The best mattress for back pain 2025: 8 expert-tested picks to help you sleep comfortably

The Saatva Classic photographed on a white wooden bedframe in a blue bedroom surrounded by tall green house plants and a bookcase shelving unit containing pillows, blankets and books
(Image credit: Future)

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.

Recent updates

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

Simply the best mattress for those with general aches and pains

Specifications

Type: Innerspring hybrid
Firmness (feel): Plush, Luxury Firm. Firm
Height: 11.5" and 14.5"
Trial: 365 nights
Warranty: Lifetime
Price bracket: Premium
Materials: Recycled steel, CertiPUR-US certified foams, cotton

Reasons to buy

+
Instantly comfy – no break-in period
+
Eases aches and pains
+
Excellent lower back support
+
Breathable (hot sleeper friendly)
+
Supportive right to the edges
+
Excellent build quality

Reasons to avoid

-
600lbs max weight capacity
-
$99 fee to exchange or return

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.

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

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2. The best budget mattress for back pain

Phenomenal lumbar support for under $400 for a queen

Specifications

Type: All foam
Firmness (feel): 8.5"
Height: 10"
Trial: 180 nights
Warranty: 10 years
Price bracket: Budget
Materials: CertiPUR-US certified foams and breathable fabric

Reasons to buy

+
Excellent value – a queen costs $359
+
Fantastic edge support
+
Isolates motion well
+
Feels cool considering it's all foam

Reasons to avoid

-
Very firm feel with minimal 'hug'
-
Side sleeping testers found it too hard

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.)

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.

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3. The best cooling mattress for back pain

A specialist cooling mattress with a zoned coil system for targeted lumbar support

Specifications

Type: Hybrid
Firmness (feel): Soft, Medium, Firm
Height: 14"
Trial: 120 nights
Warranty: Lifetime
Price bracket: Premium
Materials: Copper-infused memory foam, foam, coils, phase-change material (cover), Celliant fibers (upgraded cover)

Reasons to buy

+
Stays cool all night
+
Comes in three firmness levels
+
Isolates motion well
+
Comes with a lifetime warranty

Reasons to avoid

-
Edges could be more sturdy
-
Celliant cooling cover costs extra

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.

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.

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4. The best mattress for chronic back pain

Our top recommendation for chronic back pain — eases persistent back and joint pain while surrounding you with luxury

Specifications

Type: Hybrid innerspring
Firmness (feel): 3-4 (we rate it a 7.5)
Height: 15"
Trial: 365 nights
Warranty: Lifetime
Price bracket: Luxury
Materials: High-density foam, micro-coils, coils

Reasons to buy

+
Dedicated lumbar support
+
Excellent pressure relief
+
Good for hot sleepers
+
1-year trial plus lifetime warranty

Reasons to avoid

-
Could feel firmer than expected
-
No way to customize it

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.

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

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5. The best memory foam mattress for back pain

Cushioned back support that's ideal for co-sleepers

Specifications

Type: Memory foam
Firmness (feel): Medium-firm
Height: 13 inches
Trial: 365 nights
Warranty: Lifetime
Price bracket: Mid-range
Materials: Memory foam, other foams

Reasons to buy

+
Comforting body-hug feel
+
Full-body pressure relief
+
Isolates motion for peaceful sleep

Reasons to avoid

-
Sleeps warmer than other mattresses
-
Slight weakness at the sides

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.

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

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6. The best firm mattress for back pain

This dual-sided bed is ideal for firm mattress fans seeking sturdy back support

Specifications

Type: Memory foam
Firmness (feel): 8 and 10 (flippable)
Height: 10"
Trial: 120 nights
Warranty: 10 years
Price bracket: Mid-range
Materials: High-density foam, comfort foam

Reasons to buy

+
Dual-sided design
+
Fantastic motion isolation
+
950lbs weight capacity

Reasons to avoid

-
Retains heat
-
Costs $99 to return

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.

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

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7. The best mattress for people with back and hip pain

A balance of firm support for the lumbar and blissful pressure relief along the hips

Specifications

Type: Hybrid
Firmness (feel): 4.5, 6.5, 7.5 or 8
Height: 13.5"
Trial: 120 nights
Warranty: Lifetime
Price bracket: Upper-mid / Premium
Materials: Pillow top, foam, coils

Reasons to buy

+
Four firmness levels
+
Dedicated back support system
+
Superb edge support

Reasons to avoid

-
$49 returns fee
-
Temp regulation could be better

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.

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

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8. The best mattress for side sleepers with back pain

Side sleeper with back pain? This is the mattress for you

Specifications

Type: Hybrid
Firmness (feel): 5-6 (we rate it a 6)
Height: 13.5"
Trial: 120 nights
Warranty: Limited lifetime
Price bracket: Upper mid-range
Materials: Memory foam, other foams, coils

Reasons to buy

+
Pressure relief for side sleepers
+
Supportive for back sleepers, too 
+
Strong motion isolation 

Reasons to avoid

-
One firmness option

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.

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

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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 MattressRead more:

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 Read more:

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-AdaptMattress

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 Read more:

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 Read more:

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

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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

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(Image credit: Future)

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.

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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."

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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.

Helix midnight elite mattress

(Image credit: Future at 3Z Brands Studios)

“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.

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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.”

A woman wearing blue and white stripy pyjamas lays on her side on the Helix Midnight Luxe mattress

(Image credit: Future)

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 Appleton
Sleep Editor

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.