Best Mattress Toppers for Back Pain

The term ‘mattress topper‘ refers to an individual layer of cushioning that rests on top of the bed’s sleep surface. Toppers are normally used to provide additional softness for mattresses that are overly firm, as well as extra support for mattresses that sag. Additionally, people with back pain can use a topper to alleviate the aches, discomfort, and pressure points that occur night after night. Toppers may be made from a wide range of materials, but those made from memory foam or latex are considered the best for back pain and pressure relief. While price-points vary by brand and model, high-quality foam and latex toppers are widely available for $150 or less.

This guide will look at the causes and symptoms of chronic back pain, common designs and characteristics of toppers that provide back pain relief, tips for first-time buyers, and our picks for the best toppers for back pain relief that are sold today.

Causes and Symptoms of Back Pain for Sleepers

The Mayo Clinic notes that the following conditions are common sources of back pain in adults:

Muscle and ligament strain: Strenuous activities like heavy lifting and awkward or sudden movements can cause people to strain their back muscles or spinal ligaments. People who are in poor physical shape may also be vulnerable to strained muscles and ligaments.
Bulging or ruptured disks: Each vertebra in the spine is cushioned with fibrous pads known as disks. These disks are vulnerable to bulging or rupturing when they press against nerves in the lower back, and this may cause shooting pains along the spine.
Arthritis: Arthritis refers to joint inflammation anywhere in the body, and osteoarthritis applies to joints in the lower back. Arthritis in the spine may cause the spinal column to become narrower, which can lead to a painful condition known as spinal stenosis.
Osteoporosis: The condition known as osteoporosis causes pores to form in bones, which causes them to become brittle and deteriorate quickly. Osteoporosis that spreads to the spinal column can cause severe back pain.
Scoliosis: Scoliosis is a skeletal irregularity that causes the spine to be C- or S-shaped. Most people with scoliosis experience some level of back pain, especially those with more pronounced spinal curvatures.

Symptoms of back pain include:

Aching muscles
Shooting or stabbing pains, particularly in one or both legs
Reduced range of motion and flexibility

Most back pain does not require medical attention, but the Mayo Clinic urges patients to see a physician if they experience the following:

Bowel or bladder problems
Fever
Significant pain after a physical injury

Choosing the Right Topper for Back Pain Relief

Unlike mattress pads and protectors — which primarily protect mattresses from spills and stains, and offer minimal cushioning — toppers are designed to provide extra support and comfort for mattress surfaces. Most make mattresses feel softer, but firmer models for excessively soft mattresses are also available.

Mattress toppers come in a wide range of shapes, sizes, and compositions. However, people with back pain should take the following attributes into consideration:

Durability: Toppers, like mattresses, often sag as the materials begin to deteriorate. Sagging can cause the topper’s surface to become uneven, leading to discomfort for any sleeper — especially those with back pain.

Conforming Ability: Some topper materials conform closely than others, forming a cradle-shaped impression around the sleeper’s body. This can help align the spine and alleviate pressure points. Materials that do not conform closely may not provide pressure relief — and in some cases, may cause more pressure to build up.

Firmness: Most toppers are designed to make mattresses feel softer. However, excessive softness can be problematic for heavier people with back pain because they tend to sink too deeply. That can make the surface uneven, which compromises how supportive the sleep surface feels, and may lead to more aches and pains. By the same token, excessively firm toppers can cause stiffness and discomfort in lighter people. Individual preferences vary from sleeper to sleeper, but most people of average weight (130 to 230 pounds) find that ‘medium firm’ toppers offer the right balance of cushioning and support for their bodies.

Density: Density, which is measured in pounds per cubic foot (PCF), is normally used to assess the firmness of foam. High-density foams can be quite firm, whereas low-density foams tend to be excessively soft. Average-weight sleepers with back pain tend to feel most comfortable on foams with a density ranging from 3 to 5 PCF, which is considered medium density. Heavier sleepers may feel more comfortable on surfaces with a density of 4 to 6 PCF, while lighter sleepers tend to prefer a density of 2 to 3 PCF.

Indentation load deflection (ILD): ILD, like density, is used to evaluate the firmness of a sleep surface. However, this measurement is most commonly associated with latex toppers. ILD specifically refers to how much weight is needed to compress a mattress surface by 25%. Common ILD measurements for latex include 18 to 22 for softer latex, 24 to 30 for medium latex, and 34 to 45 for firmer latex.

Thickness: Toppers may measure anywhere from one inch to six inches thick, but thicker does not necessarily mean better. This is because thicker toppers tend to be very soft, which can cause excessive sinkage and uneven support for heavier people. Thinner toppers tend to be firmer. In most cases, people with back pain prefer toppers that measure two to three inches thick.

Sizing: Topper sizing depends on the size of the mattress beneath it. For sleepers who do not share their bed with anyone, the topper’s size should match that of the mattress. Those who sleep with a partner may choose to use a topper that only covers their side of the bed; this is particularly useful for couples with differing firmness preferences.

Composition: A wide range of materials are used to make mattress toppers. The table below compares the pros and cons of the six most common materials used in toppers. To read our analyses of each topper material, visit the links in the top row of the table.

Topper Material	Convoluted Polyfoam	Feather	Fiber	Latex	Memory Foam	Wool
Description	Contoured (‘egg-crate’) polyurethane foam	Outer plumage from ducks or geese	Rayon, polyester, down alternative, and other synthetic fibers	Natural substance extracted from rubber tree sap	Viscoelastic polyfoam engineered to soften when in contact with body heat	Wool sheared from sheep or lambs
Durability	Poor	Fair	Poor	Excellent	Good	Very Good
Conforming	Poor to Fair	Poor to Fair	Poor to Fair	Very Good to Excellent	Very Good to Excellent	Fair to Good
Pain/Pressure Relief	Poor to Fair	Fair to Good	Fair to Good	Very Good to Excellent	Very Good to Excellent	Fair to Good
Thickness Options	Very limited	Limited	Very limited	Wide	Wide	Limited
Availability	Moderate	Moderate	Moderate	Limited	Wide	Limited
Average Price Range	$30 or less	$100 to $150	$60 to $100	$100 to $400	$100 to $200	$150 to $300
Overall Rating for Sleepers with Back Pain	Poor to Fair	Fair to Good	Poor to Fair	Very Good to Excellent	Very Good to Excellent	Good to Very Good

As the table shows, latex and memory foam are usually the most suitable topper types for people with back pain.

Important Considerations for Mattress Topper Buyers

If you are shopping for a new mattress topper and comparing different brands and models, here are a few factors to keep in mind:

What is your topper budget? The average memory foam topper is priced between $100 and $250, while latex toppers may cost up to $400. However, less expensive options are widely available. Be sure to calculate your budget and browse available toppers in different online and brick-and-mortar locations.
Do you prefer memory foam or latex? Memory foam conforms more closely than latex and sleepers tend to experience more pain and pressure relief. However, foams may sleep hotter and emit unpleasant off-gassing odors. Memory foam toppers have shorter lifespans, as well. Latex toppers are highly durable, fairly cool, and less prone to off-gassing smells — but these models tend to be more expensive, and sleepers do not experience the same level of conforming.
What is the density and/or ILD of the topper? This is an important question because, in many cases, the topper specifications will include density or ILD — not both. Density is normally used for foams while ILD is normally applied to latex, but some models may provide both measurements. Understand that density and ILD can both be used to evaluate topper firmness.
How much do you weigh? People who weigh less than 130 pounds typically prefer softer toppers with lower densities and/or ILD measurements. These toppers allow them to sink deeply and conform closely to their sleep surface. On the other hand, those who weigh more than 230 pounds may be more comfortable on a firmer, high-density topper. These toppers will not sink too deeply and provide even support. Most sleepers who are considered average weight (130 to 230 pounds) will be best suited for a medium firm topper with average density and/or ILD measurements.
What topper thickness do you prefer? People with back pain generally feel more comfortable on toppers measuring two to three inches thick. However, toppers may range from one to six inches thick, depending on the brand, model, and material composition. Many topper models are available with multiple thickness options.
What size is your mattress? If you sleep alone, your topper should cover the entire width and length of the mattress surface; topper sizes generally correspond to mattress sizes. If you share your bed with someone, then a Twin-size topper that covers your side of the mattress may be more suitable.
Do you sleep hot? Memory foam tends to absorb more body heat than latex, and sleepers often complain of excessive warmth. Gel-infused foams can feel cooler than standard foams. Additionally, a cooling mattress topper made of materials like gel memory foam will not sleep as warm for most people.
How long does the warranty last? Mattress topper warranties generally cover defects in the product for two to five years. However, some toppers do not come with any sort of warranty.