What's the Best Mattresses for Back Pain

80% Experience Back Pain

Eight out of ten people will experience back pain at some point in their lives1. This can range from a dull, constant ache to chronic debilitating pain. Since we spend approximately one-third of our days in bed, our choice of mattress can have a huge impact on whether this pain continues or improves.

Research has shown that simply getting a new mattress can help improve sleep quality and reduce back discomfort2. However, the type of mattress you choose also plays an important role. There are two main characteristics to look for when choosing the best mattress for both back support and sleep comfort – firmness and the physical components of the mattress.

Pain and mattress types


For years, doctors have recommended hard beds for people with lower-back pain, but a 2003 study showed that this type of mattress might just add to people's misery. During this study, Spanish researchers replaced the mattresses of 313 patients who had a history of unexplained chronic lower back pain with a new "firm" or "medium-firm" mattress, without telling them which mattress type they received3. The patients were then asked to rate their lower back pain on a scale from one to 10 when they woke up and again 30 minutes after getting out of bed. About 82% of patients who slept on the medium-firm mattresses said their pain had improved compared to 68% of those sleeping on firm mattresses.

According to experts, medium-firm mattresses better adapt to the natural curvatures of the spine. This leads to better pressure distribution when lying in bed, resulting in less pain while lying down or after getting up. In fact, this type of medium-firm support has been shown to reduce back pain by 57.2%, shoulder pain by 60.8%, and back stiffness by 59.1%, improving quality of sleep by 60.7%4.

Mattress firmness and pain relief

Physical Components

Traditional innerspring mattresses provide support using hard metal coils interspersed throughout a wood-framed structure. This method does not allow weight to be distributed evenly and causes pressure points to develop where contact is made between the springs and body. As time goes by, the springs may also become stiff or loose, causing the body to be supported unevenly.

As a result the spine can be drawn out of alignment – one of the most common causes of back pain. Other medical conditions, such as herniated disks, osteoarthritis, degenerative disk disease and spinal stenosis are inflamed when the body is not supported properly.

A better alternative is a memory foam mattress – especially if coupled with an adjustable bed frame – as it helps evenly distribute body weight, completely eliminating pressure points. Memory foam also doesn’t sag or weaken in ways that can contribute to poor spinal alignment.

Proper support for your spine

For people with back pain, sleeping on a memory foam mattresses may be the best option for relief and a restful night's sleep. Scientific research has found that people with lower back pain have more disturbed, less restful and less refreshing sleep than people without back problems5,6. This leads to a vicious cycle since the pain interferes with sleep, but disturbances in sleep also contribute to the experience of pain7. However, foam mattresses have been shown to significantly reduce periods of unstable sleep compared to traditional spring mattresses8, making them the best choice for promoting deep, healing sleep.

Sleeping on a memory foam mattress reduces back pain, resulting in more restful sleep.

What to Watch Out For

One important aspect to consider when comparing mattress warranties is sagging. Many innerspring and foam mattress warranties only cover sagging over 1.5" deep, whereas Amerisleep mattresses are warranted against sagging over 0.75". This is important because comfort is often affected before sagging reaches a depth of 1.5”.

The greater a mattress's sagging depth, the more likely it is that discomfort or pain will occur, especially when sagging reaches over one inch.
Mattress sagging depth and pain

memory foam vs. innerspring comparison

Memory Foam
Above Average
Average - Above Average
Good - Excellent
Good - Fair
Good - Excellent
Good - Fair


1Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl. 1985;11:1-98.

2Jacobson BH, Boolani A, Smith DB. Changes in back pain, sleep quality, and perceived stress after introduction of new bedding systems. J Chiropr Med. 2009;8(1):1-8.

3Kovacs FM, Abraira V, Pena A, et al. Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial. Lancet. 2003;362:1599-1604.

4Jacobson BH, Gemmell HA, Hayes BM, Altena TS. Effectiveness of a selected bedding system on quality of sleep, low back pain, shoulder pain, and spine stiffness. J Manipulative Physiol Ther. 2002;25:88-92.

5Cesta A, Moldofsky H, Lue FA, et al. Sleep and musculoskeletal pain in workers following a soft tissue injury. Sleep. 1998;21:289.

6Hartman K, Pivik RT. Sleep, Variations in motor and EEG activities in chronic low back pain subjects: relationship to sleep quality. Sleep Res. 1995;24:393.

7Moldofsky H. Sleep and pain. Sleep Med Rev. 2001;5(5):385-396.

8Scharf MB, Stover R, McDannold M, Kaye H, Berkowitz DV. Comparative effects of sleep on a standard mattress to an experimental foam surface on sleep architecture and CAP rates. Sleep. 1997;20(12):1197-1200.

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