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Chronic back pain affects millions of adults in the U.S. and many experience frequent sleep disruptions due to the constant discomfort. Choosing a comfortable, supportive mattress can significantly reduce aches and pains during the night, leaving sleepers feeling well-rested and more alert the next morning. By the same token, choosing the wrong mattress can exacerbate back pain and its repercussions.
People with back pain should consider several key factors when selecting a new mattress. These include the material construction, thickness, and firmness of the mattress, as well as the individual’s weight and preferred sleep position. And because a new mattress represents a significant financial investment for most households, price-point is another important variable to take into account.
Read on to learn more about how people with back pain can improve their sleep experience with the right mattress. Below you will find our list of the top mattresses for back pain. Our findings are based on verified customer and owner experiences, as well as intensive product research.
Best Mattresses for Back Pain
Editor’s Pick – Saatva
Best Value – Helix Dusk
Best Luxury – Awara Mattress
Best for Lightweight Sleepers – Layla Mattress
Best for Average Weight Sleepers – Bear Mattress
Best for Heavyweight Sleepers – DreamCloud Mattress
The best mattresses for sleepers with back pain offer a balance of body conforming and structural support; the bed contours to the sleeper for targeted pain and pressure relief without sagging too excessively, which can cause the sleep surface to become uneven and lead to more discomfort. Our Editor’s Pick, the Saatva, features an innovative coil-on-coil design that provides exceptional support to sleepers.
The comfort system is built with pocketed coils, along with pressure-relieving memory foam and polyfoam layers. Steel-tempered bonnell coils make up the support core; these durable springs reinforce the entire bed very well and help minimize sinkage along the edges where people tend to sit. The Saatva is available in three firmness settings – Medium Soft’ (4), ‘Medium Firm’ (6), and ‘Firm’ (7.5) – as well as 11 1/2″ and 14 1/2″ profiles. This product range should accommodate most sleepers with back pain, regardless of their body type or preferred sleep position. Good airflow throughout the coil layers also makes the Saatva suitable for those who usually sleep hot.
Saatva offers free White Glove delivery to customers in the contiguous U.S. and Canada. This service includes in-home assembly and old mattress removal; comparatively, most competing brands charge at least $100 for White Glove delivery. The Saatva is also backed by a 120-night sleep trial and a 15-year warranty, both of which are longer than average.
Last year, Helix introduced a new line of hybrid mattresses that accommodate different sleepers in terms of body type, firmness preference, and other factors. We’ve selected the Helix Dusk as our Best Value pick because it offers a good balance of body cushioning and overall support. The Dusk is ‘Medium’ (5.5), making it optimal for sleepers weighing between 130 and 230 pounds – particularly side sleepers seeking a softer mattress for better spinal alignment. The mattress has a blended foam comfort layer that contours to the sleeper’s body without sagging or hugging too tightly. Meanwhile, the bed’s high-density foam transitional layer and pocketed coil support core reinforce the sleep surface to prevent indentations from forming. This allows back and stomach sleepers to feel comfortable and well-supported on the Dusk, as well.
Temperature neutrality is another key strength. Strong air circulation throughout the coil layer helps cool off the bed, making it a good option for people that normally sleep hot. The Dusk also isolates motion transfer better than many competing hybrids and produces very little noise; these two factors indicate the bed is ideal for couples, as well. If the Helix Dusk is too soft or too firm, shoppers can choose from five other beds in the brand’s collection with different firmness settings. Dual-firmness mattresses and a bed specifically designed for heavier people are also available through Helix.
Helix provides free mattress shipping anywhere in the contiguous U.S. The Dusk and other Helix hybrids are backed by 100-night sleep trials and nonprorated lifetime warranties.
Our Best Luxury pick for sleepers with back pain is the Awara Mattress, which features an organic-cotton and natural wool, along with an organic Dunlop latex comfort layer. In addition to being eco-friendly, these materials offer exceptional, year-round temperature neutrality for people who typically sleep hot. The Awara Mattress is ‘Medium Firm’ (6) and offers moderate yet consistent conforming, making it ideal for sleepers with back pain who weigh at least 130 pounds.
The Awara Mattress also offers zoned support, thanks to its multi-gauge pocketed coil support core. Low-gauge (thicker) coils support the sleeper’s shoulders, midsection, and other areas of the body where weight is concentrated, while high-gauge (thinner) coils offer support to the head, legs, and other lighter areas. As a result, the bed is less prone to sagging and indentations; and because it has a latex comfort layer, the Awara Mattress has a longer-than-average expected lifespan of at least seven and a half years.
Awara offers free shipping to customers in all 50 states. The mattress is backed by a 365-night sleep trial and a lifetime warranty. Both of which are much longer than average.
Lightweight sleepers who frequently experience back pain typically need a mattress that conforms closely and provides targeted pressure relief to the neck, shoulders, lower back, and other sensitive areas. The Layla is a flippable memory foam mattress with different firmness settings on each side. One side is Medium Soft (4), and the other side is Firm (7). This makes it suitable for lighter people who prefer softer settings, as well as heavier individuals who feel most comfortable on firmer surfaces.
Both sides of the mattress feature copper-infused memory foam comfort layers. This material conforms closely for targeted pressure relief in sensitive areas of the body. The copper infusion also allows the mattress to sleep cooler and can help improve bloodflow in sleepers with poor circulation. The ‘Medium Soft’ side has an additional layer of convoluted polyfoam for extra cushioning, as well. The Layla mattress also isolates a significant amount of motion transfer and does not produce any noise, making it a good choice for couples.
People in the average weight group (130 to 230 pounds) tend to prefer beds with moderate firmness, typically ‘Medium Soft’ to ‘Medium Firm.’ The Bear Mattress is considered ‘Medium Firm’ (6.5) and offers moderate yet consistent conforming for those in this weight group, as well as heavier individuals who don’t like sleeping on ultra-firm mattresses.
The Bear Mattress also aids back pain sufferers with its Celliant fabric cover. This material absorbs body heat from sleepers and converts it into infrared energy before transmitting it back into their skin. This process does not cause excessive warmth; rather, sleepers often experience stronger blood circulation, exceptional pain relief, and a speedier physical recovery after runs, long workouts, and other strenuous activities. The Bear Mattress also offers great motion isolation and does not make any noise when bearing weight.
The Bear Mattress has a below-average price-point compared to other memory foam models, making it a top-value pick. Free delivery is available to customers in all 50 states, and the mattress is backed by a 100-night sleep trial and a 10-year warranty.
People in the average weight group (130 to 230 pounds) and heavyweight group (more than 230 pounds) typically prefer firmer mattresses that balance close body conforming and robust support. The DreamCloud is a prime example; it is a hybrid mattress with a ‘Medium Firm’ (6.5) feel that is constructed with three layers of memory foam and one layer of latex in the comfort system. Sleepers experience improved spinal alignment and targeted pressure relief without sagging excessively, making the DreamCloud a great option for sleepers in these weight groups.
Edge support is another key strength. The pocketed coil support core is encased in high-density polyfoam to reinforce the bed and minimize sinkage around the edges. Its thick comfort system also minimizes motion transfer to a significant extent and it produces very little noise, making it suitable for couples.
The price-point for the DreamCloud is much lower than that of the average hybrid. Customers in the contiguous U.S. qualify for free shipping, and White Glove delivery – which includes in-home mattress assembly and old mattress removal – is available at an additional charge. The DreamCloud is backed by a 365-night sleep trial and a lifetime warranty.
Roughly 80% of adults will experience lower back pain at some point in their lives, and for millions this is a chronic, lifelong condition. Back pain is also a leading contributor to poor health and early mortality. Choosing the right mattress is crucial for individuals with back pain issues. The right mattress can alleviate pressure and aches in the most sensitive areas, such as the neck, shoulders, hips, and lumbar region of the lower back. The wrong mattress often exacerbates the issue, and may cause pressure to develop in new areas of the back.
This guide will look at mattress qualities that benefit sleepers with back pain, such as body-contouring and support, as well as the importance of using body weight and preferred sleep position to determine which mattress is best for you and your sleep partner. First, let’s look at some common types of back pain and how they impact sleep quality and duration.
A healthy spine serves three primary functions:
Unhealthy spines are often unable to perform some or all of these functions, and back pain is a common result. The term ‘back pain’ may refer to anything from minor aches and pains to debilitating conditions that affect other parts of the body. Back pain generally falls into two categories:
According to the Mayo Clinic, common causes of acute and/or chronic back pain include the following:
Muscle or ligament strain: Lifting objects that are too heavy or moving awkwardly are two common causes of strain in back muscles and spinal ligaments. The spasms that accompany this type of strain are often exacerbated by poor physical health.
Bulging or ruptured discs: Intervertebral discs are found between the vertebrae that form the spinal column, and form fibrocartilaginous joints that support and cushion the spinal structure much like shock absorbers. They have thick, durable exteriors and a soft, jelly-like filling. Bulging and ruptured discs create painful sensations when they come into contact with nerves, although some people with disc problems do not experience serious — if any — back pain.
Arthritis: Arthritis refers to inflammation of at least one joint in the body that leads to joint pain and stiffness. The most common forms of arthritis include:
Because arthritis is associated with chronic and widespread pain, people with this condition often have a difficult time falling and staying asleep.
Skeletal irregularities: Irregularities of the back and spine that can lead to pain and pressure include:
Most people with skeletal irregularities consider back-sleeping to be the most comfortable sleeping position, while some find additional relief by sleeping on their side with towels or pillows beneath the knees and ribs. Regardless of their most comfortable sleep position, people with these irregularities may experience frequent sleep disruption due to back pain and other symptoms of their condition.
Osteoporosis: Osteoporosis is a condition characterized by skeletal degeneration that causes bones to become porous and brittle. Osteoporosis fractures often occur in areas like the hips, wrists, and spine. This condition can lead to severe back pain if any of the vertebrae fracture or collapse.
In addition to these medical conditions, doctors have identified the following risk factors for acute or chronic back pain:
Sleeping on a mattress that does not provide proper spinal support can also lead to back pain. The table below lists five regions of the spine that one should consider when trying out a new mattress.
|Region||Cervical Spine||Thoracic Spine||Lumbar Spine||Sacrum||Coccyx (Tailbone)|
|Location||Neck||Upper to mid-back||Lower back||Base of spine||Bottom tip of spinal column|
|Number of Vertebrae||7 individual vertebrae||12 individual vertebrae||5 individual vertebrae||Triangular bone with 5 fused segments||Rounded bone with 3 to 5 fused vertebrae|
|Vertebrae Names||C1 to C7||T1 to T12||L1 to L5||S1 to S5||Coccygeal vertebrae|
|Function||Facilitates head movements, such as nodding, shaking, and neck rotation||Protects vital organs and stabilizes the spine for proper balance||Supports body weight and facilitates movement around the midsection||Facilitates pelvic movement, as well as leaning||Unknown for humans, though it connects to vital muscles, tendons, and ligaments|
A mattress should reduce back pain by providing an even, stable surface that helps the sleeper maintain proper spinal alignment, regardless of their sleep position. However, each sleep position affects spinal alignment in different ways, and the sleeper’s body weight is also an important factor to consider. In the next section, we’ll look at ways to choose a mattress based on these two individual factors.
In terms of sleep position, most adults qualify as side-, back-, or stomach-sleepers. The table below explores these three positions in greater detail.
|Variations||Log (arms and legs are straightened)
Fetal (arms and legs are bent)
Yearner (legs are straight, arms extend outward)
|Soldier (arms straightened, one leg straight while the other is bent at the knee)
Starfish (both arms extend over the head and both legs are slightly bent at the knees)
Savasana (arms and legs are straightened)
|Freefall (one or both arms rest beneath pillow, legs are fully extended and slightly apart)|
|Natural Spinal Alignment?||Yes, although an uneven sleep surface can cause the spine to curve and pressure to build up||Yes; the spine is straightened and aligned as long as the sleeper maintains a back position||No; due to the large concentration of weight in the stomach, this position usually causes people to sink too deeply into the mattress|
|Pros||Better air circulation through the breathing passages
Relieves pressure on the heart to help prevent heartburn
Minimal pressure option for people with hip pain and scoliosis
|Prevents acid reflux
No extra pillows are needed for comfort and support
Sleepers are less prone to facial wrinkles
|Reduces risk or snoring and sleep apnea
Fewer facial wrinkles than side-sleepers
|Cons||May restrict blood flow in the shoulders and arms
Extra pressure on stomach and lungs
Placing face directly onto the pillow can cause wrinkles to form
|Sleepers are at higher risk of sleep apnea because airflow is somewhat restricted
High snoring potential
|Discouraged by physicians and sleep experts due to high pressure and discomfort potential
Sleepers are prone to tossing and turning, which can disrupt sleep
|Ideal Sleep Surface||The mattress should be firm enough to support the body without allowing it to sink too deeply
Pillows may be placed in certain areas (such as below the knees or ribs) for optimal comfort and support
|The mattress should provide even support from the neck to the tailbone
Mattresses that are too firm can create gaps between the lumbar and the sleep surface
Mattresses that are too soft may sink too deeply and lead to poor alignment
|The mattress should be firm enough to prevent the stomach from sinking too deeply
Stomach-sleeping is considered the least healthy sleep position, so alternative positions are recommended.
Additionally, experiences with different sleep positions are tied to body weight. Generally speaking, people who weigh less than 130 pounds require softer mattresses in order to enjoy body-contouring and pressure relief, while those who weigh more than 230 pounds feel more comfortable on firmer mattresses that don’t cause them to sink too deeply. Mattress firmness is illustrated using a 1-10 scale, with 1 being the least firm and 10 being the firmest; the vast majority of mattresses sold today fall between a 3 (Soft) and an 8 (Firm), and the most common firmness is a 6 to 6.5 (or Medium Firm).
The next table lists the ideal firmness settings for different weight groups in each of the three most common sleep positions. Please note that sleep experience is highly subjective, and that individual sleepers may find their comfort preferences do not correspond to the information listed in this table.
|Weight Group||Below-average (less than 130 lbs.)||Average (130 to 230 lbs.)||Above-average (more than 230 lbs.)|
|Ideal Firmness for Side Sleeping||3 (Soft) to 4.5 (Medium Soft)||5 (Medium) to 6.5 (Medium Firm)||6.5 (Medium Firm) to 8 (Firm)|
|Ideal Firmness for Back Sleeping||4 (Medium Soft) to 5.5 (Medium)||5 (Medium) to 6.5 (Medium Firm)||6 (Medium Firm) to 8 (Firm)|
|Ideal Firmness for Stomach Sleeping||3 (Soft) to 4.5 (Medium Soft)||4 (Medium Soft) to 5.5 (Medium)||6 (Medium Firm) to 7.5 (Firm)|
Next, let’s look at the top-rated mattresses according to side-, back-, and stomach-sleepers in different weight groups.
Mattress type is another important consideration for people with back pain. The five most common mattress types provide varying experiences for sleepers, depending on their body weight and preferred sleep position. The table below lists the differences and similarities between innerspring, foam, latex, hybrid, and airbed mattresses.
|Construction||Foam comfort layers
Steel coil support cores
|Memory foam/polyfoam comfort layers
Polyfoam support core
|Latex comfort layer
Latex/polyfoam support core
|Latex/memory foam comfort layers
Pocketed coil support core
|Foam comfort layer (or no comfort layer)
Adjustable air chamber support core
|Average Price-point (Queen)||$700 to $1,100||$800 to $1,200||$1,800 and higher||$1,200 to $1,800||$2,000 and higher|
|Availability||Very common||Very common||Somewhat common||Somewhat common||Somewhat rare|
|Support||Fair to Good||Fair to Good||Good to Very Good||Good to Very Good||Good to Very Good|
|Conforming||Fair to Good||Good to Very Good||Good to Very Good||Good to Very Good||Good to Very Good|
|Firmness Options||Poor to Fair||Good to Very Good||Fair to Good||Fair to Good||Fair to Good|
|Durability||Poor to Fair||Fair to Good||Good to Very Good||Fair to Good||Poor to Fair|
|Light Sleeper Rating (Less than 130 lbs)||Fair to Good||Fair to Good||Good to Very Good||Poor to Fair||Fair to Good|
|Average Sleeper Rating (130 to 230 lbs)||Fair to Good||Good to Very Good||Good to Very Good||Fair to Good||Good to Very Good|
|Heavy Sleeper Rating (More than 230 lbs)||Poor to Fair||Good to Very Good||Good to Very Good||Good to Very Good||Poor to Fair|
|Rating for Sleepers with Back Pain (All Weights)||Poor to Fair||Good to Very Good||Good to Very Good||Fair to Good||Fair to Good|
When shopping for a new mattress and comparing different brands and models, here are a few factors for sleepers with back pain to keep in mind.
What is your mattress budget? Airbeds and latex mattresses are often effective for sleepers with back pain, but these models can easily cost $2,000 or more in a Queen size. Memory foam and hybrid models tend to be somewhat cheaper, and online-only brands typically have lower price-points compared to brands with a brick-and-mortar presence.
How much do you weigh? Body weight can be used to determine the ideal firmness for a new mattress. People who weigh less than 130 pounds — particularly those who sleep on their sides — tend to feel most comfortable on mattresses that are Medium (5) or softer. Less firm surfaces allow them to experience close conforming and better pressure relief. People who weigh more than 230 pounds, on the other hand, often prefer firmer mattresses (Medium Firm or firmer) because they don’t sink too far.
What is your preferred sleep position? People who sleep on their sides may require softer mattresses that conform to their figures and help align their spine, while stomach-sleepers often prefer firmer mattresses that don’t sink too deeply below their stomachs.
Do you share your bed with another person? Sleep partners may not agree on the ideal firmness setting. In these cases, a mattress that offers dual firmness — different firmness settings on each side of the bed — may be the best option.
Does the mattress come with a sleep trial? Most mattress manufacturers offer a sleep trial, allowing customers to test out their new mattress for a certain length of time (typically 90 nights or longer); if the customer is dissatisfied with the mattress before the trial period expires, then they may return it for a refund or, in some cases, exchange it for a new model. Some sleep trials include ‘mandatory break-in periods,’ which require the purchaser to test out their mattress for at least 30 nights before returning it. However, sleep trials can save customers a substantial amount of money in the long run if they decide they are unhappy with their new purchase.
What are the warranty terms? The vast majority of mattresses sold today come with product warranties that span at least 10 years in length, but these warranties tend to vary in terms of the following two factors:
In addition to choosing the right mattress, people who live with back pain can further optimize their sleep environment with the following accessories and components:
Select the right pillow: Pillow loft, or thickness, is crucial for sleepers with back pain. The proper amount of loft can alleviate pain and pressure in the neck, shoulders, lumbar region, and other sensitive areas, while the incorrect amount of loft can make these issues much worse. In order to determine the best loft for you, it’s important to consider your head size, body weight, and shoulder width, as well as the firmness of the mattress you use. The table below features a detailed breakdown of the three general loft categories.
|Loft Category||Thickness||Optimal Head Size||Optimal Weight||Optimal Shoulder Width||Optimal Mattress Firmness|
|Low||Less than 3″||Small||More than 230 lbs.||Narrow||Soft to Medium Soft|
|Medium||3″ to 5″||Average||130 to 230 lbs.||Average||Medium|
|High||More than 5″||Large||Less than 130 lbs.||Broad||Medium Firm to Firm|
Pillow composition is also important because some materials provide more support and comfort than others. Materials like buckwheat, memory foam, and latex conform closely to the sleeper’s head and alleviate a fair amount of pressure, but these pillow types tend to be fairly expensive. Cheaper models, such as polyester and down alternative, do not conform and support as much.
If you experience chronic back pain, then supplemental pillows can be used in addition to the one beneath your head. People who sleep on their back may find relief by placing a pillow beneath their knees, while side-sleepers often feel more comfortable with pillow between their knees and beneath their ribs.
For more information about pillows, please visit our Best Pillows — Buying Guide and Information page.
Use a topper: A topper is an individual layer of cushioning that rests on top of the mattress cover. Toppers are designed to adjust the firmness of the sleep surface; most toppers make the mattress feel less firm, although some topper models may increase the firmness. Toppers can be ideal for people who are dissatisfied with their mattress firmness but are unable to return their mattress, as well as couples with differing firmness preferences. Toppers may be made from a wide range of materials, including feathers, memory foam, convoluted polyfoam, latex, or wool; price-points vary by material composition and brand, but most cost less than $150.
Topper firmness, thickness, and density are all important considerations, and the ideal settings often depends on the sleeper’s weight and preferred position. The table below features more information.
|Sleep Position||Weight Group||Ideal Firmness||Ideal Topper Thickness||Ideal Topper Density|
|Side||Less than 130 lbs||Soft to Medium Soft||1″ to 2″||2.5 PCF and lower|
|130 to 230 lbs||Medium Soft to Medium||2″ to 2 1/2″||3 to 4 PCF|
|More than 230 lbs||Medium Firm to Firm||2″ to 3″||4 PCF and higher|
|Back||Less than 130 lbs||Medium Soft to Medium Firm||1 1/2″ to 2 1/2″||2.5 to 3 PCF|
|130 to 230 lbs||Medium to Firm||2″ to 3″||3.5 to 5 PCF|
|More than 230 lbs||Medium Firm to Firm||2″ to 3″||4.5 PCF and higher|
|Stomach||Less than 130 lbs||Medium Soft to Medium Firm||1″ to 1 1/2″||3 PCF and lower|
|130 to 230 lbs||Medium Firm to Firm||1″ to 2″||2.5 to 4 PCF|
|More than 230 lbs||Firm to Extra Firm||2″ to 3″||3.5 to 4.5 PCF|
To learn more about toppers, check out our Best Mattress Toppers guide.
Invest in an adjustable bed: Adjustable beds are designed for customization. Most models can be elevated or lowered at both the head and foot of the bed to create different sleeping positions; angled surfaces can ease back pain for many sleepers. Additionally, many newer adjustable bed models offer a ‘silent massage’ function, which generates small vibrations in the sleep surface that can alleviate aches and pains. Most adjustable beds sold today have remote controls, including those can be adjusted using smartphones or tablets.
Adjustable beds can be quite expensive. The baseline cost is roughly $1,000, but most models cost at least $2,000 — and some reach $3,500 or higher. However, many sleepers with back pain find that adjustable beds are a worthwhile investment that greatly improves their sleep quality. To learn more, visit our Adjustable Bed Reviews guide.
For more information about sleep products and sleeping strategies for people with pain issues, check out the following pages on Tuck.com: