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The 2018 buyers’ guide: best mattresses for back pain

Here is our in-depth buyers’ guide for people suffering from back pain while sleeping and our attempt to help you find the best mattress for back pain to fit your particular needs. Read on and let us know your thoughts.

back pain guy

What is the best mattress for back pain?

We are always being told to practice good posture when standing or sitting to prevent back pain. Proper posture ensures that the spine stays straight so that the neck, shoulders and the three ‘sections’ of the back (lower, middle and upper) stay healthy.

Good posture is also important when we sleep, but how do you ensure that when you’re deep in dreamland? If you constantly wake up with an aching back or don’t get enough sleep at all because of back pain, you need to consider what you’re sleeping on. Your mattress may be causing you back pain or making an existing spine condition worse.

The best mattress for back pain is one that keeps your spine in proper alignment when you lie on it, whether you sleep on your side, back or stomach. When your spine is aligned in bed, you will have a more comfortable and restful sleep, allowing your body to recover and heal itself better from the day’s exertions.

If your mattress is too soft or too firm, it doesn’t support your neck and lower back like it should. Because everyone has a different body type, preferred sleeping position and spine health, there isn’t really a one-style-fits-all mattress.

Sleep experts do recommend going for a ‘medium-firm’ mattress but again, this is subjective and based on the average adult sleeper. What may be too firm for you may be considered soft by someone else. Good thing that there are different kinds of mattresses in the market today, with most of them offering a trial period so you can determine which one works best for you. There are also mattress companies that offer customization, allowing you to tailor your mattress around your particular back pain problems. If you’re not happy with the mattress, you can send it back for a refund and try something else.

Where did the ‘go medium-firm’ advice come from? Well, in one research, new mattresses were provided for 313 test subjects with lower back pain. The subjects were assigned either “firm” or “medium-firm” mattresses, which they slept on for 90 days. At the end of the study period, the researchers observed that those who slept on medium-firm mattresses reported the least amount of discomfort.

It does sound convincing but the researchers also stated that the subjects may have had better sleep simply because they got a new mattress. This is why it’s time for you to take a look at the mattress you’re currently sleeping on – maybe it’s time to change it up!

What is the best mattress for lower back pain?

The low back, also called the lumbar spine, is made up of interconnecting bones, muscles, joints, ligaments and nerves. All of these parts work together to provide flexibility, strength and support. The complexity of the lumbar spine’s structure is a marvel but it also leaves this part of the body susceptible to pain and injury.

Low back pain can have a variety of symptoms from mild to severe, and it can start suddenly or gradually. The symptoms of low back pain are the following:

  • Muscle tightness and spasms in the low back, hips and pelvis
  • Difficulty going from standing to sitting and vice versa
  • Difficulty standing up straight or walking
  • Pain that gets worse after a long period of standing or sitting
  • Dull or achy pain in the low back
  • Stinging pain that moves from the low back area to the backs of the thighs down to the lower limbs or feet

Pain in the low back is often caused by a pulled or torn ligament or muscle. This can happen after a sports injury, a sudden movement or after lifting a heavy object. It can also occur because of poor back posture.

Treatment for low back pain ranges from doing stretching exercises to surgery. The Harvard Medical School also suggests choosing the right mattress for managing low back pain. The best mattress for low back pain is one that reduces pressure points, contours to the body’s shape and promotes proper spine alignment.

Spine specialists also suggest using a mattress that incorporates zoning. A “zoned” mattress is one where the different sections have different levels of support. This improves the alignment of the spine. In a zoned mattress for example, it is softer where the hips and shoulders lie, as the these regions are the heaviest parts of the body. Because these areas are softer, they allow the shoulders and hips to sink in the mattress and keep the spine aligned.

What is the best mattress for upper back pain?

Less common than low back pain is pain in the upper and middle back. The bones in the upper and middle back don’t move or flex as often as the bones in the lower back, and instead work in tandem with the ribs to help protect the heart and lungs, and also keep the back stable.

Pain in the upper and middle back may be caused by poor posture, a vertebral fracture, trauma from an accident or collision, improper lifting technique, pressure on the spinal nerves, osteoarthritis or an infection. Upper and middle back pain may also be caused by muscle strain, overuse or injury to the discs, ligaments and muscles that support the spine.

The common symptoms of this kind of back pain are muscle stiffness and a dull or burning pain in the upper and middle back. In more serious cases, symptoms such as loss of bladder or bowel control, weakness in the arms or legs and tingling or numbness in the arms, chest, belly or legs require a trip to the doctor straightaway.

For most people, upper back pain develops when they tend to assume a hunched position when standing, sitting or lying down. Bad posture also causes pain in the shoulders.

Those who suffer from upper back pain may benefit from a medium-firm mattress, which lessens the pressure on the upper back that firmer mattresses can cause.

What is the best mattress for chronic lumbar pain?

Chronic lumbar pain or chronic lower back pain is a more intense kind of pain than acute low back pain. It is less likely to fluctuate and usually lasts longer than three months. Chronic lumbar pain in the low back may travel down the legs. Those who have this condition experience greater pain when sitting too long in one position, bending over or lifting heavy objects.

Because pain doesn’t seem to wane, those who have this condition have difficulty getting a restful sleep, or enough sleep for that matter. This contributes to fatigue during the day and a poor quality of life when not treated.

One of the ways to alleviate chronic lumbar pain is using a mattress that promotes good sleeping posture and pain relief. The ideal mattress is something that is soft enough to cradle the body yet still offers a firm surface to keep the spine aligned. Again, mattresses in the medium-firm range, especially those that combine memory foam and coil springs, may be good for chronic lumbar pain sufferers.

mattress for pregnant women

What is the best mattress for relieving back pain in pregnant women?

Mothers-to-be often experience pain in the back during the later stages of pregnancy. Studies show that 50 to 70 percent of pregnant women suffer lower back pain. As the weight of the baby increases, the body’s center of gravity shifts forward, and pregnant women tend to lean back to compensate for the shift in posture. This puts stress on the lower back, which can result in pain and soreness.

In bed, the extra weight also contributes to a greater pressure on the mattress, which can make the mattress sag in the abdominal and hip area. This results in the spine not being properly aligned, making back pain worse.

Sleep is the time when the body heals itself, but when the mattress doesn’t provide the right support, those back muscles are not given the chance to relax and heal.

Pregnant women can benefit from a firmer mattress that also provides the right amount of softness and pressure relief. If the mattress is too soft, the body would sink into a hammock position, which causes the spine to curve unnaturally.

One of the best options for pregnant women is a memory foam mattress that has the ability to adapt to the shape of a pregnant woman’s body while still offering that ‘give’ for added comfort. There are also mattresses that have a customizable support system that is made up of interchangeable components, allowing users to configure the different parts to match their needs as their body changes.

Should you choose a firm mattress? Why or why not?

For decades, it has been believed that sleeping on a firm mattress – or on the floor – is good for alleviating lower back pain. Recent studies have found that this is not true at all. If a mattress is too firm, it is not able to contour enough to the body. It doesn’t provide support to the lower back for back sleepers, and it doesn’t let side sleepers rest comfortably because their shoulders and hips don’t sink in enough.

In general, medium-firm mattresses are the most recommended for people with back pain. The moderately firm sleeping surface allows the body to heal properly from strains and other injuries. If your current mattress is too firm, a memory foam padding or topper can provide some contouring and pain relief.

How often should you replace your mattress to avoid back pain?

As often as you need to, really. Different mattresses have different life spans, but even if there’s still around 5 years left in your mattress warranty, that doesn’t mean you have to stick with it if it’s giving you back pain.

Most mattresses have a 10-year manufacturer’s warranty but again, this has nothing to do with comfort. We recommend trying out different mattresses to see which one ultimately works for you to relieve and prevent back pain. Money-back guarantees on mattresses can be between 30 and 100 days, which should be enough time to let you feel the difference.

It’s important to note here that some mattresses may require periodic flipping and rotation to prevent indentations, which will make you sink further into the bed, resulting in unnatural spine curvature and back problems. Memory foam mattresses however do not need to be flipped or rotated.

How to find a back-friendly mattress / Things to consider when choosing a mattress if you suffer from back pain

Choosing the best mattress for you depends on a number of factors, including your body weight and body type, your sleeping style, where you feel pain and your personal preference. If there is a mattress showroom near you, it’s highly advisable to go there and check different mattresses out. Here are some tips on finding a back-friendly mattress:

  • Research expert recommendations for the best mattress for back pain
  • Read reviews on different mattresses so you can narrow down your options. Keep in mind that comfort is subjective, so it’s ideal to read different reviews and see which ones show up most often in the list of top mattresses for back pain.
  • In the showroom, spend 15-30 minutes on a mattress you’re eyeing. Try on different sleep positions to see which mattress helps in alleviating back pain the most.
  • Don’t limit yourself to innerspring mattresses – check out memory foam mattresses and hybrid mattresses as well.

What causes back pain? / What are the different kinds of back pain?

We’ve touched on the common causes of lower and upper-middle back pain. Here’s a more comprehensive list of what makes our backs ache.

  • Stress – you don’t need a lot of research to prove that stress causes a lack of sleep. When you have anxiety and feel stressed out, you tend to be restless, tossing and turning in bed. The more you do so, the more prone you are to pulling a muscle or falling asleep in an unnatural position. And if you are unable to sleep peacefully, your body won’t be able to rejuvenate. You feel fatigued during the day and your muscles need to work doubly hard to do your tasks. This can result in lower back pain.
  • Muscle strain – strained muscles are usually the result of sudden movements and heavy lifting
  • Abnormally aligned spine – poor posture can often result in abnormal spine curvature, which can lead to lower back pain.
  • Scoliosis – a condition where the spine curves to either the left or right side of the body. Braces are usually worn to help keep the spine in proper alignment and reduce scoliosis progression.
  • Spondylolisthesis – this condition occurs when a vertebra slips out of place. This then causes the nerves of the spine to become compressed.
  • Abdominal aortic aneurysm – usually a result of atherosclerosis that is not properly addressed. This causes back pain when it occurs in the area of the aorta.
  • Sciatica – can occur as a result of injury, sitting for long periods, and irritation in the root of the lower lumbar and lumbosacral spine.
  • Degenerative Disc Disease – this painful condition may be brought about by physical trauma or as part of the body’s aging process. This disease is characterized by a loss in the elasticity of the discs in the spinal column, which means they are not able to provide the right cushioning.
  • Spinal stenosis – this is a condition characterized by a narrowing of the spinal column, increasing the pressure on the nerves and spinal cord. Back pain and numbness in the lower extremities are common symptoms.
  • Spinal compression fractures – most spinal compression fractures are brought about by osteoporosis.
  • Disc ruptures – the discs that are located between the vertebrae serve to relieve pressure on the spinal nerves. These discs may become compressed and even rupture, causing back pain.
  • Kidney stones – when substances such as uric acid, oxalate and calcium clump together in the urinary tract, they form kidney stones. Through medication, these kidney stones can exit the body naturally through urine but the process can be painful.

What causes back pain while sleeping?

If you have back pain while sleeping but don’t suffer from any of the conditions listed above, then it’s possible that your mattress may be lacking in comfort and support. Consider the state of your current mattress. Is it lumpy, too soft or too firm? If the mattress you are using is unable to keep the spinal cord in proper form, then it may be causing you back pain.

This is why it is often recommended to choose a mattress that keeps your spine in a straight and natural alignment. The right mattress relieves the pressure points that are usually associated with back pain. This is a quality most often found in a memory foam mattress, which can conform to the body’s shape.

Aside from the mattress you are using, it can also be that the position you sleep in makes you more susceptible to back pain.

Medical professionals recommend avoiding sleeping on the stomach to relieve pressure in the neck, shoulders, lower back, hips and knees. If you sleep on your stomach, the natural curve of the spine changes, assuming a “flat” position. This unnatural curve adds strain on the back muscles. When you sleep on your stomach, you also turn your neck to the right or left and stay that way for a prolonged period. This often results in neck, shoulder and upper back pain.

How can sleeping on the wrong bed cause back pain? How can a mattress relieve back pain?

When you sleep on the wrong mattress, it can lead to back pain or worsen the pain you’re already experiencing. The wrong bed contributes to back pain in three major ways:

Lower back misalignment – if you sleep on a bed that’s too firm, too soft, does not provide contouring and offers no support, chances are you sleep with your spine in the wrong alignment. If you do this every night, over time it could worsen your condition.

Sleep interruption – if the mattress you are using is uncomfortable to sleep on, you probably change sleep positions often, tossing and turning just to find that sweet spot where you feel comfortable enough to sleep. Usually you just get exhausted from moving too much and you don’t really get a long, deep slumber but have a quick, shallow series of naps instead.

It’s important for people to complete a full sleep cycle but those who sleep on a lumpy bed or uncomfortable mattress typically aren’t able to do so and soon wake up tired and groggy. Because your muscles aren’t able to decompress, relax and heal during the night, they take on more strain during the day.

Injury aggravation – the discs in your spine may break down when subjected to a sustained pressure from a bad bed. For example, if your mattress is too soft, it can cause you to sleep as if you’re in a hammock. Imagine the shape of a banana – that’s you when sleeping on a too-soft mattress with not enough support for your hips.

Sleeping in this position puts a lot of pressure on the lower back, particularly the spinal discs. When your spinal discs break down, they are unable to perform their task of providing stability for your neck and lower back. This can also aggravate spinal disc issues you may already have.

Signs that you need a new mattress

How do you know for sure if it’s time to replace your mattress? Watch out for these signs:

  • You feel back pain and stiffness in the morning
  • You cannot sleep peacefully and are restless all the time
  • You wake up in the middle of the night because of pain in your back
  • You toss and turn often in bed trying to get comfortable
  • You sleep better when you’re sleeping in another bed, like in a hotel or a friend’s house
  • You can see indentations, lumps or sagging in the mattress
  • You haven’t changed your mattress for 10 years and it smells funky
  • You feel a spring poking your back
  • You feel like you’re in a hammock – your hips sink a lot lower than your shoulders

If you experience any of these on a regular basis, it means you need to consider using a new mattress that provides the right amount of comfort and support.

How can a mattress relieve back pain?

How we spend our days contributes to how healthy (or unhealthy) we become. Since we spend nearly a third of our day in bed, we really need to make sure we’re doing it right, starting with the mattress we use. As we have discussed, what we sleep on, how our body is positioned and the quality of sleep we get all have an effect not only on our waking hours but also on our quality of life.

Many people do not realize that the cause of their back pain is sleeping in an inadequate bed for years. They think it is only because of stress and fatigue at work and fail to consider their mattress as the culprit in not enabling their body to work out its kinks on its own, which it does when we’re asleep.

It’s a vicious circle: you can’t sleep because you’re in pain and you’re in pain because you can’t sleep. To break this endless cycle, you need to choose the right mattress. Keep in mind that there’s really no perfect mattress that would suit the entire population; you have to find your own mattress soul mate.

The best mattress for back pain is one that is able to contour to your body’s natural shape instead of your having to toss and turn or adjust. A mattress with a contouring property would be able to support your lower back, and relieve pain from pressure points (shoulders, hips, feet), allowing the back muscles to release tension and enabling the vertebrae to decompress. When your body is fully relaxed and you are asleep, your blood circulates better and damaged tissue is repaired.

correct sleeping position

What is the recommended sleeping position to avoid back pain?

Whatever you do, don’t sleep on your stomach! We’ve mentioned this before, but sometimes some things bear repeating. This advice is going to be hard to follow for those who have been sleeping on their stomachs since they were babies, so we’ll explain why it’s often necessary to shift position to avoid back pain when sleeping.

What happens if you sleep on your stomach?

When you sleep on your stomach, your spine will flatten and lose its natural S shape. This puts strain on the muscles of the lower back, which try to flex and keep the natural curvature of the spine. To breathe, you would naturally turn your head sideways, keeping your neck twisted and putting strain on the shoulders and neck. The only good thing about sleeping on your stomach is that it opens up the airways, which means you lessen your likelihood of snoring.

Those who can’t avoid sleeping on their stomach, or eventually return to a stomach-sleeping position in the middle of the night, can benefit from a mattress with a medium firmness. This kind of mattress eases the pressure on the hips and knees and keeps the spine in proper alignment to prevent back pain. Another way to alleviate back pain when stomach sleeping is by placing a small pillow near the lower abdomen or pelvis to “push” this area up and ease the strain on the back, and removing the pillow from under the head.

What happens if you sleep on your side?

Side sleeping also opens up the airways, making breathing easier. This is why snorers are often told to sleep on their side. Those who do forget are turned to their side by their poor sleeping partner who couldn’t sleep a wink. Sleeping on the side is better than sleeping on the stomach if you want to prevent back pain. Side sleeping takes stress off the neck and benefits the back when you tuck your legs up. Not only does this position promote the spine’s natural curvature and take the stress off the back muscles, it also lets blood circulate easier around your body.

Side sleepers usually find medium to medium-soft mattresses because these allow the shoulders and hips to sink a bit lower in the bed to keep the spine aligned. Medium-firm mattresses with thicker comfort layers are usually recommended because these are able to contour to the hips and shoulders better than a firmer or thinner mattress.

What happens if you sleep on your back?

Sleeping on your back distributes body weight evenly on the sleeping surface, promoting easier blood circulation and preventing numbness. Sleeping in this position usually gives you the best restful sleep, which is key to helping the body heal and reduce muscular pain. Those who suffer from back pain are often encouraged to sleep on their back with their legs propped up (with a pillow under their knees) to ease the tension on the lower back and promote natural spine curvature.

The downside to back sleeping is that it restricts the airways, making it difficult to breathe and increasing your likelihood of snoring.

Back sleepers are already doing their back some good by sleeping in a good position. Since they require less contouring to be comfortable, medium to firm mattresses are for them.

Different kinds of mattresses and how they contribute to easing back pain

Different strokes for different folks, different beds for different sleepyheads. Thanks to mattress manufacturers seeking to meet the needs of sleepers everywhere, we have a wide array of mattresses to choose from, from memory foam mattresses to air mattresses. If you have back pain, which one should you choose? Here’s a brief rundown of the mattresses available to you and what these can do in terms of easing back pain.

  • Memory Foam Mattresses – designed to contour around the shape and natural curves of the body, distribute weight evenly and provide support for the head, shoulders, hips, knees and feet to promote proper spine alignment and eliminate pressure points on these areas to relieve pain.
  • Air Mattresses – mattresses with air-filled columns or cores. The flow of air in the air chambers can be adjusted to change the firmness of the mattress, allowing you to control the amount of counter pressure the mattress provides according to your sleep position and personal preference.
  • Latex Mattresses – similar to memory foam but provides more bounce and support. The spongy, springy material provides pain relief in common problem areas like the neck, shoulders and hips. Latex and memory foam mattresses are the two most recommended mattress types for those who experience back pain.
  • Adjustable Mattresses – these mattresses have adjustable sections, allowing you to elevate your legs or upper torso to achieve the proper alignment of the spine. Adjustable mattresses have an ergonomic design, which allows for a more natural spine curvature and better blood circulation for a more relaxed sleep. These mattresses come in different types, including memory foam and latex.
  • Spring Mattresses – many people grew up sleeping on a spring or innerspring mattress, which has coils inside to give that firm, bouncy feel. Spring mattress technology has evolved through the years, making them less “creaky” and more able to support the different parts of the body. There are also hybrid mattresses now that combine the support provided by springs and the comfort of memory foam.
  • Foam Mattresses – usually considered the simplest mattress type, foam mattresses are usually made of a whole block of foam. While these provide adequate support and some conforming ability, you usually don’t have a choice when it comes to firmness.
  • Waterbeds – there was a time when waterbeds were all the rage because of their ability to conform to the body’s contours, but these beds don’t give enough support or push-back. While you can adjust firmness by adding or removing water, waterbeds are not recommended for those who suffer from back pain.

woman sleeping on a pillow

 How about the pillows?

The foundation or base of a mattress distributes the weight of the mattress evenly, which not only contributes to mattress longevity but to your comfort as well.

Pillows can also be used to alleviate back pain and give you a better night’s sleep, but only if their height or loft is compatible with your mattress and preferred sleeping position. If the pillow under your head is too high and too firm, it would put strain on the neck and shoulders and result in back pain. Side sleepers usually prefer thick, fluffy pillows while those who sleep on their back prefer thinner pillows. What’s important is that the pillow should work in tandem with the mattress to keep the spine properly aligned.

Pillows should be used to support the head and neck to allow the shoulders to rest on the mattress. For side sleepers, placing a pillow between the knees helps to keep the hips level. For back sleepers, as mentioned it is ideal to place a pillow under the knees.

What to look for in a mattress to avoid back pain

If you’re on the lookout for the best mattress for back pain, here are some factors to consider:

  • Firmness – aim for something Goldilocks would love, something that’s not too stiff and not too soft. Medium-firm is the most recommended mattress firmness level to avoid back pain. To know if a mattress is just right for you, it should be soft enough to conform to your body and firm enough to support your lower back if you sleep on your back, and your shoulders and hips if you sleep on your side.
  • Support – the mattress should provide good support for the head, shoulders and hips as these are the heaviest parts of the body that would sink further into the mattress than other body parts. The mattress should be able to keep your body on a flat and level plane. A sagging or too-soft mattress offers inadequate support and creates an unnatural sleeping position, which can result in back pain.
  • Comfort – the mattress should provide just the right softness to reduce pressure points so you can be comfortable. A mattress that is able to cradle your body well while keeping your spine properly aligned can help prevent back pain from occurring.
  • Cooling – A mattress should also let you sleep cool so you don’t toss and turn and wake up sweaty in the middle of the night. Some mattresses make use of cooling gel technology to let you sleep cool, while others have Celliant fibers in their mattress covers. Celliant is a mineral-based, thermo-reactive fiber that has been scientifically proven to promote blood circulation and ease muscle pain. These fibers work by taking the excess heat from the body and converting it to infrared light, which increases oxygenation of the body, allowing the body to regulate its temperature better. Aside from Celliant, other cooling fabrics commonly used in mattresses are Lycra and Performance Polyester, both staples in sports clothing for their moisture-wicking and cooling ability.
  • Conforming ability – a good mattress for back pain should be able to mold to the body’s contours to support a natural sleeping position. The mattress should be able to support the different parts of the body properly. It should “absorb” the shoulders and hips of side sleepers, heels and buttocks of side sleepers as well as the stomach, chest and knees of stomach sleepers.
  • Customization – if you can’t find a ready-made mattress that suits you, then try having one custom-made. Some mattress companies offer customization, allowing you to order a mattress that meets your unique needs. You will need to provide the manufacturer with details including your weight, height and firmness preferences.
  • Value for money – mattresses, no matter how exquisitely made they are, still need to be replaced when they start giving you back pain, exhibiting signs of wear and tear (sagging and lumpiness), start smelling bad or when they’ve reached the end of their life span. A good mattress can serve you for an average of 10 years. So when choosing a mattress for back pain, consider price, quality, durability, warranty and value.