The Best Mattresses for Back Pain

Back Pain Mattress

Back pain is on the rise, with about 80 percent of adults experiencing back pain at some point in their lives. It impacts everything from sleep to daily life. In fact, the American Chiropractic Association ranks back pain as the leading cause of missed work.

A good night’s sleep seems like the perfect cure for ailments like back pain. But what if your mattress is keeping you from a restful night or even worsening your back pain? This guide will let you know what to look for—and what to avoid—when choosing a mattress for back pain.

Best Back Pain Mattress Reviews

Best Overall: Saatva

Construction:

Saatva offers an innerspring mattress with coil-on-coil construction, meaning it has two layers of coils. The support layer is comprised of hourglass-shaped steel coils. It’s topped by a comfort layer featuring layers of polyfoam, memory foam and 14.5-gauge pocketed coil. The mattress also comes with a Euro pillow top for additional cushion and an antimicrobial organic cotton cover.

Pros:
  • Coil-on-coil provides better support and contouring compared to traditional innerspring mattresses
  • Multiple thickness and firmness options available
  • Affordable price point for a luxury mattress ($999 for queen)
Cons:
  • Innerspring mattresses tend to be less durable compared to other types
  • Heavy and difficult to move
  • Motion isolation is a weak point of most innerspring mattresses
Why We Picked It:

The unique coil-on-coil construction found in the Saatva provides the support and body-conforming qualities that are crucial for back pain sufferers. We would recommend the Luxury Firm model, which is medium firm and a good fit for those with back pain.

Saatva Mattress

Editor's Choice: Tomorrow Sleep Hybrid

Construction:

Tomorrow Sleep offers a hybrid mattress available in two firmness options, medium soft and medium firm. The comfort layer construction varies by firmness, and because we would recommend medium firm for back pain sufferers, we’ll look at that option. The support layer is composed of pocketed coils, a polyfoam base layer and polyfoam side encasement. It’s topped with gel polyfoam plus a layer of memory foam. Its phase-change cover absorbs body heat for cooler sleep.

Pros:
  • Strong edge support
  • Phase-change cover sleeps cool
  • Good motion isolation
Cons:
  • Heavy and difficult to move
  • Noise potential
  • Takes longer to decompress than other online brands
Why We Picked It:

The Tomorrow Sleep mattress offers the best of both worlds when it comes to spine alignment. Pocketed coils provide solid support and a thin, dense comfort layer conforms to the body without letting you sink too much. The mattress also comes with a 365-night sleep trial, which is plenty of time to see if this is the right mattress to ease your back pain.

Tomorrow Sleep Mattress

Best Value: Bear

Construction:

Bear offers both foam and hybrid mattresses, but we would recommend the foam mattress for individuals with back pain. Its support core is made of high-density polyfoam and is topped with a comfort layer of polyfoam and cooling-graphite gel memory foam. The mattress comes with a cover made of polyester and Celliant™, which redirects the body’s energy back as infrared light.

Pros:
  • Close conforming
  • Good motion isolation
  • Below average price point
Cons:
  • Only one firmness option available
  • Weak edge support
  • 30-night break-in period required for sleep trial
Why We Picked It:

While the Bear mattress only offers one firmness rating, at medium firm, it’s the right level for back pain sufferers. The memory foam layer provides good body-contouring and pressure relief. Celliant™ fabric found in the cover is made to increase blood flow and tissue oxygenation, which can help those who suffer from chronic pain.

Bear mattress

Best Foam: Loom & Leaf

Construction:

Loom & Leaf is a foam mattress with a base support layer of high-density polyfoam topped with transition layer polyfoam. Two components make up the comfort layer: 5 lb visco-elastic memory foam and a top layer of cooling gel-swirl memory foam. The mattress comes with an organic cotton cover.

Pros:
  • Provides excellent conforming and pressure relief
  • Cooling gel layer is good for those who sleep hot
  • Design minimizes motion transfer for those who co-sleep
Cons:
  • Newer product so lifespan is unknown
  • Relaxed firm will not provide enough support for individuals over 230 pounds
  • Weak edge support
Why We Picked It:

Loom & Leaf is often compared to Tempurpedic, which can cost nearly $5K. The mattress has superior conforming properties and eliminates pressure points. The relaxed firm option is likely best for lighter weight individuals or those without serious back issues. The firm option might be better for those over 230 pounds.

loom and leaf mattress

Customizable: Helix

Construction:

The Helix mattress is a hybrid composed of a support core of high-density polyfoam. The comfort layer starts with pocketed coils topped with transitional polyfoam and finally a top layer of Helix’s proprietary blend of polyfoam. The mattress comes with a polyester cover.

Pros:
  • Mattress design and firmness are customizable
  • Dual firmness options for those who co-sleep
  • No noise
Cons:
  • Sleeps somewhat hot
  • Edge support is questionable
  • Lifespan is unknown as company is newer
Why we Picked It:

Helix provides a sleep quiz on their website and will tailor the design of your mattress to your needs based on your answers. The result is a mattress that takes into consideration your body and sleep style. For someone suffering from back pain, a mattress customized to your needs may be just what you need.

Helix Mattress

How Back Pain Affects Your Sleep

What Causes Back Pain?

Back pain can be divided into two main types:

  1. Acute – Acute pain is relatively temporary, lasting three months or fewer. It’s usually related to an accident or injury and subsides when the root cause is treated.
  2. Chronic – Chronic pain is long-lasting and can be caused by an accident, injury or condition like osteoarthritis. The pain often continues after the root cause has been treated.

According to Cleveland Clinic, 98 percent of back pain is caused by one of the following:

  • Muscle strain or sprain – Awkward movements or improper lifting can lead to temporary muscle strain and back pain.
  • Herniated disc – Discs act as cushions and shock absorbers between individual vertebrae. Too much pressure can cause them to bulge or rupture. This injury is common among individuals who spend a lot of time sitting.
  • Disc disease – Often related to age, degenerative disc disease causes spinal discs to break down so they are less able to absorb weight and shock.
  • Osteoarthritis – Facet joints make the spine flexible and allow for bending and twisting, and they are surrounded by protective cartilage. Osteoarthritis is the breakdown of this cartilage and can cause vertebrae to grind against one another.
  • Spinal stenosis – The spinal canal that surrounds the spine often narrows with age, which can pinch and irritate nerves.

Relationship Between Back Pain and Sleep

Sleep and back pain have a reciprocal relationship. Back pain can often lead to trouble sleeping, and poor sleep or the wrong sleep surface can exacerbate back pain. In fact, an estimated 50 - 80 percent of individuals with back pain report trouble sleeping. Back pain can lead to trouble with both falling asleep and staying asleep:

Falling Asleep

Falling asleep requires a calm environment free of distractions. For someone with back issues, it’s difficult to focus on anything but the pain. These individuals may toss and turn, trying to get comfortable. The longer they are awake, the more stressed they become, which can make the pain seem worse.

Staying Asleep

Once back pain sufferers fall asleep, pain may wake them throughout the night. Even if they do not register these awakenings, they can’t fall into a deep sleep, leaving them less refreshed in the morning.

In turn, the way we sleep can worsen back pain. We often think about posture when we’re standing or sitting, but what about when we’re lying down? Not all sleep positions were created equal when it comes to back pain. The table below outlines which sleep positions are best for specific types of back pain.

Type of Back Pain Ideal Sleep Position
Muscle Strain or Sprain Depending on the injury, sleeping on your back or side will be most comfortable. A pillow between your knees can help keep your spine aligned.
Herniated Disc Sleeping in a curled up fetal position (on the side with knees up) reduces bending of the spine and opens up joints.
Disc Disease Sleeping on your back with upper body slightly elevated—with a wedge pillow or adjustable bed—opens up the disc space.
Osteoarthritis The fetal position helps open up facet joints and relieve pressure.
Spinal Stenosis The fetal position can help relieve pressure on the nerve root.

In combination with other medical interventions, one of the best ways to treat—or better yet prevent—back pain is to ensure proper spinal alignment. 

Our spines naturally curve in an S shape and the more we can maintain this natural curvature, the better. A good sleep surface preserves and supports this curvature.

The wrong mattress can exacerbate back pain by throwing the spine out of alignment. In addition, proper sleep is important in allowing a body to recover. An uncomfortable mattress that causes you to toss and turn might keep you from recuperating from back pain.

How Your Mattress Can Relieve Pain

Finding a good mattress is only a piece of the puzzle when it comes to treating or relieving back pain, but it’s a key element. Some qualities to consider when choosing a mattress for back pain include:

  • Spinal Alignment – Mattresses are comprised of two primary layers: the top comfort layer and the bottom support layer. The support layer is crucial for those suffering from back pain as its primary job is to ensure spinal alignment. Some parts of our bodies, like our pelvis and shoulders, are heavier than others. A supportive - or responsive - mattress holds up these parts of the body to maintain our spine’s natural S shape.
  • Firmness – All mattresses are rated on a 1 - 10 firmness scale, where 1 is the softest mattress and 10 is the hardest. Back pain sufferers have often been told to sleep on a very firm mattress, but recent studies show that this advice might be misguided. While weight, sleep position and preference all come into play, the best mattress for those with back pain is medium firm, or 5-7.
  • Pressure Point Relief – The heavier parts of our bodies not only need proper support. They also need a mattress that conforms to them and relieves pressure points. The top comfort portion of a mattress serves this purpose. A comfort layer that is too thin or that sits on top of a support layer that is too firm will lead to aches and pains in the morning.
  • Cooling – Some individuals naturally sleep hot, no matter the temperature outside. Warmer bodies have decreased blood flow and thus less oxygen, which can contribute to chronic pain. While a recent Dutch study showed that we all benefit from sleeping cooler, it is even more vital for those living with back pain. Consider choosing a mattress that is built to keep the body cooler, either through cooling gels or construction that allows air to flow freely.

How Mattress Type Impacts Pain

Pros:

Memory foam is a soft material that changes shape when pressure or heat is applied. It conforms easily to the body so can be very effective in ensuring spinal alignment and relieving back pain, especially for lighter weight individuals (under 130 pounds). It also eliminates pressure points, which is important for side sleepers.

Cons:

Memory foam may conform too much to the body, especially for individuals over 230 pounds, which can actually cause misalignment. A strong support core is important to prevent this. Lower quality foams can also break down quickly, leading to a loss of support and sagging over time.

Other Shopping Considerations

In choosing the best mattress for back pain, it’s important to also think about several other factors that can affect comfort. Other considerations include:

Sleep Position.

As discussed above, some sleep positions are better for back pain than others. Sleep position may also impact the effectiveness of a specific mattress chosen to help with back pain. Back and side positions are considered best for back pain sufferers as they are more likely to keep the spine in alignment. Sleeping on the stomach leads to a large concentration of weight on the stomach, causing sagging in the spine. Each position also requires different firmness because pressure points vary by position. Side sleepers may want to look for a slightly softer mattress than back sleepers.

Weight and Body Shape.

Bodies come in all shapes and sizes, and each comes with specific needs when choosing a mattress. Those over 230 pounds will generally want to go firmer to gain proper support. Sinking into a mattress too much throws off spinal alignment. Lighter individuals, under 130 pounds, will want to find a mattress with a thick comfort layer to maximize pressure relief.

Sleeping Alone vs. Partner.

If finding a mattress to relieve back pain isn’t difficult enough, those who co-sleep need to consider the needs of their partners. If your partner has significantly different preferences, body type or sleep style, you may consider a split bed that allows you each to customize your side of the bed to suit your needs. Especially if you suffer from back pain, compromising on mattress qualities may not be an option.

Sleep Temperature. 

Some individuals sleep hotter or colder than average, which can lead to trouble falling or staying asleep. Mattress materials and firmness can have an impact on sleep temperature in a few ways. Softer mattresses tend to sleep hotter as they allow the body to sink lower, trapping heat and reducing air circulation. Traditional memory foam is also known to sleep hot, so those who struggle to keep cool should look for a memory foam mattress with cooling gel or a different material.

Best Mattresses for Back Pain Picks

Brand Name Price (Queen)
Best Overall Saatva $999
Editor's Choice Tomorrow Sleep Hybrid $990
Best Value Bear $840
Best Foam Loom & Leaf $1,099
Customizable Helix $995