Best Mattress for Back Pain

At the end of the day, sleep is crucial for the body’s recovery, but back pain can negatively impact your sleep quality. A mattress that lacks proper support for sleep posture and spinal alignment can make back pain worse. Our testing has shown that the best mattresses support the spine and promote even alignment, which helps alleviate back pain and promote deeper, more restorative sleep.

Our team has evaluated hundreds of mattresses using a comprehensive methodology that incorporates several performance categories. For these picks, our testers focused on major mattress performance categories related to back pain, like pressure relief, support, and ease of movement.

Watch Video: We Tested the Best Mattresses for Back Pain — Here Are Our Favorites

Watch our video below to learn more about our lab’s top mattress picks for sleepers with back pain.

Real Testing by Real Experts
We’ve put together our top-rated mattresses for back pain relief below, giving them different accolades for their outstanding features in our test lab. Our testing team has tested over 1,300 mattresses to uncover the truth about how well each bed performs in a variety of contexts. We’ve done intensive research into the causes and realities of living with back pain (along with how back pain interacts with mattresses), working with medical experts and everyday people to figure out what makes a bed a good match for back pain. For more information about how we test mattresses, check out our methodology section below.

We’ve also included an informative buyer’s guide that covers common causes of back pain in bed, the best types of mattresses to alleviate it, and how to choose the right mattress based on construction and materials.

Our Recommendations

If you carry extra weight around the midsection, a mattress with zoned layers might be a solid investment. The WinkBed is a luxury hybrid available in four firmness options, so most people should find at least one design that feels comfortable and supportive. The company’s generous return policy also allows you to exchange your initial selection if you aren’t satisfied with how soft or firm it feels.

How It Performed

Our team tested each version of the WinkBed. Those weighing less than 130 pounds found the medium soft (4) feel most comfortable, particularly the side sleepers on our team. The medium firm (6) feel received favorable ratings from testers weighing 130 to 230 pounds across all three position groups. Our back and stomach sleepers weighing 130 pounds or more also found the firm (7) design comfortable, and those weighing more than 230 pounds were impressed by the robust support of the WinkBed Plus (8).

Thanks to the zoned coils, the WinkBed performed well during our tests for edge support and ease of movement. Most of our testers were able to move across the surface of the mattress with little resistance, and the perimeter felt stable as we mimicked movements associated with getting in and out of bed, tying our shoes, and changing positions near the edges. Temperature control was another strength of the WinkBed during our tests. This can be attributed to steady airflow throughout the coil system and the breathable, moisture-wicking Tencel cover.

What It’s Made of

The medium soft, medium firm, and firm WinkBed models feature adaptive polyfoam quilted into the surface, followed by a layer of denser foam for added cushioning and reinforcement for your body. WinkBed Plus models swap out the second foam layer for zoned latex, which feels highly responsive and shouldn’t buckle too much beneath your body — even if you weigh more than 230 pounds.

All WinkBeds feature zoned pocketed coils in their support cores. Thicker coils line the perimeter to protect the edges from deep sinkage, and also rest beneath your chest and hips to push back against the extra weight of these areas. A cover made of eucalyptus-derived Tencel fabric encases the entire mattress.

Customers in the contiguous U.S. receive free ground shipping with their WinkBed purchase, and each mattress comes with a 120-night trial period. As part of WinkBeds’ return policy, you may exchange your initial mattress for a softer or firmer model if you aren’t satisfied with how it feels. The replacement mattress comes with its own 60-night trial. All WinkBed mattresses are additionally backed by lifetime warranties.

Read Our Full Review of the WinkBed

The DreamCloud Mattress is a hybrid that combines adaptive comfort layers with a strong support system. A medium firm (6) feel ensures cushioning for the shoulders, lower back, and hips, but our testers found the thick pocketed coils maintained an even surface for their bodies and minimized uncomfortable sinkage around the midsection — a common source of aches and pains. Approachable pricing and a generous sleep trial sweeten the deal even further if you’re shopping on a budget.

How It Performed

While the DreamCloud’s strongest ratings came from our side sleepers between 130 and 230 pounds, the mattress was well received by testers across a wide range of body types and sleep positions. Ample cushioning prevented our side sleepers from feeling sharp pressure points in their shoulders and hips, which often occur for people who use this position. The back sleepers on our team didn’t sink too much despite the thick, adaptive foam layers.

Temperature control was another performance area where the DreamCloud excelled during our tests. We’ve attributed the mattress’ above-average cooling to a moisture-wicking cashmere-blend cover and steady air circulation through the coil system. Thanks to the thick foam layers, the mattress also performed better than many competing hybrids in categories like motion isolation and pressure relief.

What It’s Made of

The DreamCloud begins with polyfoam quilted into the cover, followed by a soft memory foam layer and additional layer of polyfoam. These materials give the mattress an invitingly plush feel when you get into bed, but each layer is progressively denser and you shouldn’t sink too deeply as your body settles into the surface. The support core contains pocketed coils over a high-density foam base. The cover is composed of a breathable, moisture-wicking cashmere-blend fabric.

Shipping is free for customers within the contiguous U.S. Each order comes with a sleep trial that spans an entire year, giving you plenty of time to test the mattress and decide whether it’s right for you. Should you decide to keep the bed, you’ll also receive a lifetime warranty against structural defects.

Read Our Full Review of the DreamCloud Mattress

Saatva’s mattress line has greatly expanded over the past decade, but the luxurious Saatva Classic is still among the company’s most popular models. One of the first major innersprings to incorporate a coil-on-coil design, the Classic is available in three firmness levels and two profiles to accommodate a wide swath of sleepers.

How It Performed

Our testers found each of the Saatva Classic’s firmness levels distinct from the other two. The soft (3) design provides deep contouring, and was popular among our side sleepers weighing up to 230 pounds. Back and stomach sleepers on our team who weigh less than 130 pounds also found this design comfortable. At the other end of the spectrum, the firm (8) feel cushions very little and feels exceptionally supportive. Our back and stomach sleepers weighing at least 130 pounds preferred this model. Those seeking a balance of conforming and stability should consider the medium firm (6), which earned favorable ratings from our testers across different weight and position groups.

All three Saatva Classic models performed well during our edge support and ease of movement tests. The dual-coil construction ensures a responsive surface that shouldn’t sink or make you feel stuck when getting in and out of bed, and perimeter reinforcement pushes back against your weight when sitting or sleeping along the edges. Both coil layers promote steady air circulation, so the mattress also scored well when we tested it for temperature control.

What It’s Made of

The Saatva Classic features a Euro-top cover cushioned with foam and plush fibers. A memory foam pad located beneath the lower back is intended to support the lumbar region and minimize pain in this area of the body, while transitional minicoils offer extra reinforcement without generating too much motion transfer.

The support core contains sturdy, low-gauge hourglass coils made of recycled steel. You can opt for an 11.5-inch mattress with 4-inch support coils, or a 14.5-inch model with 7-inch coils. We recommend the latter if you need exceptional support to sleep comfortably. A cover made of breathable, GOTS-certified organic cotton encases the entire mattress.

The Classic’s sticker price is reasonable compared to other high-end innersprings and hybrids. Saatva is one of the only online mattress brands to offer free White Glove delivery to all customers in the contiguous U.S. This service includes full setup in a room of your choice, and removal of your old mattress and box spring upon request. All purchases are backed by year-long sleep trials and lifetime warranties.

Read Our Full Review of the Saatva Classic

The Brooklyn Bedding Signature Hybrid combines adaptive foam and supportive coils for an overall balanced feel. With three firmness options to choose from, you can pick the model that best suits your sleep position and personal sleep preferences.

How It Performed

The mattress is available in medium soft (4), medium firm (6), and firm (8) options. Our testers found the foam comfort layers offered very good pressure relief, regardless of the firmness level. The medium soft option was an excellent fit for side sleepers up to 230 pounds and back sleepers up to 130 pounds, since these individuals need deep cushioning for the shoulders, hips, and spine. Back and side sleepers between 130 and 230 pounds gave favorable ratings to the medium firm option, while the firm model felt most comfortable to stomach sleepers weighing at least 130 pounds and back sleepers over 230 pounds.

The coils give the Signature Hybrid a responsive feel, especially in the firmer models. This is ideal for sleepers who prefer beds that are easy to move around on. Meanwhile the softer models outperformed the firm model in our motion isolation tests, which may benefit anyone who shares the bed with a restless sleeper.

What It’s Made of

All three firmness options begin with a quilted surface for a plush feel, followed by two polyfoam layers to enhance cushioning. Layers vary in thickness and firmness depending on the model you choose. The support core is composed of pocketed coils that generate sturdy support, with strong coils around the perimeter to boost edge support. Airflow through the coils helps keep the bed cool, but for an additional fee you can also add a pillow-top made with a specialized GlacioTex cooling fiber.

Brooklyn Bedding offers a 120-night sleep trial and 10-year warranty. Shipping is free to addresses in the contiguous U.S.

Read Our Full Review of the Brooklyn Bedding Signature Hybrid

A mattress that promotes spinal alignment can be helpful for anyone who wakes up with pains or sore spots in their shoulders, back, and hips. The Nolah Evolution 15 contains four foam layers to cushion and contour to the body, evenly distributing your weight to improve your alignment, while a zoned coil system pushes back against extra weight from your midsection and significantly reduces sinkage.

How It Performed

We tested all three of the Evolution 15’s firmness levels. The medium (5) design conforms closely, and we found it best suited to side sleepers — especially those weighing up to 230 pounds. Our back and stomach sleepers under 130 pounds felt comfortable on this design, but also gave favorable ratings to the medium firm (6) feel. For the firm (8) model, our testers weighing more than 230 pounds received adequate support and didn’t sink too much.

The Evolution 15 utilizes open-cell foam layers engineered to promote circulation and breathability. As a result, our temperature control tests showed very little heat buildup. The zoned coils also allowed the mattress to perform well during our tests for edge support and ease of movement. The two firmest models were particularly strong in these categories.

What It’s Made of

Four foam layers make up the Evolution 15’s comfort system, the topmost of which is encased in a Euro-top cover. These layers are progressively denser from top to bottom, so you’ll feel plush cushioning when you get into bed while the underlying foams keep your body on an even plane.

The zoned support core features thicker coils along the perimeter and beneath your chest and hips. This facilitates movement across the surface, and also helps ensure you’ll feel extra pushback around heavier areas of the body. The entire mattress is encased in a cover made of proprietary ArcticTex fabric that feels cool to the touch.

The mattress comes in seven sizes, including a split king. Nolah offers free ground shipping within the contiguous U.S. Each Evolution 15 purchase includes a 120-night sleep trial, but you can opt out of the trial period and reduce your up-front costs by as much as $150. A lifetime warranty against structural defects backs each mattress. For additional coverage, you can purchase an accident protection plan that covers stains and other types of physical damage not included in the standard warranty.

Read Our Full Review of the Nolah Evolution 15

The Layla Hybrid pairs copper-infused memory foam and high-density polyfoam with a support core of pocketed coils. The mattress is flippable, with different firmness levels on each side. We found this design excelled at pressure relief and motion isolation, while also sleeping cool and providing adequate support for a wide variety of sleepers.

How It Performed

The dual-sided construction offers two different mattress firmnesses, so the Layla Hybrid was a great option for most of the testers on our team. We noticed the medium soft (4) side was best suited to sleepers who weigh less than 130 pounds while the firm (7) side was a better option for sleepers who weigh at least 130 pounds. The coil springs reinforced the edges and made it relatively easy for our testers to move around on the firm side of the mattress. Although memory foam tends to trap heat, air flows through the coils to help the mattress sleep cool.

What It’s Made of

The medium soft side has a 2.5-inch comfort layer of copper-infused memory foam. The memory foam contours to the body to a moderate extent to provide strong pressure relief, while the copper infusion is meant to combat heat retention. This layer rests on 2 inches of zoned transitional polyfoam that provides varying amounts of support to different areas of the body. In contrast, the firm side has a thinner layer of memory foam over 1.5 inches of zoned polyfoam. The mattress is encased in a breathable cover made of polyester, viscose, and spandex with vinyl handles on the sides for easier flippability. The support core consists of 6-inch pocketed coils between the foam layers. A cover made from a stretchy polyester, rayon, viscose, and poly-lycra blend encases the mattress.

The Layla Hybrid comes with a 120-night sleep trial and is backed by a 10-year warranty. Shipping is free to the contiguous U.S.

Read Our Full Review of the Layla Hybrid

Most of our testers found the Bear Elite Hybrid comfortable thanks to adaptive foam layers that reduce pressure, a supportive coil system, and cooling components that minimize heat buildup. The mattress is also available in three firmness options — and if you choose a split king size, Bear allows you to choose a different firmness for each side of the bed.

How It Performed

The medium (5) Elite Hybrid design was most popular among our side and back sleepers weighing up to 230 pounds. This model features foam layers that contour closely to the body for optimal weight distribution, even alignment, and fewer pressure points along the spine. Those seeking a slightly more supportive build should consider the medium firm (6), which earned rave reviews from our side sleepers between 130 and 230 pounds, and our back sleepers weighing up to 230 pounds. The firm (8) feel provides light cushioning and robust support, making it most comfortable for our side sleepers over 230 pounds, back sleepers of at least 130 pounds, and stomach sleepers between 130 and 230 pounds.

The Elite Hybrid’s zoned transitional layer proved effective at maintaining an even surface for our bodies, especially around the chest, stomach, and hips. This was particularly true for the medium firm and firm designs. Our thermal sensors also detected minimal heat buildup during temperature control tests, and we noticed a good deal of pushback along the perimeter when testing the mattress for edge support. Another strength of the Elite Hybrid was motion isolation. The medium model performed especially well for us in this category.

What It’s Made of

All versions of the Elite Hybrid begin with a memory foam comfort layer, followed by a transitional layer of polyfoam. The memory foam is infused with copper, which is meant to help with temperature control. The coils also generate steady circulation throughout the interior, and a cover made of Celliant-blend fabric is intended to keep the surface cool.

The coils are zoned to be thicker and sturdier along the edges, allowing you to sleep along the perimeter and get in and out of bed without sinking too much. A high-density foam base layer rounds out the hybrid design.

All customers in the contiguous U.S. receive free ground shipping with their Elite Hybrid purchase. The mattress is backed by a 120-night sleep trial and a lifetime warranty against structural defects. You may purchase additional protection that covers stains and other types of physical damage for up to 10 years.

Read Our Full Review of the Bear Elite Hybrid

Many people prone to back pain and pressure buildup get the relief they need from mattresses with soft, adaptive comfort layers — but this hugging effect can also lead to uncomfortable heat retention. With the Casper Snow, you get the best of both worlds. The comfort layers contour deeply to distribute your weight and properly align your spine, while gel-infused foam, phase change material, and proprietary “HeatBand” technology work together to keep you cool throughout the night.

How It Performed

As a medium (5) mattress, the Casper Snow is noticeably softer than many of the other hybrids we’ve tested. The most favorable ratings came from our side and back sleepers weighing up to 230 pounds, who appreciated the Snow’s close conforming and cradling. Some of the stomach sleepers on our team weighing under 130 pounds felt adequately supported, but most testers who use this position found the mattress too soft.

Many of the softer foam hybrids we’ve evaluated underperform in the temperature control category, but the Snow lived up to its name during this stage of our tests. Thermal mapping detected very little heat buildup, and most of our testers felt reasonably cool while lying on the mattress. Other strong performance areas included motion isolation and pressure relief. 

What It’s Made of

The Snow begins with a top layer of AirScape polyfoam, an open-cell material engineered to resist body heat buildup and promote airflow. HeatDelete bands embedded beneath the polyfoam dissipate heat for additional cooling. The memory foam transitional layer is zoned to push back against extra weight in your midsection while cradling lighter areas of your body.

The support core contains pocketed coils encased in high-density foam. These coils stabilize the mattress and the foam border provides some perimeter support, but you may still notice some sinkage when lying close to the edges of the mattress or getting in and out of bed. The cover is composed of CoolTouch phase change material.

The Snow is on par with the average hybrid model in terms of cost, and Casper offers free ground shipping throughout the contiguous U.S. and provincial Canada. Your order includes a 100-night sleep trial. Should you decide to keep the mattress, it’s further covered under a 10-year manufacturer’s warranty.

Many mattress brands advertise their beds as “soft” or “plush,” but the fact is some people benefit from less cushioning and a firmer feel from their sleep surface. These individuals are great candidates for the reversible Plank Firm Luxe, which features a firm (7) feel on one side and an extra firm (9) feel on the other. The latter is one of the firmest surfaces we’ve tested in our lab, and should be suitable for anyone who has found other foam hybrids too soft.

How It Performed

Due to the Plank Firm Luxe’s exceptionally firm design, the mattress earned its most favorable ratings from back and stomach sleepers weighing 130 to 230 pounds. The majority of our testers preferred the firm side, but some of our back and stomach sleepers found the extra firm surface provided better overall support.

As is often the case with firmer mattresses, the Plank Firm Luxe performed exceptionally well during our edge support and ease of movement tests. The mattress also sleeps quite cool thanks to consistent airflow through the coil layer. You can opt for a phase change panel on each side if you tend to overheat in bed or sweat in your sleep.

What It’s Made of

The Plank Firm Luxe’s firm side features a layer of quilting material, followed by latex-like TitanFlex foam and high-density polyfoam. These materials provide a small measure of cushioning without sacrificing firmness or support. The extra firm side does not contain any TitanFlex and the polyfoam layer is thinner, creating a surface that cushions very little. A shared support core of pocketed coils rests between the comfort systems.

In addition to the standard model, you can order phase change panels to be sewn into both sleep surfaces of the mattress. Phase change material is engineered to dissipate body heat on contact and maintain a cool, comfortable surface at all times. Note that adding these panels will increase the sticker price by up to $200.

The Plank Firm Luxe is reasonably priced compared to other hybrid models and ground shipping is free within the contiguous U.S. The mattress is available in 12 different sizes. These include standard mattress dimensions, as well as a split California king for couples with adjustable beds and several RV-friendly options. You’ll receive a 120-night sleep trial with your purchase, and a 10-year warranty against structural defects should you decide to keep the mattress.

Read Our Full Review of the Plank Firm Luxe

Many mattresses provide back pain relief, but the Level Sleep Mattress is one of the only available models that is specifically created with this purpose in mind. A three-zone design provides enhanced support for the torso and lumbar region while gently cradling the head and reinforcing the hips. The result is a mattress that maintains an even sleep surface from head to toe, reducing aches and pains in the process.

How It Performed

The mattress’ “Tri-Support” construction features a soft (3) feel for the head and shoulders, a firm (7) feel for the midsection, and a medium (5) feel for the hips and legs. As such, Level Sleep earned favorable ratings from our side and back sleepers weighing up to 230 pounds. Stomach sleepers under 130 pounds also felt comfortable during our tests. We detected very little buildup when testing the mattress for pressure relief, as well.

Other strong performance areas for Level Sleep include motion isolation for couples, consistent cooling, and above-average edge support. The all-polyfoam design creates more responsiveness compared to beds with memory foam layers, so our testers encountered minimal resistance when moving across the surface.

What It’s Made of

The Level Sleep Mattress consists of three polyfoam layers. The topmost layer is fairly adaptive, while the underlying layers are denser and more supportive. Since the transitional layer is divided into three firmness zones, your upper and lower back shouldn’t sink too deeply into the mattress. A breathable poly-rayon cover encases the foam layers.

The Level Sleep Mattress is competitively priced and customers in the contiguous U.S. enjoy complimentary ground shipping. Your order includes a generous sleep trial that runs for an entire year, and the mattress is backed by a lifetime warranty for added peace of mind.

Read Our Full Review of the Level Sleep Mattress

Data-Driven Results You Can Trust

At Sleep Foundation, we’ve personally tested hundreds of mattress models to bring you the top picks listed above. Our expert team includes product testers that represent a wide range of body types, sleep positions, and comfort preferences. After thorough hands-on testing, we consider these selections to be the best of the bunch.

How Our Testing Process Works

To evaluate mattresses for back pain relief, we ask our testers to lie down on each mattress. Ideally, a mattress should contour to the body while maintaining even support, so we measure how deeply the mattress sinks beneath the tester’s weight. We also use body-mapping sensors to pinpoint locations where painful pressure points are likely to occur. Although we relied on feedback from all of our testers, we focused on those who have a history of upper and/or lower back pain.

To learn more about our mattress evaluation process, check out our product research methodology below:

Dive Deeper — In-Depth Mattress Guides

For more help deciding which mattress is right for you, check out our guides broken down by mattresses for your particular requirements.

How Back Pain Affects Sleep

Back pain is a widespread problem that affects an estimated 80% of adults at one time or another. It can make all types of daily activities difficult including walking, working, sitting, and lifting even lightweight items. Unfortunately, we know that back pain complicates sleep as well, making it hard to find a comfortable position to fall asleep and keep sleeping soundly through the night. Research studies have found that over half of people with lower back pain report sleeping problems.

People with pain tend to have fragmented sleep that occurs from waking up during the night. Upon waking up, getting back to sleep can be difficult because of ongoing aches and discomfort. Pain can also contribute to stress, depression, and anxiety, all of which can be detrimental to quality sleep.

Smaller changes can contribute to pain reduction as well. Taking care when lifting, sitting with proper posture, and avoiding unnatural movements can reduce aggravation of back pain. Based on our product research, we’ve found that having a mattress that keeps the body aligned can reduce stress on the spine and facilitate better sleep.

Types of Back Pain

Back pain can present in many different ways and for a wide variety of reasons. To help classify back pain, it is normally described as either acute or chronic. Acute back pain comes on rapidly and is often a sharp, intense pain. Chronic back pain lasts for three months or longer and persists despite attempts to remedy it.

Another way to distinguish between types of back pain is based upon which part of the back is affected.

• Lower back pain
  
  Lower back pain is by far the most common type of back pain. It affects the lumbar region, which includes the lowest five vertebrae (L1-L5) of the spine. Pain in this area is the second most common reason — after only cold- and flu-like symptoms — why people visit their doctor.
  
  Lower back pain can be tied to basic muscle strain as well as to more complicated issues affecting the nerves, organs, and vertebrae. Examples of possible causes include compression fractures, ruptured or herniated disks, and narrowing of the spine (spinal stenosis).
  
  The lower back has more curvature and range of motion than other parts of the back, and this makes it more susceptible to injury related to movement and posture, including positioning during sleep. If a mattress offers insufficient support, the lower back may twist or bend in an unnatural way. For example, we’ve found that if the bed is too soft or is worn out, the hips, which carry more weight, may sink deeply into the mattress and out of alignment with the lumbar area. When that or any other misaligned position is held for an extended period during the night, it can be a direct contributor to back pain.
• Mid back pain
  
  Middle back pain is much less common than lower back pain. The middle back is generally identified as above the lumbar spine but below the rib cage. The anatomy in this area is designed to promote stability over flexibility, reducing the propensity for movement-based injury compared to the lower back.
  
  Even though mid-back pain is less common, it can still occur as a result of numerous conditions. Nerve compression, damage to discs, fractures, and muscle or ligament injury can occur in this region. Middle back pain can also be caused by serious underlying problems, like tumors or organ problems, making it important to get it reviewed by a doctor, especially if it occurs alongside other unexplained symptoms.
  
  Stiffness and aching in the mid-back can arise because of poor posture and lack of spinal support. Because of the amount of time spent in the lying position during sleep, these alignment issues can often be connected to a mattress that does not adequately support the body and cushion a person’s pressure points.
• Upper back pain
  
  Upper back pain is less common than lower back pain but occurs more frequently than middle back pain. It affects the thoracic region, which runs from the bottom of the rib cage up to the lower neck and involves the 12 vertebrae that connect to the ribs. As with middle back pain, the reduced flexibility of bones and muscles in this region make movement-based strains less common than in the lower back.
  
  Upper back pain can occur for similar reasons as the mid-back — nerve, disc, muscle, ligament, or vertebrae problems — but there is a greater likelihood that this pain is connected to a potentially serious health issue. Pain in the upper back and shoulders can also come about because of awkward or unsupportive body positioning. If a pillow is not the right height or if a mattress doesn’t properly accommodate the shoulders, it may place undue pressure on the anatomy of the thoracic region, heightening the risk of upper back pain.
• Neck pain
  
  Neck pain can occur due to different reasons. Many people develop strains and sore spots due to less-than-optimal posture, which can be especially problematic for people who sit at a desk for their jobs. As with back pain, issues with your vertebrae – such as disc issues – can also lead to neck pain. Another important consideration is the pillow you use. Our product tests reveal time and time again that, in order to reduce aches and pains, a pillow should provide enough support and loft to keep your neck aligned with the spine and hips. Other factors at play include age, physical activity level, and previous injuries with lingering effects.

Regardless of whether back pain has started suddenly or has been a long-term issue, people experiencing it should make sure to get checked out by a doctor. Not only can a physician help try to relieve pain, they can conduct a full diagnostic process to determine if back pain is being caused by a more serious underlying health issue.

Can Sleeping Position Affect Back Pain?

Sleeping position can have a direct effect on back pain. Each sleeping position creates a unique set of pressure points and areas that need cushioning, and this is why our testers believe having the right mattress to suit your sleeping position is an important part of preventing and reducing back pain.

Back sleepers tend to have their most serious pressure points around the lumbar area. Our pressure tests on various mattresses have shown that if a mattress is too soft, the weight of the abdomen will cause this region to sink out of alignment with the rest of the back and hips. If the mattress is too hard, it won’t accommodate the natural curvature of the spine in the lumbar area. For this reason, a medium-firm to firm mattress usually works best for back sleepers.

Side sleepers have high-impact areas where the body is the widest, notably at the shoulders and hips. A mattress needs to be contouring enough to cushion those pressure points but not so soft as to let them sink too deeply into the bed and out of line with the rest of the body. Most side sleepers on our test team get the best results from a medium to medium-firm mattress.

Stomach sleepers have pronounced pressure points in the lumbar area and around the neck. If their pillow is too tall, it can put excess bend in the neck and upper back. If the mattress is soft, the pelvic area can dip too far, putting the body in a U shape that stresses the spine as well as the muscles and ligaments in the lower back. As a result, stomach sleepers on our team tend to have less back pain if they use a thin pillow and have a firm mattress. Stomach sleepers who weigh more than 230 pounds may even benefit from an extra firm mattress.

Body weight is an important factor to consider along with sleeping position. People who weigh more will sink further into a mattress, exacerbating the risks in all sleeping positions of the heavier parts of the body becoming misaligned. Sleepers of above-average body weight (over 230 pounds) typically need a firmer mattress than someone of average weight who sleeps in the same position.

Similarly, people who weigh under 130 pounds are less prone to sinking into the bed, and can sleep on a softer, more contouring mattress without the same risks of the body sagging out of alignment.

Sleeping Position Video

For more information about how side sleeping and other positions affect your sleep, check out the video below.

Can a Mattress Cause Back Pain?

A mattress can definitely be a cause of back pain because it plays such an important role in how the body is positioned through the night. Most people know that posture is important but only think about their posture in the context of standing and sitting. This can cause them to overlook the importance of having a mattress that is the proper fit for them based on their body shape, weight, and sleeping position.

If the spine and joints aren’t aligned and well-cushioned during sleep, they won’t be able to relax. Instead of recovering, the body will be strained, exacerbating pre-existing back issues and sowing the seeds for new ones. The easiest way to know whether a mattress is a contributing factor to back pain is if the pain tends to be the most pronounced in the morning when you wake up. If the pain is the worst when you get out of bed and subsides during the day, we recommend taking a close look at whether your mattress is playing a part in your aches and pains.

Which Type of Mattress is Best for Back Pain?

A key step in choosing a mattress is deciding which mattress type is most likely to work for you. Virtually all mattresses on the market today can be broken into five types based on their construction and materials.

Within each category, you can find consistent features; however, we know there can be notable variation from one brand or model to the next. Some types allow for a greater diversity of designs, which leads to a wider variation in the expected feel and performance of any specific mattress.

Hybrid

Definition: Hybrids are constructed with an innerspring support core that is supplemented by a significant comfort system that may include layers of foam, latex, microcoils, cotton or fiber fill, down, and/or wool. The comfort layers on a hybrid are much more robust than on an innerspring mattress.

Highlight: Balanced Features. Hybrids try to capture the best of multiple bed types without suffering from their downsides. For example, we’ve found that hybrids tend to offer moderate to significant contouring that aids in pressure point relief, while their coils permit excellent ventilation, making temperature regulation a plus on most hybrid beds.

Innerspring

Definition: An innerspring mattress is composed almost entirely of metal coils. There may be a thin layer of cotton, polyester, or foam above the coils, but we generally find that this layer does not significantly change the mattress performance. Historically, innersprings were the most common mattresses, but their popularity has declined considerably as foam, latex, and hybrid models have gained steam.

Highlight: Inexpensive and Customizable. A benefit to innersprings is that they are among the most inexpensive options that you can find. One option we recommend is to use the money saved to customize the bed’s feel with a mattress topper.

Latex

Definition: Latex mattresses have an interior construction made completely with latex, which is a type of rubber. Most mattresses use natural latex from trees, but synthetic or blended latex is used occasionally. The comfort layers and support core may employ different types of formulations of latex.

Highlight: Supportive Contouring. We’ve tested numerous latex beds, and most of them have moderate contouring effects. This allows the bed to cushion the body without an excessive amount of sink.

Airbed

Definition: Airbeds feature a support core of inflatable chambers. Sleepers can use a remote or smartphone app to control a pump that can add or remove air from the chambers, adjusting firmness in real time. There may be other materials, including foam, latex, cotton, polyester, or wool, layered as a comfort system above the support core.

Highlight: Adjustable Firmness. Our test team believes the primary benefit of airbeds is their adjustability. Being able to quickly modify the firmness of the bed can be a huge plus for people with back pain because it lets them get “dialed in” depending on the nature of their pain and posture at that exact point in time.

Foam

Definition: Foam is layered to create both the support core and comfort system of an all-foam mattress. Memory foam is a popular material in foam mattresses as is polyurethane foam (polyfoam), which can be manufactured to have a range of distinct characteristics. Latex may be included among the layers, but no coils are used in a foam mattress.

Highlight: Deep Contouring. Memory foam tends to offer the highest degree of hug. This allows these mattresses to deliver proportional cushioning to the areas of the body that need it most. Side sleepers on our test team can attest that foam is especially useful for cushioning sharp impact points like shoulders and hips.

How to Get Relief on a Budget

When you’re struggling with back pain, you may feel like you’re willing to give anything to get relief, but the realities of your budget can mean that you have to think about the impact of any mattress purchase on your bottom line. The good news is that there are multiple wallet-friendly ways to improve your bed, enhance your sleep, and give your back a rest.

Consider Buying a Mattress Online

A great way to score a deal on a new mattress is to buy online. Most online mattresses are sold directly by the manufacturer. Eliminating the middle-man and the need for showroom space means lower prices. Your purchase isn’t just more affordable, but also generally protected through a sleep trial that allows you to return your bed if it doesn’t feel right, or help ease your back pain.

Trial return policies offered by online mattress companies are particularly helpful for anyone looking for pain relief in a new mattress. Shopping brick-and-mortar generally doesn’t allow that benefit. And it remains a challenge to properly assess how back pain will ease without actually sleeping on the bed.

Why Buy a New Mattress?

Many sleepers buy new beds to replace an old mattress that has lost its support or is simply no longer comfortable. Other sleepers purchase new mattresses to alleviate pain caused by an incompatible mattress  — for example, switching from a firm to medium firm mattress to relieve pressure buildup. We polled more than 100,000 Sleep Foundation subscribers to find out the top reasons people purchase new mattresses.

Try Changing Up Your Sleeping Position

Changing your sleeping position is one way to try to get back pain relief.

If you are a back or stomach sleeper with a soft mattress and you don’t have the budget for a new bed, you can try switching to a side sleeping position that will receive more support from your existing mattress. In general, experts recommend that stomach sleepers try to adjust to side or back sleeping because it’s easier to get appropriate support in those positions.

For people with acute pain, temporary changes to your sleeping position may help to reduce stress on already sore or achy parts of your back.

Additional Sleeping Accessories for Sleepers With Back Pain

Besides a mattress, other accessories that can play a part in making your bed conducive to quality, pain-free sleep. Upgrading your pillows and your bed base can be done as a lower-cost way of improving your sleeping surface.

Pillows

Pillows play an important role in preventing and reducing back and neck pain. We’ve evaluated hundreds of pillows and found that models that provide proper support to the neck can improve spinal alignment. In addition to supporting the head, pillows can be strategically placed to provide cushioning and comfort to other parts of the body.

Numerous factors affect which is the best pillow to best help an individual fight neck and back pain. The amount of loft of your pillow should fit your personal preference and body shape. The right loft level is also largely determined by the firmness of your mattress and your sleeping position, as outlined in the following tables.

Sleeping Position	Pillow Loft Recommended
Back	Medium
Side	Medium or High
Stomach	Low

Mattress Firmness	Pillow Loft Recommended
Soft – Medium Soft	Low
Medium	Medium
Medium Firm – Firm	High

To reduce back pain, pillows can be used to support other parts of the body besides just the head and neck.

• Side sleepers may find it helpful to put a pillow between their knees, especially if they draw their legs up toward their chest. Our testers have noticed that using a pillow in this way can reduce pressure on the hips and lumbar area. A full-length body pillow can be used to prevent twisting through the lower back.
• Back sleepers can benefit from a low-to-medium loft pillow placed beneath the knees, which can aid in maintaining a more natural bend in the lower back.
• Stomach sleepers may get pain relief by placing a thin pillow below the pelvis to hedge against excess pressure or sinking of the lumbar area. Some stomach sleepers on our team use no pillow at all for their head or may rest only their forehead on a very thin pillow.

Bed Platforms and Bases

The base of the bed can contribute to a supportive overall sleeping surface for people with back pain.

Some people opt for an adjustable bed, which allows for the upper and lower body to be raised at various angles. The optimal position for any sleeper on an adjustable base will depend on the type of back pain that they have and their sleeping position. Back sleepers, for example, frequently find that a slight elevation of the torso and legs helps take pressure off of the lower back. It is essential to ensure that your mattress is compatible with an adjustable bed before purchasing and setting one up.

Mattress Features To Look For to Relieve Back Pain

When shopping for a mattress to help relieve back pain, some features are more important than others. With so many products and a bevy of marketing hype, it can be tough to parse out what really matters. Based on our extensive experience testing mattresses, we believe that you’re most likely to get the most satisfaction out of your purchase by focusing on certain key considerations:

• Mattress Type: The materials and design will play a huge role in the performance of a mattress. The contouring, bounce, firmness, temperature regulation, and motion isolation of a mattress will be different for each mattress type, so it is critical for shoppers to think about their priorities and choose a mattress with components that will best meet their needs.
• Zoned Support: Weight from the body is not distributed evenly; instead, certain areas tend to require more cushioning. A zoned mattress takes that into account and offers reinforced support in those areas.
• Quality Materials: We’ve found that a mattress made with excellent materials is much more likely to provide the performance, reliability, and durability that people with back pain need.
• Firmness Level: Firmness is a key driver of mattress comfort and is largely a matter of personal preference. At the same time, the right firmness level can play a big part in whether a mattress offers sufficient support, and that will depend significantly on a person’s body weight and sleeping position.