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Best Mattresses for Back Pain – 2021 Reviews and Buyer’s Guide

Medically Reviewed by Dr. Jenny Iyo

Written by Keith Cushner

Quick Overview

Chronic back pain affects millions of adults in the U.S. and many experience frequent sleep disruptions due to the constant discomfort. If you’re one of these individuals, we have good news. With the right mattress, you can reduce your aches and pains during the night, helping you to feel more well-rested and alert during the day. What’s the “right” mattress for your back pain? It depends on several factors, including the material construction, thickness, and firmness of the mattress, as well as your weight and preferred sleep position.

Below you will find our list of the best mattresses for back pain. We’ve selected these mattresses based on thousands of hours of testing, as well as intensive product research and verified customer experience data. After our reviews, we invite you to keep reading our buyer’s guide to learn more about how people with back pain can improve their sleep experience with the right mattress. We share all the insider knowledge you need to know when buying a mattress to alleviate back pain.

Best Mattresses for Back Pain
First Time Buying a Mattress?

Hop down to our Buyer’s Guide for a crash course on finding the best mattress for back pain.

 

Best Mattresses for Back Pain - Reviewed

Best OverallSaatva Classic

Best Overall – Saatva Classic

Highlights

  • Multiple firmness options (4,6,7.5)
  • 180-night sleep trial
  • 15-year warranty
  • Sturdy and responsive coil-on-coil design
  • Consistent breathability and cooling
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Best OverallSaatva Classic

saatva.com

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The Saatva Classic checks several boxes for sleepers with back pain. The mattress is quite supportive thanks to its innovative innerspring construction, which features a Euro-top padded with polyfoam and memory foam over a transitional layer of pocketed minicoils and an hourglass coil support core. This coil-on-coil design makes the mattress very sturdy and responsive without feeling overly stiff.

The Saatva Classic’s versatile design is another strong point. Customers can choose between three firmness levels: medium soft (4), medium firm (6), or firm (7.5). The mattress is also available in two profiles – 11.5 or 14.5 inches – to sleepers based on their preferred thickness.

Since the Saatva Classic is so springy, most people won’t have too much trouble moving across the surface. The mattress is also well suited to couples who prefer responsive beds for sex. Both coil layers promote steady airflow to help the mattress stay cool, which also makes it a good option for hot sleepers and those who reside in warm climates.

The sticker price for this mattress is quite reasonable given its luxurious construction. Additionally, Saatva provides free White Glove delivery – including full in-home assembly and old mattress removal – for all orders in the contiguous U.S. Customers also receive a 180-night sleep trial and a 15-year warranty with their purchase.

The Bottom Line.

The Saatva Classic stands out thanks to its innovative construction, which fuses traditional innerspring qualities with modern construction. A wide range of design options makes the mattress suitable for most people across different body type and sleep position groups.

  • Sleepers who prefer bouncy beds. The Saatva Classic’s coil-on-coil construction produces a very responsive feel along the surface reminiscent of traditional innerspring models.
  • Hot sleepers. Both coil layers circulate air to help the mattress core maintain a comfortable temperature, making the Saatva Classic a solid choice for hot sleepers.
  • Shoppers looking for a mattress with strong edge support. The coil layers reinforce the perimeter to minimize sinkage and make getting in and out of bed easier.
  • Those who would rather not set up a new mattress themselves. Saatva provides free White Glove delivery for all orders, which includes full assembly in a room of the customer’s choice and removal of their old mattress at no extra cost.

Not Recommended for:

  • Sleepers who prefer deep body-contouring. Even with a medium soft feel, the Saatva Classic does not conform very closely. Those who enjoy the “body hug” of memory foam may find the mattress too stiff.
  • Couples. Motion isolation is minimal for the Saatva Classic due to its responsive coil-on-coil design. Sleepers may also notice squeaks and creaks from the hourglass coils when their partner moves in bed.

Most ComfortableNest Bedding Alexander Signature Hybrid

Most Comfortable – Nest Bedding Alexander Signature Hybrid

Highlights

  • Multiple firmness options (3,5.5,7.5)
  • 100-night sleep trial
  • Lifetime warranty
  • Luxurious pillow-top design
  • Replaceable comfort system allows owners to customize the feel
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Most ComfortableNest Bedding Alexander Signature Hybrid

nestbedding.com

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The Alexander Signature Hybrid from Nest Bedding is another mattress available in multiple firmness levels. The soft (3) feel offers very close contouring and is best suited to lighter people and side sleepers, the medium (5.5) feel provides a good balance of cushioning and support for back sleepers, and the firm (7.5) feel is best suited to heavier individuals who need more reinforcement.

The hybrid is designed with memory foam and polyfoam comfort layers contained within a luxe pillow-top layer. Regardless of which firmness a customer chooses, the pillow-top delivers extra padding to prevent the mattress from feeling excessively stiff. The support core consists of pocketed coils arranged in a zoned configuration to provide extra push-back along the perimeter and prevent people from sinking too much when they sleep near or sit along the edges.

Like other hybrids, the Alexander Signature is a good option for hot sleepers thanks to consistent airflow throughout the coil chamber, as well as a cover made from cooling phase-change material. The pillow-top layers can also be removed and replaced if customers are not satisfied with their initial firmness selection.

The Alexander Signature Hybrid is competitively priced, but Nest Bedding will deliver it for free anywhere in the contiguous U.S. Customers may test out the mattress for up to 100 nights and exchange the comfort layers as needed. A lifetime warranty is also included with purchase.

The Bottom Line.

Thanks to its pillow-top design, the Alexander Signature Hybrid is ideal for sleepers looking for a balance of plush body-cushioning and strong overall support. Nest Bedding also offers three firmness options and allows buyers to exchange the model during their sleep trial for added customization.

  • Sleepers who prefer a combination of contouring and support. A pillow-top padded with conforming foam layers and a pocketed coil system give the Alexander Signature Hybrid a very balanced feel.
  • Hot sleepers. The coils promote steady airflow throughout the mattress interior to regulate its core temperature and keep sleepers comfortable. The cover is quilted with phase-change material for added cooling.
  • Couples who normally find coil mattresses too disruptive. Motion isolation is above-average for the Alexander Signature Hybrid, and the coils produce a relatively low amount of noise.
  • People who are unsure of their optimal firmness level. Nest Bedding offers three firmness options for this mattress. Customers can exchange for different comfort materials if they find their initial firmness too soft or too firm.

Not Recommended for:

  • People who feel most comfortable on highly responsive mattresses. While the coils provide some noticeable springiness, the Alexander Signature Hybrid lacks the bounciness of traditional innersprings and more responsive hybrids.
  • Couples who like bouncy beds for sex. The foam layers may sink a bit during amorous activities, which can hinder movements for couples.

Best OrganicEco Terra

Best Organic – Eco Terra

Highlights

  • Multiple firmness options (5,6.5)
  • 90-night sleep trial
  • 15-year warranty
  • Excellent cooling for hot sleepers
  • Durable latex hybrid construction
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Best OrganicEco Terra

ecoterrabeds.com

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The Eco Terra is a latex hybrid with an exceptionally resilient design. The comfort layer is composed of durable Talalay latex that contours to the body and alleviates pressure, but won’t develop permanent indentations as quickly as foam. A support core of thick pocketed coils provides great overall stability, especially along the edges. As a result, the Eco Terra’s expected lifespan far exceeds that of the average mattress model.

The mattress is also well suited to hot sleepers. The latex is ventilated and cut with cooling channels, which prevents the material from absorbing too much warmth, and the coils circulate air throughout the mattress core. The cover is made of organic cotton for added breathability.

Customers choose from two firmness levels. The medium (5) models deliver closer contouring and cushioning along the spine, making this option suitable for side sleepers, while the medium firm (6.5) feel provides more reinforcement for back and stomach sleepers.

The Eco Terra is very reasonably priced compared to the average latex hybrid. The company also offers free shipping and returns for all U.S. orders. Customers receive a 90-night sleep trial for testing out the mattress and a 15-year warranty that covers structural defects.

The Bottom Line.

The budget-friendly Eco Terra is a durable, responsive mattress that provides strong support and noticeable responsiveness. The layers also offer consistent breathability and temperature control.

  • Those who prefer very responsive mattresses. As is often the case with latex hybrids, the Eco Terra feels quite springy on the surface. Most people will have little difficulty moving across the mattress.
  • Hot sleepers. The Eco Terra excels at temperature neutrality thanks to its ventilated Talalay latex, air-circulating coil system, and breathable organic cotton cover.
  • People who struggle getting in and out of bed. Ultra-sturdy edge support ensures most people will be able to get on and off the Eco Terra with relative ease.
  • Value seekers. Compared to other latex hybrids, the Eco Terra is exceptionally low-priced.

Not Recommended for:

  • Sleepers who want or need a mattress that contours closely. The latex comfort layer will conform gently, but this material won’t hug and cradle the body to the same extent as memory foam.
  • Couples. The above-average responsiveness of this mattress means co-sleepers will feel more transfer across the surface when their partner moves in bed and may experience more disruptions as a result.

Best ValueDreamCloud Premier

Best Value – DreamCloud Premier

Highlights

  • Medium Firm (6.5)
  • 365-night sleep trial
  • Lifetime warranty
  • Thick, pressure-relieving comfort system
  • Good motion isolation
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Best ValueDreamCloud Premier

dreamcloudsleep.com

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People who weigh more than 230 pounds typically prefer firmer mattresses that balance close body conforming and robust support. The DreamCloud Premier is a prime example. It is a pillow-top hybrid with a medium firm (6.5) feel constructed with layers of memory foam and polyfoam in the comfort system. Sleepers experience improved spinal alignment and targeted pressure relief without sagging excessively, making the DreamCloud Premier a good option for heavier individuals.

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 Premier 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 Premier is backed by a 365-night sleep trial and a lifetime warranty.

The Bottom Line.

The smart construction of the DreamCloud Premier prevents sagging, a prime concern for heavier individuals with back pain. This durable hybrid bed provides sufficient contour as well, enabling soothing pain relief.

  • Back and side sleepers. Foam comfort layers contour to the sleeper’s body, while the pocketed coil core prevents the from sinking too deeply into the mattress.
  • Sleepers in the average and heavy weight groups. The DreamCloud Premier is composed of sturdy foams and materials that can support sleepers of heavier weights.
  • Those who prefer thicker, closely conforming comfort layers. A pillow-top cushioned with foam gives the DreamCloud Premier a luxuriously plush surface feel.
  • Value seekers. The DreamCloud Premier is much more affordable than the average hybrid mattress, and comes with a 365-night sleep trial and lifetime warranty to boot.

Not Recommended for:

  • Lightweight sleepers. The DreamCloud Premier may feel too firm for these sleepers.
  • Stomach sleepers. Stomach sleepers may find their midriff area sinks lower and out of alignment with the rest of their body.

Best CoolingEcoCloud

Best Cooling – EcoCloud

Highlights

  • Medium Firm (6)
  • 120-night sleep trial
  • Lifetime warranty
  • Durable latex hybrid construction
  • Sleeps exceptionally cool
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Best CoolingEcoCloud

winkbeds.com

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Not all sleepers with back pain want a softer feel and deep conforming. Some prefer more responsiveness and a gentle body contour that cushions the body without the “hug” of adaptive foam. These sleepers are prime candidates for a latex hybrid, and the EcoCloud by WinkBeds is an excellent choice for this mattress category.

The EcoCloud is constructed with two layers of Talalay latex over thick pocketed coils. The mattress has a medium firm feel, so it should provide adequate support for most people while minimizing pain and pressure points along the spine. Back sleepers in particular should find the mattress comfortable, but it also provides enough conforming and support for side and stomach sleepers who weigh up to 230 pounds.

Latex is an exceptionally durable mattress material that resists indentations and wear and tear better than foam, so owners can expect a long lifespan from their EcoCloud. Another advantage of latex is above-average temperature control, especially compared to memory foam. The EcoCloud features open-cell latex that is very breathable, allowing the mattress and its sleepers to remain cool throughout the night. The coils also promote airflow for added temperature regulation, and the cover is made of organic cotton and moisture-wicking wool.

The EcoCloud is competitively priced, but still costs less than many competing latex hybrids – a notoriously expensive mattress type. WinkBeds also ships the bed for free to all customers in the contiguous U.S. The mattress comes with a 120-night sleep trial and a full-replacement lifetime warranty.

The Bottom Line.

The EcoCloud is a latex hybrid that delivers gentle contouring and back pain relief much like memory foam, but without hugging the body too closely or sleeping excessively hot. The natural durability of latex also ensures long-lasting comfort and support.

  • Back sleepers. While the EcoCloud has received favorable ratings across different sleep position groups, the mattress is especially well suited to back sleepers thanks to its supportive design.
  • Hot sleepers. Latex hybrids tend to sleep quite cool and the EcoCloud is no exception. This can be attributed to its breathable cover and comfort layer, as well as a coil system that promotes steady air circulation.
  • Those who enjoy the feel of a springy mattress. The latex and coils combine to create a very responsive surface for the EcoCloud.
  • People who struggle getting on and off of their mattress. A stabilizing coil system provides excellent edge support and reduces sinkage when people sit along the perimeter of the mattress.

Not Recommended for:

  • Sleepers who prefer the body-hug of foam beds. People who enjoy the feel of memory foam or adaptive polyfoam may not receive enough contouring from the EcoCloud.
  • People who awaken easily from their sleep partner’s movements. The EcoCloud is quite responsive, resulting in a fair amount of motion transfer when someone moves in bed.

Best for Lightweight SleepersNectar Mattress

Best for Lightweight Sleepers – Nectar Mattress

Highlights

  • Pressure relief from two memory foam layers
  • Medium-firm (6)
  • Excellent motion isolation
  • 365-night sleep trial
  • Lifetime warranty
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Best for Lightweight SleepersNectar Mattress

nectarsleep.com

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The Nectar Mattress delivers a soothing night’s sleep at a great price, making it a budget-friendly option for people with back pain.

In the Nectar, multiple foam layers work together to provide top-notch pressure relief. The top two layers are made with quilted memory foam and gel-infused memory foam that contour to the body and give the necessary support to pressure points. The Hi Core foam transition layer adds resilience and, along with the polyfoam support core, provides a bulwark against too much sink.

The Nectar has a medium firm feel – around a 6 on the firmness scale – that gives it broad appeal, including to sleepers in virtually any position. It provides above average motion isolation and despite having a memory foam comfort system, it resists excessive heat retention.

With an accessible price for such a robust mattress, the Nectar doesn’t need any added bonus to make it a top choice. Nevertheless, Nectar sweetens the deal with a sleep trial that lasts an entire year, far outpacing the sleep trials that come with most mattresses. The company provides a lifetime warranty to protect your investment over the long-term.

Standard shipping of the compressed Nectar mattress to your doorstep is free, and you can opt for White Glove delivery for an added charge.

The Bottom Line.

Those who want a supportive mattress and a great deal won’t find a better option than the Nectar mattress. This quality mattress delivers back pain relief for a lower-than-average price point, free standard shipping, and 365-night sleep trial.

  • Sleepers in any position, especially side and back sleepers. The foam layers contour to the sleeper’s body, ensuring spinal alignment.
  • Sleepers with sharp pressure points. Two comfort layers of memory foam allow sleepers to sink into the mattress while keeping their spine aligned, offering relief for pressure points and back pain.
  • Value seekers. The Nectar mattress boasts excellent support and quality construction, with perks like free shipping and an extensive sleep trial, all for an affordable price.

Not Recommended for:

  • Lightweight sleepers who weigh less than 130 pounds. The Nectar feels more Medium Firm vs. Medium, which may feel too firm for these sleepers.
  • Heavier sleepers who sleep on their stomach. As a foam mattress, these sleepers may sink too deeply into the mattress and pull their lower spine out of alignment.

Best for Average Weight SleepersLeesa Hybrid

Best for Average Weight Sleepers – Leesa Hybrid

Highlights

  • Medium Firm (6.5)
  • 100-night sleep trial
  • 10-year warranty
  • Breathable design provides good temperature control
  • Strong coils stabilize the edges without generating too much transfer
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Best for Average Weight SleepersLeesa Hybrid

leesa.com

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People who weigh between 130 and 230 pounds typically require a balanced feel from their mattress. The comfort layers should contour closely enough to reduce pain and pressure points, but the mattress should also provide an adequate amount of support to prevent deep, uncomfortable sinkage. The Leesa Hybrid, which is medium firm (6.5), is one model that fits this description perfectly. Three foam layers cushion the body and provide noticeable conforming, while a sturdy support core of pocketed coils stabilizes the mattress and keeps sleepers on an even plane.

In our testing, we found the Leesa Hybrid was a popular model across different position groups. Average weight side sleepers receive enough padding for their shoulders and hips to ensure even alignment and less discomfort along the spine, while back and stomach sleepers can rest comfortably without their midsections and hips dipping beneath the surface too much.

Temperature neutrality is another major strength of the Leesa Hybrid. The top foam layer is aerated to allow extra airflow near the surface and keep sleepers cool, while the coils generate circulate air throughout the mattress core. Thanks to its thick coil system, the Leesa Hybrid also excels at edge support and should feel perfectly secure when owners sleep near or sit along the perimeter.

For a hybrid model, the Leesa Hybrid’s price-point is very reasonable. Shipping is also free for customers in all 50 states and most of Canada. A 100-night sleep trial and 10-year warranty is included with each purchase.

The Bottom Line.

The Leesa Hybrid’s medium firm feel and adaptive foam layers make it popular with sleepers in the average weight group. The mattress is also a great option for hot sleepers and people seeking a bed with strong edge support.

  • Back sleepers. The Leesa Hybrid fared well with our testers across all position groups, but those who prefer back sleeping awarded it the highest ratings.
  • People who prefer the feel of a responsive mattress. While not as bouncy as some competing coil mattresses, the Leesa Hybrid provides a springy surface and shouldn’t hug the body too closely.
  • Hot sleepers. A ventilated upper foam layer and steady airflow through the coil system allow the Leesa Hybrid to sleep very cool.
  • Those who have a hard time getting in and out of bed. Sturdy edge support allows most people to get on and off of the Leesa Hybrid with relative ease.

Not Recommended for...

  • Lightweight side sleepers. While the mattress has proven popular with most people regardless of body type or preferred position, side sleepers weighing less than 130 pounds will probably find the mattress too firm.
  • Couples. The coils create some surface-level responsiveness that can produce more motion transfer, potentially leading to sleep disturbances for co-sleepers.

Best OverallHelix Midnight

Best Overall – Helix Midnight

Highlights

  • Medium (5.5)
  • 100-night sleep trial
  • 10-year warranty
  • Comfortable balance of contouring and support
  • Consistent breathability and temperature control
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Best OverallHelix Midnight

helixsleep.com

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Helix Sleep offers an extensive line of hybrid mattresses that vary in terms of firmness and contouring level. We’ve selected the Helix Midnight for its balanced medium feel. A comfort layer of contouring memory foam cushions the body and alleviates pressure in the lower back and other areas along the spine, while thick pocketed coils reinforce and stabilize the bed to prevent excessive sinkage and added aches and pains.

The Midnight is particularly well suited to side sleepers, a group that often experiences back pain due to uneven alignment. Back and stomach sleepers who weigh up to 230 pounds should also find the mattress sufficiently supportive. The Midnight is a good choice for hot sleepers too. The coils promote steady airflow to help keep the mattress core cool, while the memory foam is infused with gel intended to draw heat away from the body.

For sleepers with back pain who require a little more padding, the Helix Midnight LUXE is an upgrade model constructed with a foam-cushioned pillow-top layer and an additional foam comfort layer.

The Helix Midnight’s price-point is very approachable, especially compared to other hybrid models, and Helix Sleep offers free ground shipping for all U.S. orders. The mattress comes with a 100-night sleep trial and a 10-year warranty.

The Bottom Line.

For many sleepers who live with back pain, the medium-feel Helix Midnight will be the best of both worlds: a mattress that conforms to the body and alleviates pressure along the spine while also supporting the body with a strong coil system. The Midnight also sleeps quite cool, and its sticker price is very reasonable.

Good for:

  • Side and back sleepers in all weight groups (light, average, heavy)
  • Those who like the close conforming of memory foam
  • Couples
  • Back pain sufferers
  • Side sleepers. The memory foam cushions the spine and improves alignment to reduce pain and pressure points for side sleepers.
  • People who weigh 230 pounds or less. Due to its medium feel, the Midnight should provide enough support for most people in the lightweight and average weight groups.
  • Hot sleepers. The coils circulate air throughout the mattress core to maintain a comfortable temperature, and the foam is infused with gel to dissipate body heat.
  • Value seekers. Compared to other hybrids, the Helix Midnight is relatively inexpensive, and shipping is free for all orders.

Not Recommended for...

  • People who weigh more than 230 pounds. Heavyweight sleepers are likely to find the mattress too soft and sink excessively.
  • Sleepers who prefer ultra-responsive coil mattresses. The Midnight contours closely and lacks the signature bounciness of traditional innersprings.

Mattress Buying Guide for Back Pain Sufferers

Below, we share everything sleepers with back pain need to consider when buying a new mattress, along with our best tips for buying a mattress.

What You Need to Know about Sleeping with Back Pain

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.

How Does Back Pain Affect Sleep?

A healthy spine serves three primary functions:

  • Protecting the spinal cord, which is considered the body’s communication systems, as well as nerve roots and internal organs.
  • Providing structural support needed for upright posture.
  • Facilitating tactile movement.

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:

  • Acute back pain, which lasts less than three months (12 weeks) and typically occurs in conjunction with an injury or accident, such as a fall or over-lifting. The acute pain often subsides as the underlying cause of the pain is treated.
  • Chronic back pain, which lasts at least three months; this may occur due to an injury or accident, or due to a physiological issue like scoliosis. In either case, chronic back pain often continues after the underlying cause of the pain has been treated.

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 the 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:

  • Osteoarthritis, or degenerative arthritis, which causes bone cartilage to deteriorate prematurely.
  • Rheumatoid arthritis, which affects the synovium material that lines the joints.
  • Psoriatic arthritis, which refers to joint inflammation caused by the painful skin condition known as psoriasis.
  • Gout, which refers to joint inflammation in the knees, ankles, and/or feet.

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:

  • Lordosis, a curvature of the lower spine that is abnormally pronounced.
  • Scoliosis, a sideways curvature of the spine that usually forms a C or S shape.
  • Kyphosis, an abnormal curvature of the upper spine.

spinal curvature disordersMost 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:

  • Age: Back pain affects people of all ages, but the condition is much more common in people who are 30 years or older.
  • Lack of exercise: People with weak, unconditioned muscles are considered at risk for back pain symptoms.
  • Obesity: Carrying extra weight — especially around the midsection — can put undue strain on the back muscles.
  • Diseases: Certain medical ailments, such as cancer, have been linked to back pain symptoms.
  • Excessive or incorrect lifting: Back pain is often tied to lifting-related injuries, which can occur if the individual lifts too much weight and/or lifts with their back instead of their legs.
  • Mental health issues: People with depression and anxiety are more susceptible to back pain and other physical manifestations of their condition.
  • Smoking: Habitually smoking cigarettes deprives the body of nutrients that are needed to nourish the disks and other areas of the back.

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

Depending on which area of the spine is in pain, certain sleep positions are more supportive than others. Paired with the right mattress, these sleep positions can provide additional relief. We review these below.

Best Sleeping Positions for Upper Back Pain

Sleep Position How It Works Additional Tips
Sleep on your side with a foam pillow. The foam allows your head to sink deeper while filling the space between the neck and the mattress, ensuring a straight spine. Match the loft of the foam to the span between your neck and your shoulder.
Sleep on your side with a thin pillow between your knees. The knee pillow relieves pressure between the hips. This pillow should be thin enough to not create additional strain in the pelvic area.
Sleep on your back with a cervical pillow for your head and neck. The dip in the cervical pillow supports a straight spine through your neck, cradling the head and relieving pain in the upper back. A neck roll is another alternative.

Best Sleeping Positions for Lower Back Pain 

Sleep Position How It Works Additional Tips
Sleep on your side with a pillow between your knees. The knee pillow helps ensure spinal alignment through the hips and pelvis. Switch sides every few nights to prevent shoulder pain or muscle soreness.
Sleep on your side in the fetal position, with your torso curled slightly toward your knees. Curling your torso increases space between the vertebrae, relieving pain caused by a herniated disc. Switch sides every few nights to prevent shoulder pain or muscle soreness.
Sleep on your back with a pillow beneath the knees. The knee pillow supports the natural curvature of the spine. Overall this position helps relieve strain or arching in the lower back. Add a thinner pillow or small rolled towel beneath the lower back if needed.
Sleep on your stomach with a pillow beneath your pelvis. Add a low-loft pillow for your head if needed. Reduces stress in between the discs, relieving pain from degenerative disc disease. Only recommended if you can’t get comfortable sleeping on your side or back. Stomach sleeping is not recommended for back pain.

Choosing the Best Mattress for Back Pain

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 terms of sleep position, most adults qualify as side-, back-, or stomach-sleepers. We review each of these three positions in greater detail below.

Side Sleeping with Back Pain

Generally, side sleeping supports good spinal alignment, although an uneven sleep surface can cause the spine to curve and pressure to build up. The best mattress for side sleepers with back pain should be firm enough to support the body without allowing it to sink too deeply. Additionally, pillows can be placed in certain areas (such as below the knees or ribs) to achieve optimal comfort and support.

Pros of side sleeping for back pain sufferers:

  • 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

Cons of side sleeping for back pain sufferers:

  • 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

Back Sleeping with Back Pain

Sleeping on your back is perhaps the easiest way to ensure proper spinal alignment while you sleep. The spine stays straight and aligned as long as you maintain a back-sleeping position. The best mattress for back sleepers with back pain 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, while mattresses that are too soft may allow the sleeper to sink too deeply and lead to poor alignment.

Pros of back sleeping for back pain sufferers:

  • Prevents acid reflux
  • No extra pillows are needed for comfort and support
  • Sleepers are less prone to facial wrinkles

Cons of back sleeping for back pain sufferers:

  • Sleepers are at higher risk of sleep apnea because airflow is somewhat restricted
  • High snoring potential

Stomach Sleeping with Back Pain

Sleeping on your stomach is not recommended for back pain sufferers. Due to the large concentration of weight in the stomach, this position usually causes people to sink too deeply into the mattress, pulling their spine out of alignment and increasing back pain. The best mattress for stomach sleepers with back pain is one firm enough to prevent the stomach from sinking too deeply. Again, stomach-sleeping is considered the least healthy sleep position, so alternative positions are recommended.

Pros of stomach sleeping for back pain sufferers:

  • Reduces risk or snoring and sleep apnea
  • Fewer facial wrinkles than side-sleepers

Cons of stomach sleeping for back pain sufferers:

  • Discouraged by physicians and sleep experts due to high pressure and discomfort potential
  • Sleepers are prone to tossing and turning, which can disrupt sleep

Selecting Your Firmness Level

Sleepers with back pain should take special care when choosing their mattress firmness. The firmness level affects how well your mattress can relieve your back pain and support spinal alignment for your particular sleep position.

The best mattress firmness for you usually depends on your 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 levels 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.

Selecting Your Mattress Type

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. Below we review each mattress type, along with the pros and cons of each for sleepers with back pain. Mattress types are listed in order of their suitability for individuals with back pain.

Foam Mattresses

Best Foam Mattresses for Sleepers with Back Pain:

Mattress Reviews
Nectar Mattress Review
Mattress Reviews
Bear Mattress Review

Foam mattresses feature comfort layers of memory foam and/or polyfoam, above a support core of high-density polyfoam. Foam mattresses are popular for their superior contouring and pressure point relief. For sleepers with back pain, these mattresses can contour to their body to support spinal alignment and relief while they sleep.

Average price: $800 to $1,200

Expected lifespan: 5 to 6 years

Benefits for sleepers with back pain:

  • Excellent conforming and pain relief
  • Motion isolation reduces disruptions during sleep
  • Widely available

Drawbacks for sleepers with back pain:

  • Mattresses made from lower-quality foams may cause sagging for heavier sleepers
  • Minimal edge support
  • Can trap heat

Latex Mattresses

Latex mattresses are made from synthetic or natural latex, with a high-density support core of polyfoam or latex, and latex comfort layers. These contour to the body, but to a lesser extent than foam mattresses. However, the responsiveness of the latex can almost feel too “bouncy” for some back pain sufferers. Because latex mattresses are so durable, especially those made from organic materials, they can be particularly supportive for heavier sleepers or anyone worried about sagging.

Average price: $1,800 and higher

Expected lifespan: 7 to 8 years

Benefits for sleepers with back pain:

  • Very durable and supportive
  • Above-average contouring and pain relief for back pain
  • Motion isolation reduces disruptions during sleep
  • All-organic latex sleeps very cool, even for hot sleepers

Drawbacks for sleepers with back pain:

  • Less available
  • Expensive

Hybrid Mattresses

Best Hybrid Mattresses for Sleepers with Back Pain:

Mattress Reviews
Brooklyn Bedding Aurora Mattress Review
Mattress Reviews
Allswell Luxe Hybrid Review
Mattress Reviews
DreamCloud Mattress Review

Hybrid mattresses have a support core of pocket coils surrounded by base polyfoam, topped with several inches of latex and/or memory foam comfort layers. These comfort layers give back pain sufferers the pressure point relief they need, while the individual pocket coils enhance the mattress’s overall contour and provide additional, dense support.

Average price: $1,200 to $1,800

Expected lifespan: 6 to 7 years

Benefits for sleepers with back pain:

  • Perfect combination of contour plus support for back pain sufferers
  • Varying firmness options can be suitable for different body weights
  • Typically sleep cool

Drawbacks for sleepers with back pain:

  • Less durable than other mattress types
  • Heavy and difficult to move
  • More expensive

Airbed Mattresses

Airbed use air in the support core, with comfort layers of foam. The support core can be filled or deflated according to the sleeper’s desired firmness level, allowing back pain sufferers to zero in on the precise amount of supportiveness they need. However, airbeds require more maintenance than any other mattress, which can be a dealbreaker for some sleepers.

Average price: $2,000 and higher

Expected lifespan: 7 to 9 years

Benefits for sleepers with back pain:

  • Adjustable firmness settings
  • Good pressure point relief for back pain sufferers
  • Can be less supportive for sleepers of light or heavy weight

Drawbacks for sleepers with back pain:

  • Less available
  • Parts need replacing over time
  • More expensive

Innerspring Mattresses

Top Innerspring Mattress for Side Sleepers:

Mattress Reviews
Saatva Mattress Review

Innerspring mattresses describe the traditional bed most people are familiar with. They feature a support core of innerspring coils, topped with comfort layers of foam. These mattresses are not known for their contour ability, so they’re often not preferred by sleepers with back pain. However, with sufficient comfort foam layers, they can provide adequate pressure relief while still providing a base of solid, evenly distributed support — as demonstrated by our Editor’s Pick, the Saatva.

Average price: $700 to $1,100

Expected lifespan: 4 to 6 years

Benefits for sleepers with back pain:

  • Strong edge support
  • Excellent airflow keeps mattress temperature cool for hot sleepers
  • Widely available

Drawbacks for sleepers with back pain:

  • Lack of conforming and pressure point relief for back pain
  • Can be prone to sagging, which may worsen back pain
  • Coil support core can create noise

Mattress Shopping FAQ for People with Back Pain

  • What firmness should you look for in a mattress if you have back pain?

    The ideal firmness for those with back pain will depend on both weight and sleeping position. Individuals under 130 pounds generally prefer softer sleep surfaces ranging from soft to medium firmness, depending on sleep position. Meanwhile sleepers between 130 and 230 pounds should generally look for a medium-soft to medium-firm mattress, and those above 230 pounds fare better with beds in the medium-firm to firm range.

  • What types of mattresses are best for those with back pain?

    People with back pain tend to benefit most from all-foam or latex mattresses, due to their ability to relieve pressure and contour closely to the body.

  • What sleeping position is best for lower back pain?

    The best sleeping position for those who experience lower back pain is on the side or back. Side sleepers should consider placing a pillow between the knees to maintain proper alignment through the pelvis and hips, and should switch sides each night to prevent shoulder pain. Some find the most relief in the fetal position, as this increases the space between the vertebrae. Back sleepers should consider placing a pillow beneath the knees to support the natural curvature of the spine.

  • What sleeping position is best for upper back pain?

    Sleepers experiencing upper back pain can find comfort and proper alignment by sleeping on their side with a foam pillow to support the head and a thin pillow between the knees to relieve pressure on the hips. Another good option is sleeping on the back with a cervical pillow to support the head and neck.

  • What type of mattress should you avoid if you have back pain?

    Those with back pain tend to prefer more contouring and pressure relief than most innerspring mattresses can offer. That said, there are exceptions in this category that contain thick enough comfort layers to provide adequate pressure relief.

Mattress Shopping Considerations for Sleepers with Back Pain

As you compare different brands and models, here are a few questions to ask yourself and factors to keep in mind when shopping for a new mattress if you have back pain.

  • 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. Back sleepers can find comfort with something in the middle.

  • Do You Share Your Bed With Another Person?

    Sleep partners may not agree on the ideal firmness level. In these cases, a mattress that offers dual firmness — different firmness levels on each side of the bed — may be the best option. Alternately, a mattress with high conforming, like a memory foam bed, can adapt to keep both sleepers comfortable at night.

  • 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.

  • 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.

    Because experiences vary, and the quality of your sleep plays an important role in your ability to cope with back pain, we strongly recommend purchasing mattresses with generous sleep trials. All of the mattresses we recommend for sleepers with back pain offer sleep trials of 100 nights or more, but the Nectar mattress (our Best Value pick) and the DreamCloud mattress (our favorite for Heavyweight Sleepers) both stand out for their 365-night sleep trials.

    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. Both our Luxury pick, the Brooklyn Bedding Aurora, and our Average Weight pick, the Bear Mattress, have this requirement. 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:

    1. Nonprorated coverage length: During the nonprorated phase of a warranty, mattress owners do not need to pay to have a defective mattress repaired or replaced (aside from shipping and handling costs, in some cases). During the prorated phase, customers must pay a certain percentage of the original mattress price to have their current model replaced, and charges may also apply to mattress repairs. Prorated charges can lead to major costs down the road.

    Purchasers should always read the fine print: some warranties spanning 15 to 20 years only offer two to three years of nonprorated coverage before prorated charges kick in.

    2. Indentation depth: Over time, mattress surfaces develop indentations where owners tend to sleep, usually in the middle of the bed. These issues may compromise the supportiveness of the mattress, which can in turn exacerbate back problems. Most warranties list a ‘depth’ used to differentiate between normal wear and tear and severe indentations that are considered a warrantable defect. Some warranties will cover indentations deeper than half an inch (1/2″) to three-quarters of an inch (3/4″), while others will only cover indentations that measure deeper than one and a half inches (1 1/2″).

    Indentations that measure one inch (1″) or deeper are considered most problematic for people with back pain, so these individuals are urged to seek out mattress warranties that cover one-inch indentations

Match Your Pillows & Bedding

In addition to choosing the right mattress, people who live with back pain can further optimize their sleep environment with the right pillow and bedding accessories.

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 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 Weight Optimal Shoulder Width Optimal Mattress Firmness
Low Less than 3″ More than 230 lbs. Narrow Soft to Medium Soft
Medium 3″ to 5″ 130 to 230 lbs. Average Medium
High More than 5″ 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 a pillow between their knees and beneath their ribs.

For more information about pillows, please visit our Best Pillows for Back Pain — Buying Guide and Information page.

Use a Mattress Topper

A topper is an individual layer of cushioning that rests on top of the mattress cover. Mattress 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 for Back Pain 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.

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