The best mattress for back pain 2025: 8 expert-tested picks to help you sleep comfortably
Our expert tested and recommended mattresses for back pain — top picks for all sleep styles and budgets
Quality sleep can be elusive if you're struggling with back pain. And if your mattress isn't providing you with the support you need, it could be making your pain worse. That's why choosing the best mattress for back pain is so important — not only can they resolve existing pain, they can help prevent it occurring in the first place.
To help you choose, we've carefully selected eight options – from the 120+ tested by our expert review team – that can soothe back pain, helping you fall into deep, restorative sleep. We've curated this list based on results from extensive testing with our new mattress methodology, combining objective and subjective data around key performance areas.
After rigorously re-testing the Saatva Classic for the third time, it has secured its position at the top of our guide to the best mattress for all sleepers and budgets. However, the Classic’s near-perfect performance has also earned it the title of the best mattress for back pain overall, surpassing the Saatva RX for the first time, thanks to its suitability for most people with aches and pains. The Saatva RX is still in the guide, but now as our top recommendation for those with chronic pain.
What should you look for in a mattress for back pain? Many people assume that a firm mattress is the way to go, but that isn't always the case. "A person's mattress needs to be supportive, and that doesn’t always mean firm or soft," says Dr. Kevin Lees, Director of Chiropractic Operations at The Joint Chiropractic. "The mattress should come in contact with the entire body of the person sleeping. If there are gaps in contact, or the mattress sinks in too far, this could lead to aggravating existing back problems, and possibly creating new ones."
Dr. Betsy Grunch, an MD and board-certified neurosurgeon, explains how the wrong mattress can make things worse: "A mattress that doesn't support the spine can lead to sagging of the spine and increased strain on the important supportive muscles of your neck and back," she says. "This can lead to increased levels of pain in your lower back, neck pain, and even headaches."
However, buying the right mattress for back pain for you doesn't mean just buying the most expensive. That’s why we’ve included options for all budgets, with the cheapest mattress in the guide — the Siena Signature Memory Foam mattress — costing under $400 for a queen, plus three of our seven picks coming in at under $1,000 for a queen. In even better news, all of these mattresses are nearly always discounted in the month's best mattress sales, which we track and update.
These are the eight best mattresses for back pain, selected by our team of expert testers. Read on to begin your journey towards better, pain-free sleep.
After a rigorous re-testing process, the Saatva Classic has entered the best mattress for back pain guide at the number one spot. It's near-perfect all-round performance makes it the best choice for most people with back pain, while the Saatva RX is our top recommendation for those with chronic pain.
1. The best mattress for back pain overall



Specifications
Reasons to buy
Reasons to avoid
Quick summary
After recently re-testing the Saatva Classic for the third time, the Classic has shot to the top of our best mattress for back pain guide. While it's not specifically sold as a mattress for back pain (for that, check out the Saatva RX below, the brand's luxury solution to chronic pain) it's packed with features, like Lumbar Zone Quilting, to protect your back, relieve pressure points, and prevent aches and pains from occurring in the first place.
The Classic is an impressive all-round performer that does pretty much everything just right, scoring an impressive 23.5 out of 25 under our new testing methodology. It's a premium innerspring hybrid bed that comes in three firmness options and two heights and sleeps comfortably from the very first night.
Read what we liked, didn't like, and how to buy it ▼
Endorsed by the American Chiropractic Association for the quality of its lumbar support, the Classic is designed not only to keep your spine properly aligned in every sleeping position, a combination of high density memory foam and zoned support means that lower back pain can quickly become a thing of the past. At $2,139 for a queen at full MSRP it's a premium mattress, but we think it's worth every cent, particularly if you're troubled by back pain.
Our review: in more detail
The Saatva Classic is the best hybrid mattress on the market today, with the look and feel of a luxury hotel bed. Our lead tester, Managing Editor Claire Davies, was struggling with lower back pain when she took delivery of the Saatva Classic earlier this year. From the first night and during the following seven months, she noted how she could feel her back straightening out when she lay down on it, and found that her spine and pressure points felt properly supported and cushioned.
That’s because while the Classic is an excellent all-rounder for (almost all) sleep positions and needs, where it really excels is in its back support. This was demonstrated further during a recent re-test in our Sleep Product Testing Lab. The Classic excelled in all areas of performance. However, its performance in two key metrics make it stand out as our top choice for those with back pain; it achieved a 5 out of 5 score for pressure relief and a 5 out of 5 for edge support.
That means the Classic provides plenty of cushioning support while holding the spine in correct alignment, has a reliably sturdy edge, which means you can sleep or sit on the edges with confidence.
Support and comfort: ★★★★★
Pressure relief: ★★★★★
Temperature regulation: ★★★★★
Motion isolation: ★★★★★
Edge support: ★★★★★
Build quality: ★★★★★
Plus, our crucial heat dissipation test showed the Saatva Classic dissipates heat at an average of 1.58°F per minute, which, according to our scoring rubric, is excellent (and so far only beaten by the Bear Elite Hybrid, which you’ll find further down the guide). This reliable temperature regulation prevents overheating, which can exacerbate back pain.
As well as being exceptionally kind to your back, the Saatva Classic is suitable to almost every type of sleeper (it has a maximum mattress weight capacity of 450lbs per sleeper). That’s because it comes in three firmness options: Plush Soft, which is best suited to lighter weight side sleepers; Luxury Firm, a safe all-rounder pick for most sleep styles and particularly combination sleepers; and Firm, the ideal option for back and stomach sleepers who need the most spinal support.
As well as that, you get two height options – 11.5" and 114.5" – so that you can choose a size that proves to be the most comfortable fit for your bed type. Saatva even provides a handy calculator to help you visualize which would be the best option for you. It comes with a lifetime warranty, plus free White Glove Delivery, which includes the set up and removal of your old bed, so you can avoid further injury to your back.
In short, the Classic lives up to its name in every way, and in most cases it's a winner for back pain. We should point out, though, that if you experience chronic back or joint pain you could be better off with the more pain-focused Saatva Rx; you'll find details of that further down the page.
What we like about it...
Why you can trust Tom's Guide
✅ Specialized lumbar support: The Classic features more supportive quilting in the center third of its pillow top as well as a half-inch memory foam lumbar crown enhanced by active spinal wire, all of which delivers outstanding lumbar support along with healthy spinal alignment.
✅ It's immediately comfortable: There's no break-in period with the Saatva Classic. Because it features the bare minimum of foam, you'll find that it's at maximum comfort levels the first time you get into bed.
✅ Suitable for all sleep positions: The Saatva Classic comes in three firmness options as well as two heights, so you can easily choose an option that fits in with both your sleep preferences and your bedroom setup.
What we don't like about it...
❌ Not for larger couples: The maximum weight capacity of the Saatva Classic is 600lbs, which means that it may not be an option for plus-size couples. There is a Saatva mattress for bigger bodies, the Saatva HD, but that will cost you an extra $1,300 in a queen size.
❌ There's a returns fee: Our long-standing gripe with Saatva is its $99 returns fee. Saatva says that this covers the admin costs for processing returns and exchanges, but it's still a bitter pill to swallow if your mattress doesn't meet your expectations.
When, where and how to buy
Saatva has viewing rooms across the USA but you can only buy online. The current MSRP for a queen size Saatva Classic is $2,139 but you'll basically never have to pay that. Saatva mattress sales run constantly and for most of the year they alternate between two deals: 15% off when you spend over $1,000 (sometimes slightly less than that), which will get you a queen for $1,819, and a set of tiered discounts depending on how much you spend, and that usually means you'll pick up a queen with $350 off.
However, the absolute best time to buy a Saatva Classic is during major sales events such as Black Friday and Cyber Monday, when you'll see a flat $400 discount on all sizes . The next time we expect to see that deal will be Presidents' Day, so if you're in no great rush, we'd advise waiting then.
Saatva Classic Mattress: our expert verdict
If you're struggling with back pain, the Saatva Classic is an incredible all-rounder that can make a real difference. It's instantly comfortable and boasts a design that's geared specifically towards providing outstanding lower back support and promoting healthy spinal alignment. Both our testers and Saatva customers have found that the Classic can help with back and joint pain. If you experience chronic back or joint pain the more expensive Saatva RX further below might be the better choice. But for most people the Classic should be more than up to the job.
Read more: Saatva Classic mattress review
2. The best budget mattress for back pain


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Reasons to buy
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Quick summary
The Siena 10” Signature mattress is the best cheap mattress we’ve ever tested, offering unbeatable lumbar support compared with any other memory foam bed in its price range. It’s surprisingly firm for an all-foam bed, but quickly contours to the shape of your body to hold your spine in correct alignment while you sleep (that’s hugely important for keeping back pain at bay.)
We gave the Siena 10” Signature an average firmness rating of 8.5 out of 10, with the back and stomach sleeping members of our testing panel appreciating its sturdy support. Average side sleepers, however, will need something with a bit more ‘give’ if they want to lie comfortably on their sides for any length of time. (If you can stretch your budget, the Nectar Premier at #4 is a great alternative.)
Read what we liked, didn't like, and how to buy it ▼
Although it's not a cooling mattress, it does a great job of keeping temperatures regulated for most sleepers (hot sleepers will need something actively cooling, such as the Bear Elite Hybrid at #3. The dense memory foam layers do an excellent job of dampening any motion across the surface of the mattress, while support around the edge of the bed is excellent (that’s important if you like/need to sit before standing.)
Our review: In more detail
At just $359 for a queen, the Siena 10” Signature memory foam mattress punches well above its cheap price tag in terms of overall comfort and performance. Forget about the typical ‘hug’ feel that you get with some memory foam mattresses (for that, check out the Nectar Premier at #4), this is a firm all-foam mattress boasting oodles of support.
Our testing panel gave the Siena an average firmness rating of 8.5 out of 10 for firmness, placing it in the true firm mattress category. While it does feel surprisingly hard when you first lie on the mattress, the 2” upper layer of contouring foam does exactly what it’s supposed to, adapting around the touch points of the mattress.
Support and comfort: ★★★★
Pressure relief: ★★★★
Temperature regulation: ★★★★
Motion isolation: ★★★★½
Edge support: ★★★★
Build quality: ★★★★
This tension was a hit with the back and stomach members of the team, with our lead tester and Senior Staff Writer Ruth Jones admitting she was “obsessed” with its support when sleeping on her stomach. Meanwhile, our Sleep Editor Nicola Appleton (who experiences recurrent lower back pain) described the Siena as “soothing” when lying on her back.
The downside to this robust support is that there isn’t enough pressure relief for side sleepers. During our studio testing, we placed a 25kg weight at the hip area of the mattress and measured a sink of 3.5" and a sink of 3" in the shoulder area. In contrast, we measured over a half an inch extra sink when testing the Nectar Premier. In short, if it's sink-in support you're after, try something with more 'hug', like the Nectar at #4.
What we like about it...
✅ Edge to edge support: Unlike most other memory foam mattresses in this price category, the Siena offers robust support along the edge of the mattress. To demonstrate this during testing, we were able comfortably rest a 25kg weight right on the bed's edge.
✅ Temperature regulating: It's not actively cooling, but the Siena does a decent job of keeping temperatures regulated. A thermal testing camera during testing showed some lingering heat retention (common for memory foam beds) but you're unlikely to overheat here unless you're already prone to.
✅ Superb motion isolation: Dense foam layers prevent motion from travelling along the surface of the mattress. That means that if you share a bed with a restless sleeper, you're unlikely to feel every toss and turn.
What we don't like about it...
❌ Minimal pressure relief: While the Siena was a hit among the back and stomach sleeping members of our testing panel, side sleepers will require a mattress with more sink-in support. If you're looking for a memory foam mattress that combines cushioning comfort for side sleepers and reliable lumbar support for back health, try the Nectar Premier instead.
❌ Potentially lacks durability: Concessions always need to be made when buying a cheap mattress. While the Siena outperforms competitors within its price range for comfort, support and overall performance, durability could be an issue. If you want a memory foam mattress that will last you for years and you can stretch your budget, we recommend the Nectar Classic as a more durable all-foam option ($649 for a queen.)
When, where and how to buy
A regular 60% off Siena mattress sale brings a queen down to $359 and a twin down to $179, so there's no need to wait for the best time to buy — this mattress is always exceptional value for money. That said, we did see a queen drop as low as $244 for Black Friday 2025, so don't rule out a surprise saving in the upcoming Presidents' Day sales.
Siena 10" Signature mattress: our expert verdict
At $359 for a queen (or even less, depending on when you buy), the Siena 10” Signature offers unbelievable value for money. It out performs any other mattresses in its price range; it isolates motion across the surface of the mattress well, provides reliable edge to edge support and superb lumbar support for healthy spinal alignment. If you're a back or stomach sleeper with back pain looking for a firm all-foam mattress for under $400 for a queen, this is it.
3. The best cooling mattress for back pain



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Quick summary
As our best cooling mattress of the year, the customizable 14” Bear Elite Hybrid is a great choice for all hot sleepers looking for a bed that actively helps regulate their temperature overnight. But with a zoned coil support system, specialist muscle recovery fibers sewn into its cover (more on these below) and a reliable balance of pressure relief and lumbar support, it is especially good for hot sleepers with back pain.
Available in three firmness levels (soft, medium and firm), you can choose a tension suited specifically to your sleep position and body type for a comfortable night's rest. Meanwhile, specialist cooling technology will help wick away body heat so you spend less time tossing and turning (which can exacerbate back pain) and more time clocking restorative sleep.
Read what we liked, didn't like, and how to buy it ▼
Our review: In more detail
Packed with a combination of heat conducting materials like Celliant (a synthetic fiber that converts body heat into infrared energy to promote muscle recovery), Phase Change Materials (PCM) that absorb and release excess heat as they change from a solid to a liquid state, and copper-infused foams that conduct heat away from the body, no mattress comes close to the Bear Elite Hybrid for cooling.
Our lab-based temperature tests revealed the Bear Elite Hybrid quickly absorbs body heat and throws it out of the mattress. When our tester got off the bed after lying on it for 15 minutes, the mattress immediately shed 7.2°F of heat. This means the sleep surface remains cool to the touch, soothing any pains through the night.
Support and comfort: ★★★★
Temperature regulation: ★★★★★
Motion isolation: ★★★★½
Edge support: ★★★★
You can pick between a soft, medium or firm Bear Elite Hybrid and our review panel tested the medium-firm model. When lying on this mattress, you can feel the quilted cover mold to your body shape, zapping pressure from joints and muscles in contact with the bed, while the responsiveness of zoned coils keep your spine in stable alignment.
However, our objective testing data revealed the Bear Elite Hybrid falls short in edge support (our 25kg weight couldn’t sit stably three inches in from the edge of the bed), which may ring alarm bells if your back pain means you need extra support getting in and out of bed. That said, our main reviewer hasn’t had any issues (or falls) getting in and out of bed at home, despite what the data suggested.
Anyone with a restless partner should also note that our motion isolation tests show movement is easily carried across the mattress, so you’re likely to feel your partner tossing and turning next to you, which is no good for soothing back pain. But this is typical of responsive hybrid mattresses and the payoff is that it's easy to move around on the bed surface. So, combination sleepers can easily switch positions without pulling themselves out of foams, potentially triggering pain points.
Alas, this is a premium bed with a premium price. If your budget doesn’t quite cut it, consider shopping the luxurious but more affordable Brooklyn Bedding CopperFlex Pro Hybrid at $999 for a queen size — it’s loaded with cooling materials and also boasts zoned lumbar support.
What we like about it...
✅ Exceptional cooling: Packed with temperature-regulating fibers, specialist cooling technology, heat-conducting foams and airy coils, the Bear Elite Hybrid helps keep you at a cool sleep temperature all night long.
✅ Zoned lumbar support: The cushioning foams, paired with responsive coils and zoned lumbar support, offer the perfect balance of pressure relief and soothing support for every sleep style.
✅ Responsive surface: If you're someone who likes to shift positions during the night you'll need a mattress with a responsive top layer, as opposed to one that traps you in dense foams (which can jolt and pull at already sore muscles.) Our subjective and objective test show that you can shift positions with ease on the Bear.
What we don't like about it...
❌ Motion isolation isn’t great: The flip side to that responsive layer means that motion travels freely across the surface of the mattress. That means that if you share a bed with a restless partner, you're likely to feel every toss and turn.
❌ Extra fee for Celliant cover: If you want to unlock the mattress's maximum cooling capabilities, you'll need to pay an extra $100 for the Celliant cover. But if you're a very hot sleeper looking for relief, we think it's it's worth the investment.
When, where and how to buy
The Elite Hybrid is the most popular bed at Bear, and its almost always discounted. At MSRP, a queen size with the Celliant cover upgrade is $2,712. But it tends to be on sale with at least 30% off and 40% off at best. Right now, you can get a queen size from $1,799 (adding the Celliant cover will set you back an extra $100 – we think it’s worth it).
Unsurprisingly, the best Bear mattress sales come around holidays, with generous discounts up for grabs around major sale periods in the calendar (we’re talking Memorial Day in May, President’s Day in February and Labor Day in September).
A queen dropped a to $1,456 for Black Friday 2025, and came with a free bedding bundle made up of pillows, sheet set and mattress protector. The next major sale is Presidents' Day, which is when we could potentially see that level of saving again.
Bear Elite Hybrid mattress: our expert verdict
Ultimately, the Bear Elite Hybrid is a strong mattress for anyone looking to quell two sleep issues at once: back pain and overheating. It offers best-in-class temperature regulation while you sleep on a cushioning surface that gently cradles pressure points and the robust coil layers beyond that surface prevent your spine from dipping. At $1,899 for a queen size with a Celliant cover now, it’s an investment, but one we think is worth it if back pain or hot flashes are keeping you up at night. Read more: Bear Elite Hybrid mattress review.
4. The best mattress for chronic back pain


Specifications
Reasons to buy
Reasons to avoid
Quick summary
The Saatva RX is a luxury handcrafted mattress designed specifically to ease chronic back pain and painful joint conditions such as sciatica, arthritis and scoliosis. It’s our top recommendation for those experiencing back pain because of the deep pressure relief it provides, alongside full body support and pain relieving comfort.
It comes in one firmness that Saatva describes as ‘supportive plush’ (3-4/10), although we rated it as medium-firm (7.5/10). It contains Saatva’s unique Therapeutic Support Core, which constantly adjusts itself to the shape of your body as you change positions in bed – or remain in the same spot. Combine this with the brand’s patented Lumbar Zone Quilting and a gel-infused memory foam to protect your spine, and the mattress is ideally placed to help provide support where it’s needed.
As you might expect, this isn’t a cheap mattress. At full MSRP a queen size costs $3,399, a $100 increase for the new year. However, it’s usually discounted by as much as $600. Still, this is the most expensive mattress on our list and, if you’re on a tighter budget you might want to consider the mid-range DreamCloud (#2), which is over $2,000 cheaper for a queen.
Read what we liked, didn't like, and how to buy it ▼
However, for the ultimate support and improvements for chronic back pain, the Saatva RX beats all the other contenders.
Our review: in more detail
Like all Saatva mattresses, the Saatva RX is handmade in the US at Saatva-owned factories. It’s one of the best luxury mattresses on the market, delivered directly to your bedroom and set up with Saatva’s free white glove service. We'd recommend it over the flagship Saatva Classic if your back and joint pain is severe.
The Saatva RX is expensive, but it's a worthwhile investment if chronic back and joint pain regularly disrupts your sleep
We reviewed a twin-size Saatva RX for a month and awarded it a test score of 4.5/5, rating it highly for exceptional pressure relief, enhanced back support and good temperature regulation. Our lead tester experiences mild scoliosis and long-term lower back pain and noticed a marked improvement in her pain levels.
Our tester sleeps alone but our objective drop tests revealed a level of motion isolation that's on par with some of the best hybrid mattresses we've tried. The surface has a nice bounce to it, so it's easy to change positions. That said, we think it might be too firm for lightweight side sleepers, who may feel a little pressure build up at the hips and shoulders.
On analyzing the Saatva RX’s user reviews, the most common complaint is that the edge support is poor – a distinct contrast to our personal experience. There are also a few complaints about the firmness being either too soft or firm, which is to be expected as firmness is subjective.
What we like about it...
✅ A perfect blend of comfort and support: The Saatva RX comes in a medium-firm feel, and chiropractors now recommend this as the best mattress firmness for back pain. During testing, we felt it delivered a magic combination of pressure relief, support and full body comfort.
✅ Reduces back and joint pain: Our main reviewer with mild scoliosis felt a big reduction in back pain when sleeping on the Saatva RX. This is down to the patented Lumbar Zone Quilting and specialist Therapeutic Support Core – two features that provide superior lumbar support and react to your body’s movements.
✅ Fantastic extras: Free white glove delivery is included with the Saatva RX, as is optional removal of your old mattress and bed base. This is great value for money. You’ll also get a full 365 nights to try out the mattress and a lifetime warranty, which adds to the peace of mind with such an expensive purchase.
What we don't like about it...
❌ Expensive: Though it's competitively priced and nearly always on sale, the Saatva RX is very expensive. If price is a barrier, the Saatva Classic (#1) is an excellent alternative.
❌ It’s very tall: A 15” height makes for a luxurious mattress, but perhaps not a practical one, especially if you have issues getting in and out of bed. Again, the Saatva Classic comes in two height options (11.5" and 14.5") if easy accessibility is important.
When, where and how to buy
Saatva mattresses are sold by Saatva itself, though we do sometimes see refurbished and past-season models popping up on mattress liquidator sites.
There are well over 20 Saatva Viewing Rooms located across America, where you can lie on every Saatva mattress and test out the brand's sleep accessories, too (these are now also being sold via Saatva's Amazon store). Saatva Sleep Guides are on hand to answer your questions, but orders still need to be placed via the website.
Saatva RX mattress prices typically fluctuate throughout the year, with the MSRP of a queen mattress now at $3,399, a $100 increase. You shouldn’t need to pay full price, though, as there's a monthly Saatva mattress sale offering 10-15% discounts. But do avoid buying during the summer months as this tends to be the only time of year that Saatva doesn’t offer a discount on its mattresses.
The best times to buy a Saatva RX is during a 15% off flash sale. These are fleeting and difficult to predict, but that's when you stand to save up to $599. At 15% off, you can buy a queen RX for $2,890 instead of $3,399.
Saatva RX mattress: Our expert verdict
The Saatva RX is a medium-firm to firm luxury mattress designed for sleepers with chronic back and joint pain. Our testing panel was impressed by RX’s balance of comfort and support, while also contouring your shoulders, hips and knees to ease any buildup of pressure. It sleeps cool, isolates motion across the surface of the mattress well and has sturdy edges for sleeping and sitting on. The Saatva RX is a specialist mattress for chronic back pain and its premium price reflects that. A queen RX costs at $2,999 at Saatva after a $400 Black Friday discount, which is a decent saving on an excellent choice that narrowly missed out on a top spot in the guide.
Read more: Saatva Rx Mattress Review
5. The best memory foam mattress for back pain




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Quick summary
Memory foam mattresses have a reputation for a sink-in, quicksand feel that, admittedly, doesn't sound good for your back pain. But while the Nectar Premier Memory Foam mattress does deliver the deep contouring we'd expect from an all-foam bed, its pressure relief earns it a place in this guide.
A medium-firm mattress, the Nectar Premier contours to your body to evenly distribute your weight and prevent pressure build-up. This contouring, paired with the dense base foams that make up the mattress' support core, means that your body is both lifted and cradled at the same time — fantastic for side sleepers. The motion isolation is also top-notch, so a restless partner shouldn't cause discomfort.
Read what we liked, didn't like, and how to buy it ▼
At $949 for a queen in the Nectar mattress sales, the Premier Memory Foam is among the most affordable beds in this guide. Beds like the Plank Firm and the Cocoon by Sealy Chill are comparably-priced foam alternatives, but they lack the cushioned feel that sets the Nectar Premier apart.
And it's this cushioning, well-balanced with the support, that's earned the Nectar Premier Memory Foam mattress a place in this guide.
Our review: in more detail
The Nectar Premier Memory Foam Mattress is a 13" tall all-foam bed that offers indulgent pressure relief at a mid-range price tag. At $949 for a queen in the year-round sale, it's a competitor to the Cocoon by Sealy Chill mattress and the Plank Firm mattress.
But what the Nectar Premier delivers that's missing from its rivals is a memory foam 'hug'. The comfort layers immediately contour to the body, delivering cushioning at the joints comparable to the plush feel of the Helix Midnight Luxe or the Bear Elite. We think it's the best memory foam mattress you can buy online.
Our testing team agrees the Nectar Premier excels at pressure relief, particularly for side sleepers. Even our lightest weight side sleeper enjoyed the Nectar's cushioning, and she often struggles to find mattresses soft enough.
Pressure relief: ★★★★½
Temperature regulation: ★★★★½
Motion isolation: ★★★★★
Edge support: ★★★★
But it's not all about cushioning, and those with back pain will recognize the importance of support. We were impressed with how well the foam core of the Nectar Premier keeps the body lifted, and our objective weight tests showed even support at the shoulders and hips (a 25kg weight sank roughly 3.8" in both areas.) However, there's a tad too much sink for stomach sleepers, who would be better off with the Plank Firm or Siena Mattress.
The Nectar Premier also excelled during our motion isolation testing. A combination of poor motion isolation and restless co-sleeper can sometimes exacerbate pain but the Nectar Premier quickly dampens movement to keep you sleeping soundly.
And while temperature regulation can be a weak area for all-foam beds, the Nectar Premier quickly removed heat during our thermal imagining tests (although hot sleepers should consider the Bear Elite or the Cocoon by Sealy Chill.) It also delivered good edge support but the softer sides do sink when you press against them — the Plank Firm is sturdier at the perimeter.
What we like about it...
✅ Ample cushioning at the shoulders and hips: The dense foams of the Nectar Premier Memory Foam mattress easily yield to the pressure points, cradling the body for a cozy sleep feel.
✅ Eats up motion: We conducted a series of drop tests in our sleep studio which demonstrated the Nectar's ability to quickly dampen motion. If you share a bed, your partner's movements shouldn't travel across to your sleep area.
✅ Even support for side sleepers: Side sleepers will find the Nectar Premier holds the body straight while cradling the touch points (the shoulders, hips and knees), for head-to-toe pressure relief.
What we don't like about it...
❌ Can trap some heat: The Nectar Premier offers good temperature control for an all-foam bed but it lacks the breathability of most hybrids. The Bear Elite Hybrid is the best choice for hot sleepers but the Brooklyn Bedding CopperFlex Pro Hybrid is a cooler alternative at $999 for a queen.
❌ Slightly weaker at the sides: On the whole we were impressed with the Nectar's edge support but the slightly softer perimeter can feel unstable when you press against it. The Plank Firm has much sturdier sides (but is also firmer all round.)
Where, when and how to buy
The Nectar Premier Memory Foam Mattress is sold both online and in-store, with Nectar mattresses found at over 4,000 stores across the country.
Online the best place to buy the Nectar Premier Memory Foam Mattress is direct from Nectar, where you can typically find a twin for $549, a queen for $949 and a king for $1,099. Nectar mattress sales run year-round and those prices stay fairly consistent, although we have spotted occasional flash sales.
Elsewhere online, the Nectar Premier is available from Raymour & Flanigan, Ashley Furniture and Mattress Firm (among others). These third-party retailers typically price match Nectar but you might miss out on some benefits — Nectar offers a 365-night trial and a lifetime warranty when you shop direct.
The Nectar Premier Memory Foam mattress is also sold via Amazon, where we have, on very rare occasions, spotted a further price drop.
Nectar Premier Memory Foam Mattress: our expert verdict
I spent several weeks sleeping on the Nectar Premier Memory Foam Mattress and while cushioning is the first thing you notice it's the support that left the biggest impression on me — you can feel the foam layers work together to keep you comfortably cradled. For side sleepers with back pain who want to avoid the bouncy feel of a hybrid, the Nectar Premier is a soothing choice. At $949 it isn't cheap but we think it's well priced for the quality and Nectar's benefits are fantastic. Read more: Nectar Premier Memory Foam mattress review
6. The best firm mattress for back pain


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Reasons to avoid
Quick summary
It's a common misconception that only a firm mattress can provide relief from back pain. However, if you sleep on your stomach or back, you'll need a mattress that can provide enough support to keep your hips and spine aligned. A firm mattress is an ideal solution and the Plank Firm is our top rated firm mattress overall.
This flippable mattress gives you a choice of options, with one side marked firm (8 out of 10 on the firmness scale) and the other extra firm (10 out of 10). Our testers found the firm side ideal for stomach sleeping, with the mattress keeping the hips perfectly aligned with the rest of their spine. They preferred the extra firm side for back sleeping.
Read what we liked, didn't like, test scores, and how to buy it▼
With a near-permanent sale on the Plank, the fact that you’re getting two mattresses in one makes it a bargain, although it’s not going to suit everyone. The mattress has quite a niche feel, but it’s not just a gimmick. This is a supremely supportive mattress that will particularly appeal to stomach sleepers with back pain, but also back sleepers with lower back pain. The flat and firm surface is particularly conducive to good spinal alignment.
With a 120-night trial, you’ll have plenty of time to decide if the mattress is right for you, although it’s worth noting that you will pay $99 if you want to return the mattress. Still, this is a reasonably priced mattress with discounts.
Our review: in more detail
Perhaps surprisingly for a firm mattress, the Plank Firm is an all-foam offering. At its core is a 6" layer of high-density foam that provides support to both sides of the bed. The extra firm side just adds a 0.75" quilted flat top to this core.
Flip over to the firm side and there’s a little more padding with a 2" layer of comfort foam plus a 0.75" quilted top. It’s quite a simple construction whichever way you flip it (on that note, it’s worth noting that there aren’t any handles on the Plank, which makes flipping it that little bit more awkward).
Temperature regulation: ★★★½
Motion isolation: ★★★★½
Edge support: ★★★★★
For many people, the firm side at 8/10 is going to be more than supportive enough for their sleeping needs. There’s minimal give, but there is just enough cushioning from the comfort foam to keep the hips from sticking up too far when sleeping on the stomach and therefore throwing the spine out of alignment.
Although Plank rates the extra firm side as 10/10, our testers did notice a small amount of give in the foam, with the mattress dropping to 9/10 after an initial wearing-in period. Back sleepers with lower back pain should particularly rate this side, which keeps the spine completely straight and supported.
The Plank Firm is also a good choice if you share a bed with a restless partner, with superb motion isolation and edge to edge support. Temperature regulation on the Plank could be better — despite being a firm mattress, the foam is a little prone to trapping heat. Fortunately, there is the option to upgrade to a GlacioTex cooling cover, which has a cool-to-the-touch feel and will keep even the hottest sleepers cool overnight. Back pain sufferers need to be comfortable overnight, as endless tossing and turning while trying to keep cool can exacerbate aches and pains.
The Plank Firm also has ACA accreditation, offering superb lumbar support and spinal alignment to ease away any back pain you might have.
What we like about it...
✅ It offers superior lumbar support: The ultra-firm feel of the Plank means that your lumbar region will always be well supported, helping to ease away back pain and particularly lower back pain if you sleep on your back.
✅ It’s supremely supportive for front and back sleepers: While we think the Firm side has a wider appeal overall for its minimal cushioning, our testing panel were pleasantly surprised at how comfortable they found the Extra Firm side when resting on their backs and stomachs.
✅ It suits heavier bodies: The Plank Firm has a maximum weight capacity of 950lbs, making it the perfect choice for heavier bodies. The extra firm side will also prevent these sleepers from sinking too far in, maintaining good spinal alignment however they sleep.
What we don't like about it...
❌ It doesn’t breathe well: It might offer fantastic support, but the dense foams of the Plank mean that the mattress struggles with airflow. Yes, you can add a GlacioTex cooling cover to solve the problem, but really hot sleepers might prefer to go for the firm version of the Bear Elite Hybrid (#3).
❌ Too firm for side sleepers: Unsurprisingly, the firm feel of the Plank means that this mattress won’t suit side sleepers, who need more cushioning at their pressure points for a good night’s sleep. Try the Helix Midnight Luxe (#7) instead.
Where, when and how to buy
You’ll find the Plank Firm mattress for sale on its own website, or through its parent company Brooklyn Bedding. It’s also available on Amazon. You’ll get a 120-night trial, 10-year warranty and free shipping, but do be aware that there’s a $99 return fee.
The Plank Firm has an evergreen discount of between 20 and 25%, although we have seen this jump to 30% during major sales events. Hold out for one of these and you’ll be able to pick up a queen size mattress for $932.40 (MSRP $1,332) — an extremely competitive price for a flippable memory foam mattress.
Plank Firm Mattress: Our expert verdict
The unyielding surface of the Plank Firm Mattress helps keep the spine aligned and prevent the hips from sinking into the mattress, regardless of whether you sleep on your stomach or your back. Combine this with excellent motion isolation, reliable support around the bed's edge and the ability to support heavier bodies and the Plank could be the perfect choice for many firm mattress fans. Read more: Plank Firm mattress review
7. The best mattress for people with back and hip pain


Specifications
Reasons to buy
Reasons to avoid
Quick summary
The WinkBed is our top recommendation for those with hip and back pain, thanks to its its zoned support system, which provides firmer support in the lumbar region and blissful pressure relief at the hips and shoulders.
Like the Saatva Classic (#1), it offers a customizable firmness options to suit every type of sleeper. That includes a Plus option, which boasts a total weight capacity of 900 pounds and is also our top pick in our guide to the best mattresses for heavy people.
Read what we liked, didn't like, test scores, and how to buy it ▼
All WinkBeds also come with the brand’s 3-Step Back Relief System, which aligns the spine and joints, as well as helping to eliminate muscle tension. There’s also a Lumbar Layer for extra support in the middle lumbar region of the mattress, and these two innovations combined help remove back pain successfully.
Our review: in more detail
The choice of four firmness options means that the WinkBed is ideal for anyone who wants to fine-tune their mattress to provide optimum pressure relief to reduced back and hip pain. The Soft version is best suited to lighter bodies and side sleepers, the Luxury Firm is more of an all-rounder, the Firm model is ideal for back and stomach sleepers who need to sleep on top of a mattress rather than sinking into it, and as mentioned, the Plus is designed to provide reliable support for heavier bodies.
All WinkBed models are made with layers of pressure-relieving gel-infused foam and zoned, pocketed coils for targeted support, and the Soft, Luxury Firm and Firm options come with pillow-tops of various thickness. The Plus, meanwhile, has no pillow-top but gains a 2.5" latex layer for extra support, as well as reinforced coils and extra engineered support around the edge of the bed.
Support and comfort: ★★★★
Pressure relief: ★★★★½
Temperature regulation: ★★★★
Motion isolation: ★★★★½
Edge support: ★★★★½
Build quality: ★★★★
Our testers trialed the standard WinkBed, sleeping on the Luxury Firm option. They noted the excellent spinal support from the Back Relief System, which is backed up by the hundreds of WinkBed 5-star customer reviews that praise the mattress for getting rid of back pain. The mattress is rated at 8/10 on the firmness scale, but it is worth noting that sleepers weighing over 300lbs may find the bed a little softer, giving more of a 6/10 feel.
Motion isolation is excellent, but we did feel that really hot sleepers might find the mattress too warm. There is now an option to upgrade to a new cooling cover that WinkBed claim helps you sleep 20% cooler for an additional $125. However, if sleeping hot is your primary concern, we would recommend the the Bear Elite Hybrid at #3.
What we like about it...
✅ Targeted support: The WinkBed has zoned coils for targeted support and both a back relief system and added lumbar support to ensure the spine is kept aligned, with aches and pains smoothed out.
✅ Custom comfort: The WinkBed comes in three firmness options as well as a Plus version that's specifically designed for heavier bodies, which means that all sleepers can be comfortable and supported in all sleeping positions.
✅ Edge-to-edge support: The reinforced perimeter of the WinkBed means that the mattress is secure even when sitting or lying on the very edges.
What we don't like about it...
❌ Average temperature regulation: It’s not the worst mattress for temperature regulation, but some sleepers might find the WinkBed a bit stuffy, which can be a particular problem for heavier bodies. However, there is now an option to upgrade to an optional cooling cover for an additional $125.
❌ Heavy: There’s no white glove delivery option with the WinkBed and this is a heavy mattress that could be taxing to move about. Not great if you’re already experiencing back pain.
When, where and how to buy
WinkBed mattresses are available exclusively from WinkBeds. You can only buy the mattress online, but the brand does have dozens of showrooms located across America where you can try the beds and discuss your requirements with the onsite sleep consultants.
After four years of a steady MSRP, the WinkBed recently increased in price. You can now expect to pay $1,799 (was $2,570) for a queen after a 30% off WinkBed mattress sale. That places it in line with its direct competitor, the Saatva Classic. However, if you go with the Classic, you’ll also get free white glove delivery and old mattress removal.
The Winkbed mattress: Our expert verdict
The WinkBed Plus is the best choice for those with both and hip pain, thanks to its combination of soothing pressure relief and sturdy lumbar support. Its high specs and overall performance gives the Saatva Classic a run for its money and, depending on current discounts, costs roughly the same. Plus, customizable firmness options make it suitable for all sleep styles, including an option for those who weigh over 250lbs. Read more: WinkBed mattress review
8. The best mattress for side sleepers with back pain


Specifications
Reasons to buy
Reasons to avoid
Quick summary
The Helix Midnight Luxe is our overall best mattress for side sleepers, although it will also suit most back sleepers too. Blissful pressure relief combined with enhanced lumbar support means that it’s a winning combination for side sleepers with back pain. The cloud-like pillow top also adds an immediate hit of plushness — perfect for side sleepers who need to ensure that their joints have plenty of cushioning.
Beneath the pillow top cover, the Midnight Luxe is packed with up to 1,000 individually wrapped steel coils, which holds you on top of the mattress. This ensures that your spine is kept in healthy alignment with the rest of your body, which is crucial for keeping back pain at bay. Our lead tester, who experiences recurrent lower back pain, never woke up with any discomfort during the entire seven month testing period.
Read what we liked, didn't like, test scores, and how to buy it ▼
The Helix Midnight Luxe usually has a sale on, with prices reduced by 20-25%, rising to 27% off with our semi-exclusive sale access around major holidays. You can expect to pay around $1,919 for a queen size (MSRP $2,398.75), leaving this mattress still firmly in the premium camp. Still, for side sleepers with back pain, nothing else on our list will give you as much comfort and relief.
Our review: in more detail
Made up of six layers, the Helix Midnight Luxe is a premium mattress with plenty of features to help sleepers with back pain rest easily. Enhanced lumbar support means that sleepers’ spines won’t slip out of alignment, ensuring that any back pain is mitigated. There’s also an option to add a zoned foam top layer for maximum lumbar relief.
Helix Responsive Foam, followed by a layer of Copper Gel Memory Foam provides body contouring support, while holding you on top of the mattress rather than allowing you to sink in. This is an important feature for back pain sufferers, as this helps to keep your spine in correct alignment with the rest of your body.
Zoned lumbar support combined with a cloud-like pillow top cover results in A* comfort for side sleepers
You will get plenty of cushioning from the pillow-top cover, which helps to soothe pressure points around the shoulders, hips and knees. We rated the mattress as a medium feel, but some sleepers did criticize it for being too firm. This is down to the fact that firmness is subjective, although it’s also likely that lightweight side sleepers may find it a little on the firm side.
Although you can’t see or directly feel any of the (up to) 1,000 individually wrapped steel coils, zoned lumbar support to support the spine and a sturdy bed edge means you'll know they’re there. These steel coils come into play again when we tackle the subject of temperature regulation — additional coils mean increased airflow, which means an all-round cooler night.
Support and comfort: ★★★★★
Pressure relief: ★★★★★
Temperature regulation: ★★★★½
Motion isolation: ★★★★½
Edge support: ★★★★
Build quality: ★★★★★
Of course, very hot sleepers will appreciate the option to upgrade to two different cooling upgrade options. However, the Luxe comes with a breathable Tencel cover that feels cool to the touch and kept our lead tester cool and comfortable during testing. Motion isolation is excellent, which will appeal to the restless sleepers out there who share a bed.
For maximum relief from your back pain, consider adding the ErgoAlign upgrade. This is a zoned top layer with ultra-dense foam around the mid-section to support and release pressure from your lumbar region. One of our testers with lower back pain slept on a Midnight Luxe with ErgoAlign for several nights while traveling and noticed that she didn’t develop the usual aches that follow her on the road.
What we like about it...
✅ Superb pressure relief: The premium quilted pillow top provides fantastic pressure relief across the shoulders, hips and knees: exactly where it's needed when side sleeping. Our lead reviewer is prone to hip pain and numb hips when sleeping on her side, but it disappeared when sleeping on the Midnight Luxe.
✅ Enhanced lumbar support: Zoned lumbar support combined with the premium memory foam layers means that you’ll get plenty of support from the Midnight Luxe, with the mattress being ideally suited to both side sleepers and even some back sleepers.
✅ Motion isolation: Another area the Helix Midnight Luxe excels in is motion isolation. If you're a restless sleeper who shares a bed, you'll experience very little motion transfer here.
What we don't like about it...
❌ Stomach sleepers will find it too soft: The Helix Midnight Luxe is an excellent choice for side sleepers and is supportive enough for back sleepers too — but will be too soft for stomach sleepers. If you’re a stomach sleeper with back pain, check out the Saatva (#1) or Winkbed (#6), which both come in adjustable firmness options.
❌ Extra lumbar support costs extra: The Helix Midnight Luxe comes with zoned lumbar support as standard, which does an excellent job of supporting the lumbar while side and back sleeping. But for the ErgoAlign layer of extra dense foam for lower back pain relief costs an extra $248.75 at full MSRP.
When, where and how to buy
Away from major sales events, the Helix always has a 20-25% discount. Historically, the best time to buy the Helix Midnight Luxe has been during the Black Friday sales. During Black Friday and Cyber Monday 2024, our exclusive coupon shaved 27% off, bringing the price of a queen Midnight Luxe to $1,732.53. That beat Helix’s general 25% discount for Black Friday and Cyber Monday. Right now, there's currently 27% off the Midnight Luxe with the code TOMS27 in the Helix Black Friday mattress sales.
However, the best Helix mattress sale in 2024 took place Memorial Day weekend, when we saw a rare 30% off sitewide discount. That dropped the sale price of a queen Midnight Luxe to $1,661 and the lowest price we’d seen all year.
Helix Midnight Luxe Mattress: Our expert verdict
There really isn’t a better mattress for side sleepers with back pain than the Helix Midnight Luxe, with our lead tester crediting it with providing relief from her lower back niggles. How? The plush pillow top layer absorbs pressure around the touch points of the bed, while the up to 1,000 individually wrapped coils hold your spine in healthy alignment. It’s well worth the investment to make bedtime a far more comfortable place. Read more: Helix Midnight Luxe mattress review
Also tested and recommended
The mattresses in this section are the highest performers from all of the other mattresses we've tested over the last several years. Ultimately, they were beaten by our top picks above, but if you haven't found an option you like in our main guide, then these are well worth considering.
DreamCloud Classic Mattress ★★★★
The therapeutic memory foam layers paired with individually wrapped coils makes this budget-friendly hybrid mattress from DreamCloud, deliver excellent pressure relief and support, perfect for soothing back pain. However, our tests revealed that it lost points for motion isolation and edge support. Overall, at $699 for a queen with a lifetime warranty and a year-long sleep trial, the mattress is indeed a great value purchase.
▶Read more: DreamCloud Classic Mattress Review
Brooklyn Bedding Copperflex Pro ★★★★½
With advanced cooling properties that rival some of the best cooling mattresses we’ve tested this year, the Copperflex Pro is another great choice for back sleepers. The medium-firm tension, plush pressure relieving pillow-top and the zoned coil layers for enhanced lumbar support are the highlights, which work together to soothe aches and pains. Plus you can save up to 25% in regular sales, which drops the MSRP of a queen bed from $1,332 to $999 at Brooklyn Bedding.
▶Read more: Brooklyn Bedding Copperflex Pro Mattress Review
Tempur-Pedic Tempur-Adapt Mattress ★★★★
A contouring luxury mattress made with NASA-developed Tempur foam that molds to your body to reduce pain during sleep. Temperature regulation isn’t the best though, with the Tempur foam retaining heat, which is why we recommend the Nectar Premier instead, as it performs slightly stronger in this area. From $1,699 at Tempur-Pedic.
▶Read more: Tempur-Pedic Tempur-Adapt mattress review
Puffy Cloud Mattress ★★★★
The Puffy Cloud is a medium firm all-foam mattress with plenty of firm support that does a great job of reducing back pain and easing pressure points. The mattress doesn’t have the best edge support though and the cover is a little slippery. You'll get $1,350 off all sizes in Puffy's evergreen sale, with pillows and sleep masks included, and a queen will cost you $949 at Puffy.
▶Read more: Puffy Cloud mattress review
Avocado Green Mattress ★★★★½
The Avocado Green mattress is the best organic mattress on the market and its firmer feel is ideal for back sleepers with back pain. However, it’s too firm for side sleepers and there’s not as much cushioning as with many of our options. You can upgrade to a pillow top but that can nearly double the cost. From $1,399 at Avocado.
▶Read more: Avocado Green mattress review
How we test mattresses for back pain
When testing and selecting the best mattresses for back pain, we know that the stakes are high.
After all, the strength of a mattress’s performance (and its suitability to your specific sleep style) will directly impact your pain levels. That’s why our testing and selection process is incredibly thorough, completely editorially independent and never influenced by third parties.
Our mattress review process rigorously evaluates all mattress types, from innerspring, foam, latex, and hybrid, specifically for their suitability for those with back pain. We focus our research and testing on four key areas, with all four areas being critical factor for back health:
Buying a mattress is an investment. So we have created an entire new testing methodology in order to create robust comparison data. Our new testing methodology rates each area of performance out of five. It combines in-depth subjective (tester experience) and objective (data-driven) tests.
How we test for pressure relief


This key area of performance measures comfort, support, and how effectively the mattress maintains healthy spinal alignment — the most crucial element for those with back pain.
Subjective Tests: A lead tester sleeps on the mattress for at least three weeks, reporting on whether their back pain improved, worsened, or stayed the same, noting if pressure points felt adequately cushioned.
Objective Tests: In the lab, a tester lies in each three sleep positions; stomach, back and side. We use a laser to align with their spine. After 10 minutes, we check for misalignment; any significant sinking suggests poor support for spinal health.
We use laser-guided measurement with 10kg and 25kg weights. By measuring the precise indentation depth when weights are placed on the surface, we quantify how much heavier body parts (like hips or shoulders) will sink. This sinkage depth determines how well the mattress resists contouring to maintain a level, supportive plane for the spine.
How we test for motion isolation
Our motion isolation tests measure how well a mattress dampens movement. This is an important area of performance for those with back pain, as being jolted awake by a partner's movement can a) exacerbate back pain b) interrupt your sleep, which is crucial for healing.
Subjective Tests: Our testing panel conduct a series of movements on the mattress — ranging from minimal, moderate and considerable — while another tester notes the level of impact of this movement has.
Objective Tests: We drop a heavy slam ball onto the mattress with an accelerometer. The device records the Initial Impact Absorption (IIA) and the Motion Dampening Speed (MDS) — how quickly vibrations stop.
How we test for edge support

Edge support is a term to describe how sturdy the perimeter of a mattress is. As well as enabling you to sleep right up to the edge of a mattress, robust edge support means you are able to safely sit before standing up (which, if your back pain is severe, you might need to do). We test for edge support in the following ways:
Subjective Tests: Testers sit on the edge to assess stability and security when getting up and down.
Objective Tests: We perform a weight test by placing a 25kg weight along the perimeter and recording how far it sinks. Minimal sinkage indicates stronger, safer edges. We also perform a roll off test, measing the exact moment a mattress no longer supportive for sleeping.
How we test for temperature regulation


As several members of our testing panel experience back pain, we know all too well that restless sleep due to overheating can exacerbate back pain. Our temperature regulation tests measures how well the mattress prevents heat retention while you sleep in the following ways:
Subjective Tests: Our lead testers sleep on the mattress for a three week period, noting its overall temperature regulating performance, as well as highlighting an external factors that could influence this performance (season, bedding type, illness, etc.)
Objective Tests: We ensure our lab is cooled/heated to 55-70°F (which is the ideal temperature for sleeping.) Using a thermal imaging camera, testers record their thermal impression upon lying down on the mattress at 5, 10, and 15-minute intervals. We measure how much the mattress absorbs and retains a tester’s body heat over 15 minutes, and how quickly it dissipates that heat for the following fifteen minutes after the tester leaves gets off of the mattress. This temperature is measured at five key points on the mattress.
Frequently asked questions
What type of mattress is best for back pain — we asked the experts
Ask almost any expert what’s the best mattress for back pain and they’ll say the same thing: there’s no one-size-fits-all solution.
And we can say that with confidence, because we did actually ask the experts.
“Simply put, there is no one best type of mattress for lower back pain, just the best one for you,” says Dr. Ben Carvosso, owner of MP Nutrition, a chiropractor and host of RPPFMs Health Matters. “The best mattress for back pain generally combines support and pressure relief.”
“A person’s mattress needs to be supportive, and that doesn’t always mean firm or soft,” says Dr. Kevin Lees, the Director of Chiropractic Operations at The Joint Chiropractic.
“The important thing is to have a mattress built for restorative sleep - one that provides comfort and coolness," advises Dr. Allison Brager, neuroscientist and sleep specialist for Molecule.
Dr. Brager also has advise on recognizing when your mattress is causing your back pain. "Beyond just the origin of the pain, your entire posterior chain will feel stiff and your back muscles will feel as if they’ve been working out while sleeping," she says. "You can have soreness and stiffness down the spine as well as the hips and just above the hips near your tailbone. Usually, the latter two are a telltale sign it’s time for a new mattress."
How to choose a mattress for lower back pain
Lower back pain is one of the most common types of back pain and in our experience, a too-soft mattress can both cause and heighten lower back pain.
The body sinks into a soft mattress at different levels. The hips, typically among the heaviest parts of the body, will often press further into the mattress than other parts of the spine.
In addition, the lower back — also known as the lumbar region — has a greater range of movement than the rest of the body.
When these two factors come together the result is often excessive twisting or curving of the lower back. And that unnatural positioning results in pain.
“In my practice, I’ve observed that mattresses offering a balance of support and cushioning help maintain proper spinal alignment and alleviate lower back discomfort,” says Dr. Carvosso. “Memory foam and hybrid mattresses are popular choices for their contouring properties and support.”
“Back sleepers with lower back pain typically prefer a firm mattress and may benefit from placing a pillow under their knees to reduce stress on their lower back,” explains Dr. Lees, who adds that side sleepers with lower back pain will benefit from a firm mattress with a pillow top in order to allow cushioning across the shoulders, hips and knees.
Is a soft or firm mattress better for back pain?
Firm mattresses are often touted as the best type of mattress for those with back pain but that blanket advice is misplaced. “The necessary level of firmness of the mattress should be determined by the person using it”, says Dr. Bestsy Grunch, a board-certified neurosurgeon with a specialist in minimally invasive spinal surgery. “That may vary based on their body habits and sleep position.”
“The most important factor is not necessarily the level of firmness, but rather the alignment of the spine during sleep to help achieve a solid night of rest with minimal interruptions due to discomfort and arousal during the night,” explains Dr. Grunch. ”For most people, a moderate to firm level of mattress is satisfactory to this mission.”
We rate mattress firmness on a scale of one to 10, with one indicating incredibly soft and 10 rock hard. The best medium-firm mattresses fall around the middle of this scale.
"I don’t want people to think that a firm mattress is the absolute all or nothing solution. A medium-firm mattress is wonderful too," agrees Dr. Brager. "But everyone is different."
“Typically, avoid soft mattresses, they don’t offer the level of support needed,” explains Dr. Carvasso. But there’s a ‘but’: “if you are a very lightweight sleeper, you may be the exception. Those with small frames and are lightweight benefit from the cushioning of a softer mattress. A medium or firm wouldn’t have enough 'give'.”
How to choose a mattress for back pain and your sleep position
Your sleeping position (the one you drop off in) is a major consideration when choosing a mattress for back pain. Dr. Brager says it's essential to rest in a position where you are the most comfortable — although her recommendation for most individuals with back pain is side sleeping.
Side sleepers typically benefit from a mattress with added cushioning, as firm beds can cause pressure build-up at the hips and knees. So even if the firm bed relieves your lower back pain, you might start aching in new places.
But back and stomach sleepers with lumbar pain should opt for something on the firmer end of medium-firm. "A very soft mattress would be uncomfortable for a stomach sleeping position or back sleeping position, and would very likely cause pain and discomfort,” advises Dr. Brager.
"Experiment with sleeping positions and be 'body aware',” she says. "If you wake up with back pain, ask yourself what position you slept in and try something new the next night to see if the result is different."
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Nicola is the Sleep Editor at Tom’s Guide, where she helps steer the mattress and sleep content published on Tom’s Guide, including our Best Mattress for Back Pain buying guide. With a career in journalism spanning the best part of two decades, Nicola brings experience to the team and the knowledge of what makes a great article, whether that’s a how-to mattress cleaning feature, a deep dive into melatonin gummies, or an in-depth mattress review. As a sleep editor, few better understand how important a decent mattress is to the overall quality of our sleep, and precisely how our sleep impacts our physical and mental health. As well as tackling the vast topic of sleep, Nicola joins the raft of expert mattress specialists at Tom’s Guide, who test and compare a wide range of mattresses in order to guide readers towards the very best options on the market.





