7 Best Mattresses and Adjustable Beds for Back Pain (2022)

Article medically reviewed and fact-checked by Dr. Dimitar Marinov (M.D, Ph.D, RDN).

If you have back pain then the first thing to do is consult with your doctor or a qualified medical professional to find out the exact cause and discuss if buying a new mattress is indeed a suitable course of action.

In all cases, the advice of such qualified professionals should supersede the information in this article.

But if you do want to buy a new mattress, then you should find this list of the 7 best mattresses for back pain that I’ve listed below to be helpful in narrowing down your search.

I’ve also included some of the best adjustable beds for back pain too.

Since adjusting the angle of your mattress can also help to reduce the pressure on your back to potentially alleviate your discomfort even further.

If you’re going to buy an adjustable bed too, then I highly recommend ordering a compatible mattress and frame at the same time using the buttons on this page because that way, you can be certain that they will work together.

And to make this article truly unique, I’ve also included a short mattress and back pain Q&A with a qualified physician below (you can also see my video review for the best mattress and bed frame for back pain below that I uploaded to our YouTube channel):

Expert Interview With Dr. Dimitar Marinov – ‘Mattresses and Back Pain’

Whilst there’s no substitute for talking to your own doctor for specific advice, I spoke directly with our resident Chief Medical Advisor and Fact-Checker Dr. Dimitar Marinov (M.D, Ph.D, RDN) to get some specific answers to the following questions that are related to beds, mattresses, sleeping, and back pain:

1: ‘What are the most common causes of back pain when sleeping?’

‘If your back pain is most prominent during the morning right after you wake up, then it is most likely the result of unfavorable sleeping posture and environment.

These factors lead to an impaired sleep quality, which according to science is tightly related to lower back pain.

For example, an epidemiological study with almost 2,000 people revealed a strong link between insufficient or troubled sleep and back pain [1].

A recent study has confirmed this relationship and has shown that sleep problems usually precede the occurrence of low back pain [2].

Multiple factors can disturb sleep and eventually lead to back pain.

Common ones are your sleep position and the quality of your pillow, bed, and mattress.

For example, a study found out that switching mattresses older than 9 years with new ones significantly improved sleep quality and reduced low back pain in all 59 participants [3].

However, some serious conditions such as autoimmune disorders can also lead to low back pain, stiffness, and discomfort right after you wake up.

Make sure to consult with a doctor first if you have similar symptoms’.

2: ‘What is the best way to sleep with lower back pain?’

‘A study has shown that interventions to improve your sleeping position can significantly improve lower back pain [4].

The main intervention in the trial was performed by using pillows.

Their main role is as prevention against torsion in the pelvic and shoulder girdles.

For example, the most common sleeping position – side-position was stabilized by adding a pillow between the knees.

People sleeping on their backs had a pillow under their knees which significantly relieved the tension on the spine.

The most unfavorable position is sleeping on the stomach which was improved by adding a pillow under the pelvis’.

3: ‘How can a mattress influence back pain?’

‘A mattress can have a significant effect on back pain.

Apart from older mattresses being worse for you back, the stiffness is also a major factor.

Contrary to popular belief, an extra firm mattress is not optimal for most people.

A large randomized controlled trial with more than 300 people revealed that for most people, a medium-firm mattress has the best effect on back pain and discomfort [5].

Sleep quality also improved significantly.

Other smaller studies have also confirmed these findings [6]’.

4: ‘Can an adjustable bed help with back pain?’

‘Considering that everyone is different, it is best to have an adjustable bed.

According to scientific evidence, it can lead to great improvements in low back pain.

One study showed that switching from a standard innerspring mattress to an adjustable bed led to a 32% pain decrease and a 73% increase in sleep quality amongst the participants [7]’.

7 Best Mattresses and Beds for Back Pain Reviewed

The best mattress and bed for back pain is the Puffy Lux Hybrid paired with the Puffy Adjustable Base because it can help to combat the widest range of back pain related conditions whilst also being suitable for just about every sleeping position and sleeping requirement.

However, I’ve also included some other mattresses for more specific requirements like sleeping cool with back pain, or if you’re shopping on a budget.

If you buy through the buttons on this page under each mattress and bed review, you’ll be able to take advantage of some limited-time discounts that could save you $100s.

1: Puffy Lux Hybrid + Adjustable Base – Best Overall

If you have back pain then I recommend buying BOTH the Puffy Lux Hybrid mattress and the Puffy Adjustable Base at the same time because the adaptiveness of the foam and springs combined with the ability to adjust the angle of your sleeping surface gives you the most amount of individualized control to help you find the sweet spot where your back pain is reduced or even absent.

I strongly recommend that you buy the Puffy Lux Hybrid and the Puffy Adjustable Base at the same time because they are guaranteed to be compatible – something that’s not typically the case when you buy the mattress and frame separately from different companies (which could also void the warranty and result in a bed that makes your back pain worse).

Click here to see my Puffy Lux Hybrid mattress review.

Click the red buttons below to get $600 OFF when you buy the frame and mattress at the same time ($300 OFF each item) for a limited time only.

The Puffy Lux Hybrid Mattress

The Puffy Lux has a 12-inch profile with a medium-plush level of firmness and can be bought in the all-foam memory foam version, or the hybrid spring memory foam model.

For back pain, I recommend the hybrid model specifically because the balance of support and pressure relief may be especially beneficial for alleviating the following types of back pain:

• Sciatica – the memory foam in the top layer of the mattress is typically more adaptive than the upholstered top layer of a regular spring mattress which may help to reduce pressure on your sciatic nerve and thus reduce the radiating pain that you may currently be experiencing as you lie down at night on your current mattress.

• Muscle strains – temporary muscle strains in your back can cause discomfort that may be eased when sleeping on the more adaptive memory foam surface of the Puffy Lux Hybrid mattress.

• Side sleepers with back pain – if you are a side sleeper with back pain then the Puffy Lux Hybrid could be ideal for you because the memory foam and adaptive springs can allow your shoulders and hips to sink more deeply into the materials to help reduce pressure points and promote better posture that may help to alleviate your back pain. You may even want to go for the all-foam version if you want maximum sinkage and material compression in the side sleeping position if you weigh less than 150 lbs.

• Stomach sleepers with back pain – if you are a stomach sleeper with back pain then the buoyant coils can help to keep your hips neutrally aligned to prevent back pain brought on by poor posture, whilst the memory foam can help to soften pressure points along your ribcage and hips too.

• Back sleepers with back pain – if you sleep on your back as a way to combat your back pain, then you may find that the memory foam is able to wrap around your lumbar region for more adaptive support and diffuse the pressure points along your spine and shoulder blades to help soothe any discomfort.

• Restless and combination sleepers with back pain – if you tend to shuffle around during the night due to your back pain, then the memory foam may help to soften the pressure points that could be leading to your frequent waking, whilst the bounce of the springs and the responsiveness of the foam can make it easier to switch positions without getting bogged down in the foam.

• Allergy sufferers with back pain – if you’re unlucky enough to have back pain and allergies then the hypoallergenic cover of the Puffy Lux can help to reduce flare-ups related to dust mites and mold spores because the cover can help to block dust mite penetration and inhibit the growth of mold. You can also remove the stain-resistant cover for deep cleaning to remove any allergens that might have been caught in the upper surface.

• Lighter weighted sleepers with back pain – if you weigh less than 150 lbs and have back pain then the medium-plush feel combined with the ‘give’ of the memory foam can allow for more cushioning and depth to help distribute your body weight more evenly across the surface of the mattress and lessen any pressure points that may be contributing to your back pain.

The Puffy Adjustable Base

Whilst the Puffy Lux Hybrid mattress alone can help to combat many different types of back pain, I feel that pairing it with the adjustable base can increase the number of conditions that it could help to combat, including:

• Lower back pain – if you have lower back pain then the addition of the Puffy Adjustable Base may be the most significant step that you can take to alleviate your discomfort because you can use the Zero Gravity setting to raise your upper body and legs at the same time to lower the amount of pressure being placed on your lower back.

• Upper back pain – if you have upper back pain then in addition to the Zero Gravity position, you can raise the upper portion of the frame up to 65 degrees to help you find the angle that best removes the compression forces on your upper back which may help to provide some relief.

• Acute and chronic back pain – adjusting the angle of your sleeping surface via the Puffy Adjustable Base may be able to help alleviate the discomfort of both short term and long term back pain.

• Arthritic back pain – spinal arthritis and arthritic back pain that stems from osteoarthritis, rheumatoid arthritis, spondyloarthritis (including ankylosing spondylitis) may require treatment through medication or even surgery, but the adjustable sleeping surface of the Puffy Adjustable Base combined with the adaptive foam of the Puffy Lux Hybrid gives you the maximum amount of scope to help work around your arthritic pain at night.

• Back pain with snoring – if you have back pain and snore a lot then raising the upper portion of the Puffy Adjustable Base can help to open up your airways to decrease the snoring whilst also reducing the pressure on your upper, mid, and lower back.

• Back pain with COPD – if you have back pain and suffer from COPD then raising the top of the bed frame can provide an incline that may make it easier to breathe at night.

• Back pain with acid reflux/GERD – if you have acid reflux/GERD and back pain then by simply elevating the upper portion of the frame in one move, you may be able to experience dual relief because you’re changing the angle so that your digestive system and lower back are no longer completely horizontal.

• Back pain with leg swelling – if you have back pain and swelling of the legs/feet (edema), then raising the lower section of the mattress can help to drain the fluid and take the pressure away from the lower back. If you have upper back pain and edema, then the Zero Gravity position can help to tackle the swelling and the pain simultaneously.

• Osteoporosis with back pain – vertebral fractures resulting from osteoporosis may cause mobility issues that could be aided by elevating the upper portion of the frame to make getting in and out of bed easier, whilst some relief from the pain itself may be achievable by playing around with the angle of the upper and lower portions of the frame until you find the sweet spot.

• Seniors with back pain – if you’re an aging sleeper then in addition to helping combat your back pain, changing the angles of the sleeping surface using the Puffy Adjustable Base may also help to make getting in and out of bed easier, whilst also combating associated conditions like leg swelling, acid reflux, and COPD.

• Abnormal spine curvature – if you have kyphosis, lordosis, or scoliosis then the adaptive nature of the foam and springs of the Puffy Lux Hybrid combined with the customizable features of the Puffy Adjustable Base may be able to produce a sleeping surface that’s more comfortable for you when compared to sleeping on a regular spring mattress and bed frame.

• Fibromyalgia and chronic back pain – the widespread and often chronic musculoskeletal pain associated with fibromyalgia typically doesn’t have a cure but having a more adaptive sleep surface may be helpful in conjunction with the physical therapy, medication, and other treatments that your doctor may advise [8].

• Slipped disc – a slipped disc can become more painful at night due to pressure created by your mattress. Changing the angle of your sleep surface may help you to find a position that allows your body weight to be distributed in a way so that the pressure on the area of injury is reduced.

• Athletes with back pain – if you frequently have back pain due to being sporty, lifting weights, or being active then in addition to addressing the underlying cause (such as poor form when deadlifting or squatting), you may find that having an adjustable sleeping surface can help you to work around the discomfort at night and help you to sit up if required.

• Pregnant women with back pain – it’s very common to end up with back pain during pregnancy due to your ligaments stretching in your pelvic and lower back regions which can create strain [9]. Having an adjustable frame may make it easier to get in and out of bed without putting extra strain on your lower back and abdominal wall.

• Couples with back pain – if you sleep as a couple and you both have back pain then going for the Puffy Adjustable Base in the split-king size allows you to each have individual control over your own twin xl mattress so that you’re not forced to sleep at the same angle.

How to Buy the Puffy Adjustable Base + the Puffy Lux Hybrid Mattress

If you click the button below and buy the frame and mattress at the same time, you can SAVE $600 in total ($300 OFF both the mattress and base) for a limited time only.

Click ‘add to cart’ and then select the Puffy Lux Hybrid mattress in the window that pops up (where you’ll be able to read more about the lifetime warranty, 101-night sleep trial, and the option to buy on 0% APR finance to increase affordability).

2: Idle Hybrid – Best Mattress For Heavy Weight Sleepers

The best mattress for heavyweight sleepers with back pain is the Idle Hybrid because this thick 14 inch, double-sided mattress has more depth to help handle heavier weights whilst the robust spring core and proprietary Cooling Buoyancy Foam work together to stop you from sinking too far into the mattress whilst also promoting better posture and reducing pressure points that may otherwise lead to back pain.

The Idle Hybrid is also compatible with all 3 of Idle’s Adjustable Bases so that you’ve got more control over the angle of your sleeping surface so that you can find the spot where your back pain is at its most subdued.

But even if you just go for the mattress, you’ll likely find that the Idle Hybrid mattress is especially suitable for the following sleeping requirements if you have back pain:

• Heavy weight stomach sleepers – if you sleep flat on your front and weigh more than 230 lbs then the luxury firm option is likely going to be the best choice for you if you have back pain because the extra surface tension can help to keep your hips in the proper alignment and your lower back well supported to avoid or lessen discomfort.

• Heavy weight back sleepers – if you’re a heavy weight back sleeper over 230 lbs with back pain then the medium or luxury firm options should be suitable for you (you can get medium on one side and luxury firm on the other if you’re unsure).

• Heavy weight side sleepers – if you’re a heavy weight side sleeper over 230 lbs with back pain then you’ll likely prefer the medium level of firmness because it will provide a touch more ‘give’ so that your shoulders can sink into the mattress more to alleviate pressure points and keep you in better spinal alignment.

• Heavy weight restless and combination sleepers – if you weigh more than 230 lbs, have back pain, and tend to shuffle around a lot during the night then both the medium and the luxury firm can work well for you because they will provide the surface tension that you require in conjunction with the Buoyancy Foam so that you can switch positions smoothly.

3: Amerisleep AS2 Hybrid – Best For Stomach Sleepers

The Amerisleep AS2 Hybrid mattress is the best mattress for stomach sleepers with back pain because it has been specifically designed to combat back pain by leveraging a medium-firm feel, responsive memory foam top layer, and zoned coil support core that can help to keep you in good posture and alleviate pressure whilst sleeping in a position that’s commonly the most susceptible to causing back pain.

And whilst adjustable bed frames aren’t typically ideal if you sleep exclusively on your front, you may want to consider the Amerisleep Adjustable Bed Frame too if you also like to sleep on your side and back because it can help to improve mobility and help you achieve a sleeping angle that may alleviate your back pain.

But even if you just opt for the AS2 Hybrid mattress alone, you’ll likely find it highly suitable if you’re a stomach sleeper with back pain with the following additional requirements:

• Stomach sleepers with back pain and allergies – the AS2 hybrid is designed to be resistant to dust mites, mold, mildew, and is low in chemical allergens.

• Warmer stomach sleepers with back pain – the coils and the breathable foam can help to allow for better air circulation and heat dissipation so that you can stay cool and pain-free.

• Restless stomach sleepers with back pain – if you tend to shuffle around due to pressure building up in your hips, ribcage, and other front-facing areas then the memory foam can help to ease the pressure whilst also keeping you well supported.

4: SpineAlign Luxury Hybrid – Best Mattress and Pillow

The best mattress and pillow for back pain is the SpineAlign® Luxury Hybrid™ 13.5 inch mattress and the SpineAlign® Adjustable Pillow because both products have been specifically designed to help promote postural alignment whilst being doctor and chiropractor approved.

More specifically, the mattress is approved by a sports chiropractor whilst the pillow was patented by Dr. Jason Loth D.C.

In addition to the pillow loft being adjustable (by adding or removing the foam fill) to accommodate your preferences to combat neck and upper back pain, the SpineAlign® mattress and pillow combination is potentially very well suited to the following sleeping positions and requirements:

• Side sleepers with back pain – going for the softer level of firmness if you weigh under 230 lbs and have back pain as a side sleeper could be the best option because you’ll be able to sink further into the Energex™, ArcticPhase™, and memory foam to experience more comfortable pressure relief. If you weigh more than 230 lbs then you might benefit from the medium feel for a touch more surface tension to guard against sinkage.

• Front and back sleepers with back pain – if you’re a front or back sleeper with back pain then the medium feel should be suitable for sleepers up to 230 lbs whilst the firmer feel can help to give you more support if you weigh more than 230 lbs to help maintain good posture in conjunction with the 8″ of Quantum Edge™ support coils.

• Couples with back pain – if you sleep as a couple and you both have back pain then the constant tossing and turning can make things even worse due to the disturbances. However, the foam and the individually wrapped coils can help to absorb the shock waves for greater peace.

5: Awara Hybrid – Best For Sleeping Cool

The best mattress for warm sleepers with back pain is the 13 inch Awara Organic Luxury Hybrid Mattress because the breathable plush Euro-top cover, cooling natural Dunlop latex foam, and 9″ of individually wrapped support coils allow for maximum airflow and heat dissipation, whilst the medium-firm feel and buoyant sleeping surface can help to keep you in good posture whilst also helping to distribute your body weight more evenly for heightened pressure relief.

The Awara mattress is suitable for a wide range of sleeping positions and styles, including:

• Front and back sleepers with back pain – the medium-firm feel, adaptive support, and natural latex foam can help to keep your spine naturally aligned to help reduce compression forces and maintain the good posture that’s critical to avoid causing or aggravating existing back pain.

• Side sleepers with back pain – even though the Awara is a touch on the firmer side, the plush pillow top allows for deeper sinkage at the surface so that your hips and shoulders can sink further into the materials so that you don’t experience pressure-based back and shoulder pain.

• Restless sleepers with back pain – if you switch positions often during the night due to your back pain then the responsive latex foam and springs can help to aid this process smoothly.

6: Level Sleep – Best For Back and Hip Pain

The best mattress for back and hip pain is the Level Sleep® mattress because this 11 inch, all-foam mattress with its adaptive Energex™ foam is split into zoned regions to provide firm support around your lower back, medium firmness around your hips, and softer pressure relief around your shoulders and head.

This combines to create a more personalized sleeping surface that can help to keep your hips aligned with your spine and reduce pressure around the more angular areas of your body to distribute your body weight more evenly and potentially help alleviate back pain.

Furthermore, the Level Sleep® mattress is recommended by chiropractors like Dr. Robert Adams and Dr. Nick Athens, whilst also being backed by clinical tests that apparently prove that the Level Sleep® mattress ‘…was proven effective in improving sleep quality’.

So if you specifically have both back and hip pain due to a range of conditions like sciatica or arthritis, then the pressure relief and postural support that the Level Sleep® mattress could provide may be ideal for you.

Click the button below to learn more about the 1-year sleep trial, lifetime warranty, and 0% APR financing options now.

7: SweetNight Twilight – Cheapest Mattress For Back Pain

The cheapest and most affordable mattress for back pain is the SweetNight Twilight hybrid mattress because the memory foam and hybrid coil construction provide both pressure relief and postural support in conjunction with a slightly firmer feel that may help to alleviate back pain in front, back, side, and combination sleepers – for both single sleepers and couples alike.

The SweetNight Twilight is also the cheapest mattress without fiberglass that I know of – which means that you won’t have to worry about this harmful irritant being released into your home.

If you’d like to learn more about the SweetNight Twilight mattress and find out why it’s my #1 pick out of all of SweetNight’s mattresses, then check out my SweetNight mattress reviews here.

But if you’re ready to buy, then click the button below to find out just how well priced this high-quality mattress for back pain is now.

How to Buy a Mattress and Bed For Back Pain

Buying a new mattress to help with your back pain first requires you to consult with your doctor to diagnose the source of your back pain and to find out if a new mattress is really going to make any difference.

If buying a new mattress is agreed upon, then you should consider the type of mattress, the firmness, and the specifics like zoned support that may be able to help specifically reduce back pain.

You may also wish to consider buying an adjustable frame because altering the angle of your sleep surface may have a significant impact on reducing your back pain due to the redistribution of your body weight relative to gravitational forces.

The 3 step mattress and bed buying guide for back pain below can help you to dial in the specifics in more detail.

1: Identify the Cause of Your Back Pain

Before you buy a mattress to potentially help with your back pain, the first thing that you must do is talk to your doctor or a qualified medical professional in order to properly diagnose the cause of your back pain.

You should then ask them if buying a mattress is likely to have a positive effect on resolving the issue and if so, the type of specifications they recommend for your specific mattress (soft, firm, spring, memory foam, etc).

Because despite what many of the marketing materials may lead you to believe, simply buying a mattress that’s designed to ‘help’ with back pain may not actually make any difference.

Since the outcome will ultimately depend on your individual condition and the method of treatment suggested by your doctor.

Below is a list of the most common types of back pain and the possible causes; ranging from physical conditions to your mattress itself and your sleeping style.

1.1: Types of Back Pain

Here are some of the most common types of back pain:

• Lower back pain – lower back pain is characterized by anything from a dull ache to a stabbing or shooting sensation that could be due to a muscle strain or a more complex medical issue [10].

• Upper and mid back pain – upper and mid back pain typically covers discomfort that ranges from the base of your neck to the bottom of your ribcage and the discomfort may arise due to a pulled muscle, pinched nerve, osteoarthritis, poor posture, or another condition [11].

• Axial back pain – axial (or mechanical) back pain is typically confined to the lower back region and doesn’t produce referred pain in other regions of the body.

• Radicular back pain – radicular back pain radiates through your back and hips and through your spinal nerve root that can cause numbness, tingling, and muscle weakness due to compression or pinching of the spinal nerve that may be due to a herniated disc or arthritis [12].

• Acute back pain – acute back pain lasts a few days or weeks and is typically due to a sudden injury or onset of a condition.

• Chronic back pain – chronic back pain typically lasts for several weeks or even longer and can be caused by injury or a medical condition.

1.2: Medical Reasons For Back Pain

When you visit your doctor, there’s a fair chance that you’ll be told that your back pain is due to one of the following causes:

• Strain – overstretched or torn muscles or ligaments due to improper lifting or an injury are a common cause of back pain.

• Sciatica – sciatica (also called radiculopathy) is caused by compression of the sciatic nerve and typically results in a shocking or burning pain in the lower back and potentially down one leg.

• Slipped disc – a slipped (prolapsed or herniated) disc is when the soft cushion of tissue between your vertebrae bulges outwards and causes pain in your lower back (although some cases may produce no noticeable symptoms) [13].

• Arthritis – osteoarthritis, rheumatoid arthritis, spondylitis, and other inflammatory conditions in the spine may cause arthritic back pain.

• Osteoporosis – a reduction in bone density can lead to painful fractures of the vertebrae.

• Abnormal spinal curvature – scoliosis, lordosis, and kyphosis are conditions where the spine curves or arches excessively and may cause discomfort.

• Other conditions – there are many other conditions that could be causing your back pain, including congenital defects like spina bifida, degenerative issues, nerve and spinal cord problems, and non-spinal causes like kidney stones, fibromyalgia, cancer, tumors, or pregnancy.

1.3: Back Pain Caused By Your Mattress

In some cases, your current mattress is the cause of your back pain – which is often the case when you awaken with a stiff lower back that eases up throughout the day, only to return again the next morning due to you sleeping in poor posture.

Sleeping in poor posture can cause back pain because it puts excessive pressure on your muscles and joints – which may also prevent you from getting into a deep sleep and/or cause frequent waking due to your neurons and muscle fibers being overstimulated as they try to correct the stress being placed upon your body.

Below are the main reasons why your mattress can end up causing you back pain:

• Sagging – a sagging mattress is typically characterized by a dip that’s more than 1-2 inches deep and extends over a significant area of the mattress; usually along the centerline of a single-sleeper bed or down each half of a double sleeper mattress. Deep sagging can cause back pain due to your muscles and joints being placed in a strenuous position night-after-night.

• Body impressions – body impressions are localized regions of sagging that are congruent with the regions that you sleep on. For example, it’s common to see body impressions develop in old mattresses around the hip region where a significant amount of weight is concentrated, which may lead to lower back pain if the dip causes your hips to drop into poor posture.

• Too soft – if your mattress is generally too soft then you may end up with backache because you sink too far into the materials and so your posture is compromised. This is a significant risk factor if you weigh more than 230 lbs, and/or sleep on your front, and/or sleep on an old mattress (especially if it’s made entirely out of low-density polyfoam or memory foam).

• Too firm – your mattress may cause you back pain if it’s too firm because you’ll not be able to sink far enough into the materials in order to achieve pressure relief on the more prominent regions of your body such as your hips. This is more likely to be an issue if you weigh less than 150 lbs because your lower body weight means that you’re naturally more inclined to lie on top of the materials (which causes a build-up of pressure on the surface of your body and in your joints).

• Insufficient support – if the lower support core of your mattress is sagging, defective, or deformed then you’ll likely experience broken posture that can lead to back pain. This is common in older mattresses that have worn out.

Below is some specific advice from qualified physical therapists Bob Schrupp and Brad Heineck in regards to finding out if your mattress is causing your back pain and what you can do about it:

1.4: Back Pain Caused By Your Sleeping Position

In addition to the mattress itself, your dominant sleeping position may be contributing to your back pain – especially if your mattress is sagging.

This is because each sleeping position creates unique pressure points on the mattress that differ from sleeper-to-sleeper based on your body weight and the characteristics of your mattress.

However, for the main sleeping positions (stomach/front, side, and back) the following generalizations apply to each position relative to the risk of back pain:

• Stomach sleepers – if you sleep strictly on your stomach then this is the position that’s most likely to cause back and neck pain when you’re sleeping on a saggy mattress or a mattress that’s too soft because the further your hips sink into the mattress, the more the pressure builds up in your lower back and neck. The heavier you are the greater the risk – so a firmer mattress with a thinner pillow (under 3 inches in loft height) tends to work the best if you’re a front sleeper over 230 lbs.

• Side sleepers – as a side sleeper, you’re more likely to experience pain in your hips and shoulders if the mattress is too firm due to the high concentration of pressure in these areas, whilst a very soft mattress (especially if you weigh more than 230 lbs) may cause your hips to sink too far into the materials which may result in a lateral build-up of pressure in your lower back.

• Back sleepers – sleeping on your back is generally considered the ‘safest’ position if you have back pain, however, you can still experience lumbar discomfort if the mattress is too soft or too firm to the extent that it causes you to sleep in poor posture or results in pressure points building up on your hips/spine/shoulders.

1.5: Back Pain Caused By Your Body Weight

In addition to the integrity of the mattress and your dominant sleeping position, your body weight can affect the likelihood of you experiencing back pain as follows:

Over 230 lbs

If you weigh more than 230 lbs then you’re far more likely to sink into the mattress materials which can increase the risk of ending up in bad posture – especially if you’re sleeping on a mattress that’s sagging, worn out, or too soft – with heavier weighted front sleepers typically being the most susceptible to experiencing lower back pain due to the risk of your back ‘hammocking’.

As a heavier weighted sleeper, you’re likely going to be comfortable in a slightly firmer mattress – such as medium-firm, firm, or extra-firm – if you’re a front or back sleeper because the increased surface tension can help to keep your hips aligned to guard against back pain.

However, if you’re a side sleeper over 230 lbs then things get a little more tricky because although you’ll need a touch more firmness to keep you in good posture, you’ll also need a bit more ‘give’ in the upper surface layers so that your shoulders can sink in and not be put under a lot of pressure.

In which case, I recommend going for a hybrid spring memory foam or hybrid spring latex foam mattress with individually wrapped coils in medium or medium-firm (consider firm or extra-firm only if you’re very heavy or you know that you like a much firmer mattress).

Because the foam will provide enough material compression to dissipate the pressure on your shoulders, whilst the firmer feel combined with the adaptive support of the springs will help to keep you in good posture to guard against back pain.

Indeed, regardless of your sleeping position, as a heavier weight sleeper I strongly recommend hybrid memory foam/latex foam mattresses due to this balance of pressure relief and support because it’s an excellent combination for reducing the risk of experiencing back pain overall.

Under 150 lbs

If you weigh less than 150 lbs then you’re going to have the opposite problem to heavier weight sleepers – instead of sinking too far into the materials, you’ll more than likely tend to rest on TOP of the mattress.

This can cause a build-up of pressure in your joints due to internal compression forces, whilst the more prominent regions of your body will likely become hot-spots for pain – typically resulting in back, shoulder, and hip pain (depending on your sleeping position and the quality of the mattress).

To combat this, I recommend going for a soft or medium-soft mattress if you’re a side sleeper under 150 lbs (maybe even an extra-soft if you’re under 130 lbs) so that the pressure is alleviated from your shoulders and hips.

Whilst a medium or medium-soft firmness might be better if you’re a front or back sleeper so that you’ve still got a touch of surface tension to help keep you in good posture and alleviate compression forces on your spine.

As a lighter weighted sleeper (especially if you have a low body fat percentage), then memory foam and latex foam topped mattresses are well-advised because the foam can mold around your body shape more precisely to guard against back pain caused by pressure points.

You can opt for all-foam designs if you so choose (especially if you sleep as a lighter weighted couple because the material can help to dampen movements very well), but hybrid mattresses are still an excellent choice too.

2: Choose the Mattress

If your doctor agrees that a new mattress may be able to help combat your back pain then you should ask them specifically what type of mattress they recommend for your condition.

Even if they can’t give you a brand name, then ask them if they link a soft or firm mattress would be best and the preferred materials.

However, in many cases, the doctor probably won’t be able to tell you exactly which model of mattress to get (unless they know a lot about mattresses), so you can use the points below for some guidance (which should be more helpful than just guessing).

2.1: Choose the Mattress Type

Buying a mattress online is a great way to save a lot of money (up to 50% or more compared to buying in-store when you factor in discounts).

But if you’ve not bought a mattress for a while, then you might feel a bit overwhelmed with all the terminology – especially now that hybrid, memory foam, and latex mattresses tend to be pushed by retailers more than regular spring mattresses.

Here’s a quick overview of the main mattress types and some suggestions on which type to get to potentially guard against back pain relative to your sleeping style and physical characteristics.

Hybrid (Best Choice Overall)

Hybrid mattresses have a spring core with either memory foam, latex foam, polyfoam, or a foam blend in the upper layer.

High-quality hybrid mattresses can be excellent for guarding against back pain because the foam in the top layers can remove the pressure that typically builds up in your back, shoulders, and hips – whilst the lower support core can help to keep you in good posture.

Hybrid mattresses with individually wrapped coils and/or zoned support are especially good for heavier weighted sleepers with back pain because the springs can stop you from sinking too far into the mattress whilst also adapting to the contours of your body for even greater pressure relief and support.

Memory Foam

Mattresses with memory foam in the upper layers can be excellent for combating back pain because the foam is specifically designed to respond to your body weight and heat so that the material can conform to the precise contours of your body shape.

This has the effect of reducing pressure points on your body – which may be very beneficial if your back pain stems from pressure-induced pain (such as sciatica, slipped discs, arthritis, or spinal curvatures).

Hybrid spring memory foam mattresses can provide this pressure relief whilst also providing excellent postural support, but there’s also the option of an ‘all-foam’ memory foam mattress where the lower support layer is typically made from polyfoam.

Whilst I personally tend to feel that hybrid mattresses are nearly always the better option for most sleepers, such all-foam mattresses can be more beneficial for couples because the all-foam design makes for a quieter mattress whilst also dampening cross-mattress transfer to reduce night-time disturbance.

Latex Foam

Much like memory foam, latex foam is excellent at providing pressure relief that can benefit you if you have pressure-induced back pain.

However, unlike some types of memory foam, latex foam doesn’t require your body heat to alter its shape in order to adapt to your body shape.

And whilst this typically means that latex foam doesn’t mold quite as precisely to your body, it means that the mattress typically retains less heat (which is great if you’re a warmer sleeper) and is a bit more ‘bouncy’ (making it easier to move around in if you’re a combination or restless sleeper).

Again, you have the option of choosing a hybrid spring latex foam mattress (which makes for the most cooling type of mattress) or to go for an all-foam latex mattress (which can be a great way to combat dust mite allergies and sensitive skin due to the hypoallergenic properties of the latex).

However, you should look for latex mattresses that are made from natural latex instead of synthetic SBR latex because natural latex tends to be more durable and smells less.

Traditional Spring

Traditional spring mattresses have an upholstered top layer that’s typically not as thick or as adaptive as the foam found in high-quality hybrid mattresses.

This means that whilst the springs can help to provide good support, you’re more likely to experience pressure point induced back pain due to the prominence of the springs.

This may not be true in every case, and you may find that a regular spring mattress is a cheaper way to buy a mattress that can help to guard against back pain.

However, to stack the odds in your favor, I personally recommend going for a quality hybrid mattress because of the pressure-relieving qualities of the memory/latex foam.

‘Orthopedic’ Mattresses

It may be the case that your doctor ends up recommending that you buy an ‘orthopedic’ mattress to help with your back pain.

However, there’s no government standard that makes one mattress ‘more orthopedic’ than another – which means that you’re typically at the mercy of the marketing spiel of each mattress company [14].

As a general rule though, you will typically find that ‘orthopedic’ mattresses tend to be on the firmer side and have qualities (such as zoned support) that may be able to provide more support for your bones and joints which may or may not help your back pain.

I would say that you’re far more likely to end up with a mattress that’s suitable in combating your back pain if you first go to your doctor to find the root cause of the issue and if given the go-ahead to get a new mattress, you pick the firmness level and materials based on your dominant sleeping position and body weight (as described in this buying guide).

Mattresses Recommended by Chiropractors and Doctors

When shopping online for a mattress for back pain, you may discover mattresses that are supposedly recommended by chiropractors, doctors, and/or backed by ‘scientific studies’.

And whilst some mattresses may indeed be recommended by such professionals, you need to keep in mind that many of the ‘studies’ referenced were commissioned by the mattress companies themselves.

I’m certainly not saying that anyone is being dishonest here but I encourage you to look into these studies if you can get your hands on the published papers and make your own decisions in regards to the validity of such claims.

2.2: Select the Firmness and Support

As touched upon previously, the level of the firmness specifies the degree of surface tension that contributes to the mattress feeling ‘soft’ or ‘hard’ when you lie down on it.

Firmness differs from support because whilst firmness is a preference that’s primarily influenced by the upper portions of the mattress (with some carryover from the lower layers), the support is dictated by the low support layer specifically.

‘Good support’ is non-negotiable when buying a mattress and is particularly important when considering buying a mattress to help with your back pain because a lack of good support can actually cause back pain due to poor posture.

To ensure that you buy a mattress with excellent support, took at the design of the mattress support core and the materials used – strong, individually wrapped steel coils are typically the best.

But if you’re going for an all-foam mattress, make sure that the lower polyfoam/latex foam layer is made from high-density foam.

Choosing the right level of firmness is more challenging because it depends on your body weight, sleeping position, and personal preference.

However the table below can help to guide you.

2.3: Look For Specifics

Looking for a mattress with the following special features may be able to help you combat or prevent back pain.

Zoned Pressure Relief

Mattresses with zoned pressure relief typically have firmer foam in the upper comfort layer around the hips to provide more support, whilst the foam around the shoulders tends to be softer to allow for more material compression.

This combination can help to provide a more personalized sleep surface that can simultaneously combat postural and pressure based back pain.

Zoned Support

Mattresses with zoned support operate in the same way as those with zoned pressure relief, except the difference in firmness originates from the lower support core – typically in the form of springs with varying gauges or foams with differing firmnesses.

The effect is generally the same and is typically used in conjunction with zoned pressure relief to provide a mattress with a zoned profile that may help to mitigate back pain.

Edge Support

Mattresses with added edge support have a section of high-density foam or firmer springs that run around the edge of the mattress to combat sinkage and roll-off.

Edge support can be useful if you have back pain and tend to hug the edge of the bed as you sleep because it can contribute to a more even sleeping surface.

All-foam mattresses without edge support tend to be the worst when it comes to sagging, so looking for edge support in such models is a must – or you can opt for a hybrid mattress for better support on the whole in general.

2.4: Adjustments and Preferences

With the design and the firmness of the mattress sorted, the last few aspects of finding the ideal mattress to help with your back pain relate to individual ‘secondary’ preferences that can contribute to a better sleep experience when chosen correctly.

Couples

If you sleep as a restless couple then an all-foam, memory foam or latex topped mattress could be a good move because the foam can help to dampen the feeling of movements whilst also reducing the pressure points that may be contributing to your restlessness.

Beyond this, if you each have back pain, then you might like to consider a split firmness if you have contrasting sleeping types so that each half of the mattress has a different level of firmness that’s better suited to each of you.

Alternatively, you could opt for a split king adjustable frame with 2 twin xl mattresses for complete individual control over your sleeping preferences (more on this in the next section).

Sleeping Cool

If you’re a warmer sleeper with back pain then going for a hybrid spring mattress with a latex foam comfort layer is likely the best choice because the foam and coils can help to encourage airflow to keep you cool whilst also adapting to support your back and lessen pressure points.

Thickness

Thinner mattresses under 8 inches are more likely to invite back pain because there’s a greater risk of you sinking through the upper support and transition layers and touching the firmer support core below (especially if you weigh more than 230 lbs and you’re sleeping on an all-foam mattress) which can result in postural and pressure-induced back pain.

To reduce this risk, it’s likely safer to go with a mattress that’s at least 10-12 inches thick and has an upper comfort layer that’s at least 3-5 inches thick to provide adequate cushioning.

If you weigh more than 250-275 lbs then you may prefer to go for an even thicker mattress to provide a greater capacity for pressure relief and support.

However, the integrity of the materials also plays a significant factor along with the type of materials used – the springs found in a high-quality hybrid mattress are typically the best option and make for some of the best anti-sag mattresses too.

Pillows

When it comes to preventing upper back, neck, and shoulder pain, having the right pillow loft (height) is crucial because it can influence the alignment of your spine and its surrounding muscles.

Picking the correct pillow loft can be difficult because it depends on your sleeping position, body type, and the firmness of the mattress relative to the two (because the heavier you are/the softer the mattress is, then the more you’ll sink in and the shallower the loft will need to be; with the inverse being true).

However, the following tables are a good starting guide:

Other Pillow Use For Back Pain

If you have back pain, then you can experiment with strategic pillow placement to potentially alleviate temporary discomfort.

For example, side sleepers with back pain may experience relief by placing a pillow between your knees and raising your legs until you hit a position where the pain subsides (I’ve personally used this technique successfully many times over the years when I’ve hurt my back doing wrestling/BJJ/MMA).

Whilst placing a low-loft pillow under your hips can have a similar effect if you’re a front sleeper with back pain, and a medium loft pillow under your knees can help to reduce the pressure on your lower back in the back sleeping position too.

However, changing the angle of your sleep surface using an adjustable bed frame may prove to be a more stable option.

Mattress Toppers

Mattress toppers are like ‘mini-mattresses’ that act as an extra comfort layer that you can use to change the firmness of your mattress to potentially alleviate your back pain.

For example, if your mattress is too soft then buying a firmer mattress topper may be able to help provide the extra surface tension that you need to combat sinkage and maintain better posture.

Whilst a softer mattress topper placed on top of a firm mattress may be able to lessen the pressure points that are causing or contributing to your pressure-based back pain.

Mattress toppers are typically a few inches deep and you can buy them in memory foam, latex foam, polyfoam, foam blends, as well as in a mix of materials that may include natural fibers like cotton or wool, or even micro coils for a springier feel.

Just be aware that a mattress topper isn’t an effective long-term solution if your mattress is sagging excessively – since the only real cure for a mattress with an insufficient level of support is a new mattress.

2.5: 30-60 Night Breaking in Period

If you have back pain and you buy a new mattress – DON’T be surprised if after your first night of sleeping on it you still have back pain (or it ends up being even more painful).

It’s quite likely that this discomfort is temporary.

Because as beat up as your last mattress was, your body probably adapted to it in some way (although probably not completely if your mattress is the definite cause of your back pain).

And therefore it can take up to 30-60 nights before your new mattress ‘breaks in’ and begins to feel comfortable for you.

Therefore it’s imperative that you give your new mattress a fair shot – aim to sleep in it every night for at least 30 consecutive nights to see if things improve (but obviously stop if your back pain becomes unbearable, and go and see your doctor again).

Sleep Trial

Because choosing the right mattress for you isn’t a perfect science, then it’s recommended that you purchase a mattress with a long sleep trial.

Because a sleep trial will allow you to return the mattress if it’s uncomfortable or for any other reason that you don’t like it (even after you’ve slept on it).

Most sleep trials last around 90-100 nights, but some of the best mattress with a long sleep trial can last up to a year or more.

Just be aware that there’s usually a MINIMUM trial period too – where you typically can’t return the mattress until the first 30 days from the point of delivery have passed to cover the break-in period.

Although you can usually return a mattress that’s not been opened immediately if required.

Other things to look out for is to ensure that if you’re ordering from a place outside of your country (such as buying a mattress online from the US when you live in Canada) that the sleep trial still applies and doesn’t incur $100’s extra in shipping fees).

Warranty

In addition to the sleep trial it’s a good idea to make sure that the mattress comes with a warranty that has at least 10 years of non-prorated coverage so that you can get a replacement mattress/new parts at no extra cost if the mattress turns out to be defective.

Some of the best mattress warranties last for the duration of your ownership of the mattress.

3: Consider an Adjustable Base

Whilst choosing the right mattress for your body type and sleeping style can potentially have the most significant impact on helping to prevent and combat back pain that stems from the previous use of an unsuitable/sagging mattress, you may find that the addition of an adjustable base could also provide some significant relief.

So if you’d like to consider buying an adjustable bed to go with your mattress then you’ll likely find the following short buying guide useful.

3.1: How Can An Adjustable Bed Help With Back Pain?

An adjustable bed can potentially help to alleviate your back pain by allowing you to alter the angle of your sleeping surface to help redistribute your body weight and reduce pressure points on your body whilst also potentially leveraging massage functions to stimulate blood flow and relax your muscles.

The study referenced by Dr. Marinov at the start of this article also states that a ‘32% pain decrease and a 73% increase in sleep quality’ was achieved by the participants who switched from a regular innerspring mattress to an adjustable bed.

Here’s an overview of the main functions that you should look for in an adjustable bed to help combat your back pain:

Upper Body Lift

Even the most basic adjustable beds allow you to raise the upper portion of the bed to help reduce the compression forces on your lower back.

Some of the more advanced adjustable beds come with a head tilt function that allows you to adjust the angle of your neck for more granular comfort which may help with upper back and neck pain.

Leg Lift

Adjustable beds with the leg lift function can help to reduce lower back pain by raising your legs so that your lower back is put under less stress.

The Zero Gravity Position

The zero gravity position is a single setting on an adjustable bed that combines the upper body and leg lift so that you’re placed in a ‘weightless’ position where the compression forces on your back are reduced – which may help to combat back pain.

Massage

Adjustable beds with a massage/3D wave massage function can help to relax your muscles and improve blood flow which may be beneficial if you have back pain that stems from muscle strains/overuse.

3.2: Who Can Benefit From An Adjustable Bed?

An adjustable bed may help to alleviate back pain, especially in the following people:

Seniors

Adjustable beds can potentially help to reduce back pain in seniors whilst also helping to make getting in and out of bed easier by lifting up the upper section of the bed – the resulting incline of which may also be able to alleviate snoring and symptoms of acid reflux/GERD.

Pregnant Women

If you’re pregnant and have back pain then you may be able to find relief by manipulating the upper and lower portions of the bed to create a custom sleeping angle that works with your body position.

Athletes

If you are a sporty or active person then the massage function may be able to relax sore muscles and increase blood flow for faster recovery [15] whilst the incline functions can make it easier to get in and out of bed if you’re injured.

Couples

If you sleep as a couple with differing sleeping requirements then purchasing a split-king adjustable base with two compatible twin xl mattresses can allow you to each have maximum control of your respective sleeping surfaces.

And assuming that the base is put together correctly, having two distinct mattresses can help to reduce motion transfer better than if you were sleeping on the same mattress for a more peaceful night’s sleep.

3.3: How to Buy an Adjustable Bed For Back Pain

Once you’ve gotten clearance by your doctor, you should first select the mattress with the appropriate specs to fit your body type and sleeping position as per the guidance above – since this is going to be the surface that you’re sleeping on directly and therefore the most likely to influence your comfort levels.

If you’ve decided that you also want to use an adjustable bed to help with your back pain then you should buy a compatible mattress and adjustable base from the same company.

Because this means that you’ll not experience the incompatibility and warranty problems that are likely to occur when buying a mattress and adjustable base from sperate companies.

Related Questions

Below are the concise answers to the most common questions related to buying a mattress for back pain.

What Firmness of Mattress Is Best For Lower Back Pain?

Whilst it’s widely believed that firmer mattresses are better for lower back pain, the best mattress for your back pain is the one that’s the most compatible with your dominant sleeping position and bodyweight – which could be a soft, medium, or firm mattress depending on your preferences.

Are Memory Foam Mattresses Good For Back Pain?

Whilst a memory foam mattress can hurt your back if it’s the wrong level of firmness relative to your body type and sleeping style, a memory foam mattress can also be good for combating pressure point based back pain if it’s the correct firmness for you because the foam can help to reduce the pressure points on your back whilst adapting to the contours of your body.

Is a Hard or Soft Mattress Better For Back Pain?

A hard (‘firm’) mattress can be better for combating back pain if you’re over 230 lbs and tend to sleep on your front due to the increased surface tension that may lead to better postural alignment, whilst a softer mattress may be better for reducing your back pain if you’re under 150 lbs and/or sleep on your side because the softer surface can allow you to sink into the materials more and reduce pressure points.

Conclusion: An Adjustable Mattress is Optimal

Providing that it aligns with the advice given by your doctor, the most optimal sleeping solution for combating your back pain is an ‘adjustable mattress’ – which comprises of a mattress with the firmness and design that complements your physical characteristics and dominant sleeping position, plus an adjustable frame that allows you to manipulate the angle of your sleeping surface to reduce pressure points on your back.

What’s the Best Mattress For Back Pain?

The best mattress for back pain is the Puffy Lux Hybrid mattress used in conjunction with the Puffy Adjustable Base because it can help to remove the pressure associated with lying down that can worsen – or even cause – back pain whilst also allowing you to adjust the angle of your sleeping surface to help you find the optimal posture for you.

Click the button below to learn more about the Puffy Lux Hybrid mattress and the Puffy Adjustable Base now and save $600 when you buy them together today (limited time offer).

Sources and References

[1] Springer – Is Insufficient Quantity and Quality of Sleep a Risk Factor for Neck, Shoulder, and Low Back Pain? A Longitudinal Study Among Adolescents. Accessed 1/10/20.

[2] Taylor Francis Online – Impaired Sleep Predicts Onset of Low Back Pain and Burnout Symptoms: Evidence From a Three-Wave Study. Accessed 1/10/20.

[3] NCBI – Changes In Back Pain, Sleep Quality, And Perceived Stress After Introduction Of New Bedding Systems. Accessed 1/10/20.

[4] IOS Press – Effects Of Sleeping Position On Back Pain In Physically Active Seniors: A Controlled Pilot Study. Accessed 1/10/20.

[5] Science Direct – Effect Of Firmness Of Mattress On Chronic Non-Specific Low-Back Pain: Randomised, Double-Blind, Controlled, Multicentre Trial. Accessed 1/10/20.

[6] Science Direct – Effect Of Prescribed Sleep Surfaces On Back Pain And Sleep Quality In Patients Diagnosed With Low Back And Shoulder Pain. Accessed 1/10/20.

[7] Europe PMC – Short-Term Outcomes Of Chronic Back Pain Patients On An Airbed Vs Innerspring Mattresses. Accessed 1/10/20.

[8] Mayo Clinic – Fibromyalgia. Accessed 27/9/20.

[9] NHS – Back Pain in Pregnancy. Accessed 27/9/20.

[10] National Institute of Neurological Disorders and Stroke – Low Back Pain Fact Sheet. Accessed 27/9/20.

[11] Michigan Medicine (University of Michigan) – Upper and Middle Back Pain. Accessed 27/9/20.

[12] Beaumont.org – Radicular Pain. Accessed 27/9/20.

[13] NHS – Slipped Disc. Accessed 27/9/20.

[14] Wikipedia – Orthopedic Mattress. Accessed 27/9/20.

[15] Firefly™ Recovery – OnPulse™ Technology. Accessed 27/9/20.

Image Attribution and Licencing

All images used with permission in conjunction with separate partnership agreements with their respective vendors.

Medical Disclaimer

Back pain is a complex and highly personal disorder that should be treated by a qualified medical professional – this article is not intended to diagnose or provide treatment options for back pain or any other medical issues. Please consult with a medical professional before buying a mattress, bed, or any other product related to your condition.

Dan

Dan is the founder and head content creator at Bedroom Style Reviews.

He has been working as a professional online product reviewer since 2015 and was inspired to start this website when he ended up sleeping on a memory foam mattress that was too soft and gave him backache.

Through in-depth research and analysis, Dan’s goal with this website is to help others avoid such pitfalls by creating the best online resource for helping you find your ideal mattress, bedding, and bedroom furniture.

Dan is a qualified NVQ Level 2 Fitness Instructor with 6 years’ experience helping clients improve their health through diet, exercise, and proper sleep hygiene.

He also holds several college and university-level qualifications in health sciences, psychology, mathematics, art, and digital media creation – which helps him to publish well researched and informative product reviews as well as articles on sleep, health, wellbeing, and home decor.

Dan also has direct personal experience with insomnia, anxiety, misophonia (hypersensitivity to sounds), and pain from both acute and long-standing sporting injuries – he enjoys writing insightful articles around these subjects to help fellow sufferers of such conditions.

Learn more about Dan here.