Five signs you need a firm mattress for your back pain

A man sits up in bed holding his painful back
(Image credit: Getty)

It’s a common misconception that a firm mattress is the only type of bed to help soothe chronic back pain. However, firmness is subjective and while guidance from chiropractors now tends to steer back pain sufferers towards medium-firm mattresses, a firmer sleep surface may be the best mattress for your specific health needs.

Each back ailment or source of pain is different, so it’s always worth consulting with your chiropractor or doctor for guidance on which is the best type of mattress for your back pain. That said, there are certain signs and indications that the best mattress for your back pain is a firm one. 

These signs include how much you weigh, the specific location of your back pain and your sleep position. If chosen correctly, the best firm mattress can offer unparalleled lumbar support — so let’s take a closer look at whether a firmer sleep surface could be a suitable option for you. 

5 signs that you need a firm mattress for your back pain

1.  You are a heavier weight sleeper 

If you weigh over 230 lbs and suffer from back pain, only the best firm mattress will provide you with adequate support. While a softer mattress will allow you to sink through the supportive layers, the best firm mattress will hold you on top of the mattress, where your lumbar will be supported and your spine is cradled in correct alignment. 

The Helix PLUS is one of the best mattresses for heavy people

(Image credit: Helix)

This is hugely important, as when our spines dip out of alignment it can exacerbate any back pain you have. What's more, if you wake with new aches and pains, it's a strong indication that your mattress is to blame for your back pain.

If you weigh significantly more than 230 lbs, you may want to think about investing in a mattress designed specifically for heavier people. Most mattresses are designed to accommodate weight in the region of 250 lbs, but the best mattresses for heavy people have been engineered to accommodate weight in the region of 500 lbs per person.

2. You are a stomach sleeper 

If you're a back pain sufferer who sleeps on their stomach, you've probably heard countless times that sleeping on your stomach is one of the worst sleep positions for back pain. And yet an estimated 7% of adults sleep on their stomach, despite the strain it puts on our lower backs.  

“If you lie on your stomach, there is no support for your spine,” James Leinhardt, a sleep position expert and the founder of mattress brand Levitex, told us when we spoke to him regarding the which is the best (and worst) sleep position

However, sleeping on a firmer mattress could help prevent gravity from pulling your spine downwards - against its natural curve - which is what happens when we sleep on our stomachs. The best mattresses for stomach sleepers with back pain will be firm enough to hold both your spine and hips in correct alignment, helping prevent a buildup of pressure and pain in the lower lumbar. 

3. You have lower back or neck pain

Finding the best mattress for your back pain is more nuanced than a one-size-fits all solution, so what sleep surface is supportive for one person may not be right for you. However, if the source of your back pain is in the lower lumbar region or neck, it's a strong indication that you could benefit from a firm mattress. 

a photo of a woman sat on her bed, holding her lower back

(Image credit: Shutterstock)

When we previously spoke to Dr. Mark Aloia, Head of Sleep and Behavioral Sciences at Sleep Number, surrounding whether firm mattresses were best for back pain, he explained that a harder sleep surface can "best support the lumbar area without shifting unwanted pressure to the hips and shoulders." 

What's more, a firm mattress can also minimize any strain on your neck by preventing your chest from any sinking.Of course, investing in the best pillow for your sleep needs will also help minimize any neck pain. 

4. You struggle to get in or out of bed

A mattress that you sink too deeply into will not provide the superior lumbar support that you require. In addition to the new back pain that you are likely waking up with, string signs that your current mattress is too soft to provide any meaningful support is that getting in and out of bed is difficult, and moving positions while in bed is a struggle, due to the level that of sink that you are experiencing. 

A woman in a brown t-shirt massages her painful lower back in bed

(Image credit: Getty)

This can leave you at risk of causing further back injury and strain. Instead, a firmer sleep surface will hold you on top of the mattress, where getting in and out of bed and shifting positions will be much easier.

5. You struggle to find a comfortable position 

When we have slept on the same mattress for a number of years, they eventually begin to lose their support (especially if it's over ten years' old). This can lead to a gradual onset of back pain. However, if your mattress is fairly new and you don't feel as though you can allow your muscles and joints to ever fully relax, it's a fairly clear indication that your mattress is too soft

The best mattress for back pain will provide ample lumbar support and outstanding pressure relief, helping to soothe aches and pains. If your mattress doesn't do that, it could be time to replace it for something firmer. However, if your mattress was a recent purchase and you aren't looking to replace it, investing in the best mattress topper for back pain could provide the immediate relief you need. 

Nicola Appleton
Sleep Features Editor

Nicola Appleton is Sleep Features Editor at Tom’s Guide, specialising in quality news content surrounding sleep and wellbeing. Nicola cut her teeth as a journalist in a busy newsroom in Bristol, UK, 15 years ago as part of a team at Britain's largest independent press agency. Since then, her job as a journalist has taken her to the States, to Sydney, and then back to Blighty, where she has written and edited features for a whole host of prominent British and international brands, including  The Independent, The Sydney Morning Herald, HuffPost, Refinery29, Stylist and more. As well as tackling the vast topic of sleep, Nicola will be joining the raft of expert mattress reviewers at Tom's Guide, helping steer readers towards the very best mattresses on the market.