The best mattresses for back pain all have lumbar support — but what is it, exactly?

A couple lie down on a mattress that they are thinking of buying together
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As a professional mattress tester who has lower back problems, I've become keenly aware of the importance of lumbar support. The lumbar supports the bulk of your body weight and helps you perform even the most basic movements. If that's compromised, you'll be limited in what you can do – and your sleep will suffer, too.

Looking back on the moments when I could hardly walk or get up without severe lower back pain, I've learned not to take my lumbar health for granted. It all begins in the bedroom – after all, we spend one-third of our lives asleep. The best mattresses make lumbar support a priority, and I'll share what those are here, along with tips on how to make your current bed more comfortable for your lower back.

Naturally, such mattresses may cost a little more than average so I recommend browsing regular mattress sales for discounts on these lumbar-friendly beds. If you're angling for some of the best deals of the year, Memorial Day mattress sales will be here before you know it. 

What is lumbar support and why is it important? 

The lumbar region refers to the five vertebrae in your lower back. It's the largest segment of your spine, spanning from your ribcage to your pelvis. The lumbar is integral to your overall balance and mobility and also helps distribute your body weight. Unfortunately, most Americans will deal with chronic or temporary lower back pain over their lifetimes, between 75% and 85% of the population..

A man sits up in bed at night, holding one hand to his lower back because he's experiencing back pain

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Lumbar support maintains the natural 'S' shape of your spine, which curves inward at your lower back (known as the lordotic curve). A mattress with sufficient lumbar support will fill the gap between your lower back and the sleep surface to keep everything aligned and reduce pressure buildup. 

For most people with lower back pain, studies show that a medium-firm mattress works best – but as we stress here at Tom's Guide, firmness is subjective so it'll all come down to what you need to feel comfortable. The most important thing is to ensure your spine doesn't cave in (due to a soft mattress) or experience significant pressure build-up (due to a hard mattress). 

In our experience, many of the best mattresses for back pain are hybrids that combine the pressure relief of foam (memory or latex) with the support and airflow of coils. You'll also want to consider an ergonomically designed mattress with targeted lumbar support. This often includes reinforced springs, a strip of foam, and/or specialized quilting at the center of the mattress. 

Saatva is known for its Lumbar Zone technology, which you'll find in all of its mattresses to some degree. Other sleep brands that incorporate similar technology include WinkBed's LumbarLayer and the Helix Luxe line's Enhanced Lumbar Support.

Can poor lumbar support cause back pain? 

A woman with long dark hair wakes up after an uncomfortable night's sleep on a hybrid mattress as she's really better off sleeping on a memory foam bed

(Image credit: Getty Images)

Whether you're sitting up or lying down, a lack of proper lumbar support can create or exacerbate lower back pain. When it comes to mattresses, you want something that comfortably fills the gap between your lordotic curve (where your lumbar is) and the sleep surface to keep your spine aligned when you're resting. 

Inadequate lumbar support will cause your spine to fall out of alignment, resulting in strain and pain. A mattress that's too soft will make your lower back sink below the rest of your body. A mattress that's too hard won't provide enough pressure relief and could even lift your hips too high. 

Here are some signs that your mattress may be causing you back pain:

  • You wake up sore as if you just completed a workout
  • You sleep better away from home (like on a hotel mattress)
  • You rotate like a rotisserie chicken and can't get comfy
  • Your mattress is visibly sagging in the middle

Even if you're confident that your mattress is to blame for your lower back issues, it's still a good idea to speak with a doctor for a proper diagnosis and a tailored treatment plan that can include upgrading your sleep setup.

3 Ways to Improve Lumbar Support on Your Current Mattress

A new mattress is often the answer for alleviating lower back pain, especially if it's clearly seen better days. However, if your bed is still in fine shape and you otherwise like it, here are a few steps you can take to level up the lumbar support:

1. Add the best mattress topper for back pain

A mattress topper sits on top of your bed and alters the feel of your sleep surface. If your current mattress is too soft, aim for a firmer topper that's either made of latex or high-density foam. On the flip side, a mattress that's too firm could benefit from a plushier memory foam topper. It'll ultimately come down to your sleep preferences and body type. (Most mattress toppers come with a trial period.)

Our favorite mattress topper for back pain is the Saatva Graphite Mattress Topper. I placed this on a firm Awara Natural Hybrid mattress and it delivered the sink-in relief I needed for side sleeping – but not at the expense of proper all-body support. My lower back pain didn't flare up and the cooling graphite gel was a nice touch. It's not cheap at $445 for a queen size, but it does come with six months to test it out at home, which is generous for a mattress topper.

2. Choose the right pillow for your sleep position 

While sleeping on the wrong pillow will affect your neck and shoulders, it can create issues with your lower back, as well. Remember that your spine should have that natural 'S' curve and the lumbar is the load-bearing segment. Ideally, your pillow and mattress will work in harmony to keep you comfortable.

So how do you buy the best pillow for your sleep position? Generally, side sleepers should look for a firm, lofty pillow that fits the nook between their ear and shoulder. Back sleepers will fare better with a medium-firm pillow with a lower loft. Stomach sleepers may want a low, soft pillow – if they even opt to use one.

Again, many pillows come with trial periods so you can take your time in determining if it's a right fit. If your sleep preferences are more fluid, try an adjustable fill pillow that allows you to make it as tall or flat as you need it. For neck or shoulder pain, try a contoured pillow.

3. Place a small pillow under or between your knees 

Relieving lower back pressure can be as simple as placing a pillow under or between your knees, depending on how you drop into bed at night. According to the Mayo Clinic, back sleepers should place a pillow under their knees to relax their back and maintain alignment. Side sleepers will want to put a pillow between their knees to benefit their spine, pelvis, and hips. 

Stomach sleeping isn't recommended if you experience lumbar pain but if you can't help but default to this position, try putting a pillow under your hips and lower stomach to relieve pressure.

While you can use a regular pillow for this, it may not stay in place throughout the night. Instead, look into a wedge pillow or a knee pillow.

The best mattresses for lumbar support

1. Saatva RX
The Saatva RX is specially designed for side or back sleepers with chronic or serious back problems including scoliosis (of which I have a mild case), sciatica, and arthritis. It's made of wrapped coils topped with 2" foam modules, 1" micro-coils nestled between two 3/4" slabs of high-density foam, and a quilted lumbar zone with a 1" strip of gel-infused memory foam underneath. It's not cheap, but if money is no object when it comes to relieving your back pain, you'll be glad you made the investment. You'll get a full year to test it out.
Read more:

1. <a href="https://www.prf.hn/click/camref:1100l8udd/pubref:hawk-custom-tracking/destination:https%3A%2F%2Fwww.saatva.com%2Fmattresses%2Fsaatva-rx" data-link-merchant="saatva.com"" target="_blank" rel="sponsored">Saatva RX
The Saatva RX is specially designed for side or back sleepers with chronic or serious back problems including scoliosis (of which I have a mild case), sciatica, and arthritis. It's made of wrapped coils topped with 2" foam modules, 1" micro-coils nestled between two 3/4" slabs of high-density foam, and a quilted lumbar zone with a 1" strip of gel-infused memory foam underneath. It's not cheap, but if money is no object when it comes to relieving your back pain, you'll be glad you made the investment. You'll get a full year to test it out.
Read more: <a href="https://www.tomsguide.com/reviews/saatva-rx-mattress" data-link-merchant="tomsguide.com"" data-link-merchant="saatva.com"">Saatva RX mattress review

2. Helix Dusk Luxe 
We called the Helix Dusk Luxe "one of the most comfortable mattresses we've ever reviewed" for its keen balance of pressure relief and support for back and front sleepers. This 6-layer mattress is anchored by a base of DuraDense foam and followed by a core of wrapped coils that are reinforced in the middle and along the perimeter for stronger support in those areas. On top are various foams that yield medium-level support and subtle contouring. Hot sleepers should consider adding a cool-to-touch GlacioTex cover that's designed to draw away body heat.
Read more:

2. <a href="https://helix-sleep.tkjf.net/c/221109/605588/9928?subId1=hawk-custom-tracking&sharedId=hawk&u=https%3A%2F%2Fhelixsleep.com%2Fproducts%2Fdusk-luxe%2Ftwin-tencel" data-link-merchant="helixsleep.com"" target="_blank" rel="sponsored">Helix Dusk Luxe
We called the Helix Dusk Luxe "one of the most comfortable mattresses we've ever reviewed" for its keen balance of pressure relief and support for back and front sleepers. This 6-layer mattress is anchored by a base of DuraDense foam and followed by a core of wrapped coils that are reinforced in the middle and along the perimeter for stronger support in those areas. On top are various foams that yield medium-level support and subtle contouring. Hot sleepers should consider adding a cool-to-touch GlacioTex cover that's designed to draw away body heat.
Read more: <a href="https://www.tomsguide.com/reviews/helix-dusk-luxe-mattress-review-year" data-link-merchant="tomsguide.com"" data-link-merchant="helixsleep.com"">Helix Dusk Luxe mattress review

3. The WinkBed
The WinkBed comes in four firmness levels, including a Plus version that's built for heavier bodies. All iterations feature zoned coils that are stronger in the middle for optimal lumbar support. On top is a Euro pillow-top that influences the overall feel of the mattress – although the WinkBed Plus instead has a top layer of high-density foam followed by a latex support layer. No matter your sleep style or body type, you're bound to find a WinkBed that'll keep you comfortable.
Read more:

3. <a href="https://winkbeds.sjv.io/c/221109/1762409/20673?subId1=hawk-custom-tracking&sharedId=hawk&u=https%3A%2F%2Fwww.winkbeds.com%2Fpages%2Fshop-winkbed" data-link-merchant="winkbeds.com"" target="_blank" rel="sponsored">The WinkBed
The WinkBed comes in four firmness levels, including a Plus version that's built for heavier bodies. All iterations feature zoned coils that are stronger in the middle for optimal lumbar support. On top is a Euro pillow-top that influences the overall feel of the mattress – although the WinkBed Plus instead has a top layer of high-density foam followed by a latex support layer. No matter your sleep style or body type, you're bound to find a WinkBed that'll keep you comfortable.
Read more: <a href="https://www.tomsguide.com/reviews/winkbed-mattress" data-link-merchant="tomsguide.com"" data-link-merchant="winkbeds.com"">WinkBed mattress review

Alison Barretta
Freelance reviewer and writer

Freelance writer and editor Alison is an expert mattress tester for Tom's Guide, and hails from Philadelphia, USA. Alison has reviewed a wide range of mattresses, pillows and other sleep accessories for Tom's Guide, putting the latest hybrid, memory foam and cooling mattresses from Casper, Nectar, Awara, Brooklinen and other leading brands through their paces. Alison has been sharing buying advice and retail news for over a decade. When she isn't reviewing mattresses, other home products or hunting for great deals to save you money, Alison can be found teaching/training in martial arts, fawning over skincare, and indulging in her quarantine-borne hobby: cooking.