Buying Guide – How to Choose the Best Mattress Topper 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 with back pain to see a physician if they experience the following:
- Bowel or bladder problems
- 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.