Choosing the Best Mattress for Low Back Pain

Your mattress can contribute to your back pain. Research shows that selecting the right mattress can help reduce pain while lying in bed, pain when you wake up, and even pain throughout the day.

The Best Choice: Medium-Firm Mattresses 

Contrary to popular opinion, a very firm or hard mattress is not the best option for most people with back pain. In fact, studies show that medium-firm mattresses are better than firm mattresses for people with chronic low back pain because they best preserve spinal alignment.
 

In a large research study of over 300 people with chronic back pain: 

  • 82% of people using medium-firm mattresses had less pain and disability 
  • Low back pain improved in only 68% of people using firm mattresses 
  • People with medium-firm mattresses were twice as likely to get better

What Does "Medium-Firm" Mean?

A medium-firm mattress provides support while still conforming to your body's shape. When you lie down, your mattress should: 
  • Support your spine in a neutral position 
  • Allow your shoulders and hips to sink in slightly 
  • Not feel “rock-hard” or overly soft 

Other Things To Consider: 

  • If you sleep “hot,” latex, hybrid or gel-infused foam are more likely to keep you “cool” 
  • If you have allergies, latex mattresses tend to be the most hypoallergenic 
  • Your body weight can influence how a mattress feels: 
    • Light (<130 lb / <59 kg): Softer mattresses can provide better cushioning.
    • Average (130–230 lb / 59–104 kg): Medium to medium-firm is usually best.
    • Heavy (>230 lb / >104 kg): Firmer support helps prevent sinking too deep.

When to Replace Your Mattress:

Consider getting a new mattress if: 
  • Your current mattress is more than 7-10 years old 
  • You wake up with back pain or stiffness 
  • Your mattress sags or has visible wear 
  • You sleep better on mattresses away from home 

The Bottom Line:

Choose comfort over firmness. While medium-firm mattresses tend to be best for most people with back pain, the most important thing is finding a mattress that feels comfortable to you. What works for someone else may not work for you. 

Tips for Mattress Shopping:

  • Test mattresses in the store by lying in your usual sleeping position for at least 10-15 minutes 
  • Look for stores with trial periods or return policies 
  • Don't assume the most expensive mattress is the best one 
  • Avoid mattresses that are extremely firm or extremely soft 
  • Consider your sleeping position and body type 

Important Note:

A new mattress alone may not solve all back pain problems.  If your back pain persists after changing your mattress, Dr. Stein is happy to provide further recommendations for treatments such as trigger point injections and/or acupuncture for your back pain.