach sleepers, and for everyone else it causes the problem it is meant to fix. A surface that does not give leaves a gap under the lower back and presses into the hips and shoulders, so the spine arches instead of lying flat. Medium-firm beat firm in the Lancet trial, and Harvard Health cites a survey of 268 back pain sufferers in which those on very hard mattresses slept worst. Sore on an extra firm bed? Soften the surface first.

The firmest surface that still has some cushioning, which usually means the firm end of medium-firm with a thin pillow or none. Stomach sleeping arches the lower back, and a soft mattress makes it worse by letting the hips sink. The best mattress for stomach sleepers with back pain keeps the hips level with the chest, so a hybrid base with a medium-firm comfort layer, the Edge Signature hybrid in Viscosoft's range, is the usual fit. A thin pillow under the hips helps too.

One with a dense support core, a comfort layer that does not bottom out, and a firmer feel than the label suggests. Firmness is rated for an average body, so a medium-firm that holds a 150-pound sleeper level sags under 250. The best mattress for a heavy person with back pain usually has pocketed coils or high-density foam underneath, at least 3 inches of dense memory foam on top, and stands 12 inches or taller. Of the two Viscosoft models, the Edge Signature hybrid gives the firmer support.

Medium-firm, around 6 to 7 on the 10-point scale most brands use, adjusted for your weight and position. That is where the evidence sits. To check whether the best mattress for back ache is the one you are lying on, slide a hand under your lower back: it should fit snugly, with no open gap (too firm) and no need to force it (too soft). Lighter side sleepers can go softer, heavier and stomach sleepers firmer.

Medium to medium-firm, with a comfort layer your shoulder and hip can sink into so your spine stays straight. Side sleepers with lower back pain need give at the shoulder and hip, and support under the waist. A mattress for lower back pain that works for a side sleeper usually has 3 to 4 inches of memory foam on a firm base. Lighter sleepers do better on an all-foam base that contours closely, heavier sleepers on a hybrid that holds the waist up, and both bases are in the mattress collection.

Yes, mostly upper back and neck pain. A pillow that is too high for a back sleeper pushes the head forward and strains the neck and shoulders. One too low for a side sleeper lets the head drop and twists the upper spine. If a new mattress moved the pain up instead of away, check the pillow next. Our guide to finding the right pillow height explains how to match loft to sleep position, and the pillow collection includes an adjustable option.

Not a special one, but a solid one. Slats more than about 3 inches apart, a queen or king frame without a center rail, or an old box spring under a foam mattress all let the mattress sag and undo the support you paid for. Use a platform, a close-slatted frame or a firm foundation with center legs. Our guide to the best foundation for a memory foam mattress covers what works. One night with the mattress on the floor tells you whether the frame was the problem.

If the pain is worst on waking and eases within an hour of moving, the mattress is the likely cause and a new one is a sensible first step. See a doctor first if the pain wakes you in the night, lasts all day, gets worse when you sit, runs down a leg, comes with numbness or weakness, or started after an injury. Those patterns point to causes a mattress will not fix, and it is worth knowing which kind you have before spending the money.