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There are few things more frustrating than getting into bed after a long day, only to spend the next few hours tossing and turning trying to find a comfortable position. And if you regularly deal with back pain, getting a good night’s sleep can feel even more difficult. While your mattress might not be the first thing you blame for those aches and pains, it might be playing a bigger role than you realise. So, if you're struggling to get comfortable at night, replacing your mattress might be a good place to start.
But with so many mattress types and firmness levels to choose from, knowing where to start can be tricky, while choosing the wrong one can even make back pain worse.
With this in mind, I spoke to spine surgeon Dr. Edward Scheid to find out what to look for in a mattress for back pain, from firmness and materials to common buying mistakes.
Read more: Should you buy a new mattress or use a mattress topper?
What should you look for in a mattress for back pain?
When choosing a mattress for back pain, spinal alignment should be one of your biggest considerations. Dr. Scheid explains that the spine has a natural S-shape, and the aim while sleeping should be to maintain this natural curve, much as you would when standing with good posture.
A mattress that’s too soft can allow your hips and pelvis to sink, causing the spine to sag. On the other hand, a mattress that’s too firm can leave a gap beneath the lumbar region and create pressure around the hips and shoulders.
“That means the muscles and ligaments around your spine stay tense all night,” Dr. Scheid says. One sign that your mattress may not be providing the right support is waking up feeling stiffer than you did before going to bed.
What is the best mattress firmness for back pain?
If you’re wondering whether a firm or soft mattress is better for back pain, there’s no need to automatically opt for the hardest mattress you can find. According to Dr. Scheid, medium-firm mattresses provide the best support for most people, with research supporting this approach.
“Unfortunately, many people still follow the outdated advice that the firmer it is, the better it is,” he says. “But firmness and support aren’t the same.”
A mattress can have a softer comfort layer while still providing the support needed to keep the spine in a neutral position. Your body weight and sleeping position should also factor into your choice. Side sleepers and lighter people may benefit from more give around the shoulders and hips, and heavier sleepers need stronger support to prevent the mattress from sagging.
Dr. Scheid adds that a mattress that’s too firm can leave the lower back without adequate support beneath the lumbar region, meaning the muscles have to work throughout the night rather than properly recovering.
What type of mattress is best for back pain?
The materials used in a mattress can also affect how it supports your body. Dr. Scheid says memory foam and latex can be good options because they contour to the body and distribute weight more evenly, helping to reduce pressure points.
A hybrid mattress could also be worth considering if you don’t want to choose between foam and traditional spring support. These mattresses can combine contouring materials with a coil core, which can provide additional support.
However, Dr. Scheid says the material itself isn’t necessarily the most important factor. “Material is less important than whether the mattress keeps your spine neutral,” he explains.
He recommends lying on a mattress for around 10 to 15 minutes in your usual sleeping position and paying attention to whether your spine feels level. This can be a useful way to work out whether a mattress is actually providing the support you need before committing to it.
Read more: How to choose the right mattress type for you
What mattress mistakes should people with back pain avoid?
Poor spinal alignment overnight is something people with back pain should be mindful of when choosing a mattress. Dr. Scheid explains that spending around eight hours a night on a mattress that isn’t properly supporting your spine can contribute to existing pain becoming worse.
“Years of poor overnight alignment put a sustained and uneven load on your spine,” he says. While a mattress alone won’t cause degeneration, Dr. Scheid says he sees many patients whose daily pain has worsened because they are sleeping on a mattress that is “fighting their spine rather than supporting it.”
In other words, rather than focusing solely on how a mattress feels when you first lie down, it’s important to consider whether it is keeping your spine properly aligned and supported throughout the night.
How can you make your mattress more comfortable for back pain?
Buying a new mattress can be a big purchase, so if you’re not in a position to replace your mattress just yet, there are some simple changes that could help improve your sleeping position.
For side sleepers, Dr. Scheid recommends placing a pillow between the knees. This can help with hip alignment and keep the lower back in a more neutral position while you sleep.
Ultimately, though, if you’re consistently waking up with more back pain or stiffness than you had when you went to bed, it may be worth reassessing whether your mattress is providing the support your body needs.
Read more: Best pillows, reviewed
Best mattresses for back pain
Nectar premier hybrid mattress
Ranked as the best hybrid option in our review of the best mattresses, the Nectar premier hybrid mattress “ticks a lot of boxes”, wrote reviewer Sarah Michael. It could be a good option for back pain as Dr. Scheid notes hybrid mattresses can “combine contouring materials with a coil core”, which can give you additional support.
In her review, Michael added: “The combination of memory foam and micro-springs gives you a sink-in feeling that bounces back and stays sturdy and supportive night after night.”
Buy now £699, Nectarsleep.co.uk
Dusk memory foam 2000 pocket sprung hybrid mattress
A memory foam mattress could be a good choice for reducing back pain, because of how they contour to the body and distribute weight more evenly. And for a budget-friendly option, this Dusk’s hybrid mattress “pleasantly surprised” reviewer Lucy Smith. She wrote: “After two years of testing, it remains consistently comfortable and has retained shape with no sagging (I measured, and it is still 25cm deep, which is the same as when it arrived). It’s truly the best budget mattress I’ve tried.”
Buy now £269, Dusk.com
Sleepeezee regency kew
For a firm option, IndyBest’s mattress expert Sarah Jones recommends the Sleepeezee regency kew. After reviewing, she wrote that the “pocket-sprung core prevents any sinking-in feeling that softer beds sometimes give,” while still softening pressure on the shoulders and hips thanks to the comfort layers on top. She added, crucially, that she noticed she woke up with less lower-back stiffness after using this mattress.
Buy now £1699, Dreams.co.uk
Meet the expert
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