Choosing the Best Mattress for Lower Back Pain

Sleeping [4] on the wrong mattress can cause or worsen lower back pain.  Lack of support from a mattress reinforces poor sleeping posture, strains muscles and does not help keep the spine in alignment, all of which contribute to lower back pain [5].

Sleep comfort is also sacrificed if a mattress does not match one's individual preferences. A mattress that provides both comfort and back support helps reduce low back pain, allowing the structures in the spine to really rest and rejuvenate during the night.

With the vast variety of mattresses on the market, choosing the right mattress can be difficult. The following practical guidelines are designed to help patients with low back pain choose the best mattress for both back support and sleep comfort.

The Best Mattress for Low Back Pain

1. Personal preference should ultimately determine what mattress is best. There is no single mattress style or type that works for all people with low back pain. Any mattress that helps someone sleep without pain and stiffness is the best mattress for that individual. Patients with low back pain should choose the mattress that meets their standards for comfort and support and allows them to get a good night’s sleep.
2. Understand and inquire about the physical components of the mattress. The coils or inner springs of a mattress provide the support. Different mattresses vary in their number and arrangement of coils. Padding on top of the mattress comes in many different thicknesses. Mattress depths typically range anywhere from 7 to 18 inches deep. Choosing the number of coils, type of padding and mattress depth should be determined by individual preferences.
3. Find a mattress with back support. A good mattress should provide support for the natural curves and alignment of the spine. The right amount of back support also helps the patient avoid muscle soreness in the morning. While there is not much clinical data about mattresses, one study found that medium-firm mattresses usually provide more back pain relief than firm mattresses.
4. Achieve a balance between back support and comfort. Overall comfort while sleeping on the mattress is equally important as sufficient back support. Sleeping on a mattress that is too firm can cause aches and pains on pressure points. A medium-firm mattress may be more comfortable because it allows the shoulder and hips to sink in slightly. Patients who want a firmer mattress for back support can get one with thicker padding for greater comfort.
5. Know when it’s time to get a new mattress. If an old mattress sags visibly in the middle or is no longer comfortable, it is probably time to purchase a new one. Putting boards under a sagging mattress to keep it from sagging in the middle is only a short-term fix for the sagging; a new mattress is still needed.
6. Shop for the best value and quality of the mattress rather than for price. Mattresses with more coils and thicker padding tend to be higher quality and also more expensive; however, a higher price does not guarantee that the mattress is more comfortable or more supportive. Mattress stores often have sales and promotions, so it is a good idea to comparison-shop for the best price after finding the right mattress.
7. Be aware of mattress advertising gimmicks. Claims that a mattress is “orthopedic” or “medically-approved” should be viewed skeptically. There has not been extensive medical research or controlled clinical trials on the topic of mattresses and low back pain. The individual must determine whether or not extra features on a mattress make it more comfortable or supportive.
8. Give the mattress a test-run before buying. To sample mattresses, people can try sleeping on different makes and models in hotels or at other people’s homes before going to a mattress store. When shopping at the store, shoppers should lay on the mattress for several minutes to decide if it is a good fit. If two people will be sleeping on the mattress, both should test it at the same time to make sure they have enough space and are both comfortable on the same style of mattress.
9. Purchase mattresses from stores and companies that are trustworthy. Consider the customer service offered by the mattress store, such as delivery options, warranty, and removal of old mattresses and the store’s return policy. Look for mattress stores where customers can return a mattress if they are not satisfied with the quality or comfort after sleeping on it for a significant amount of time (i.e. a couple of weeks to a month).

To help preserve the quality of a new mattress, it should be repositioned every six months to ensure that the mattress is evenly worn. This includes rotating 180 degrees and flipping the mattress lengthwise on a regular basis. The Better Sleep Council advises against putting a mattress on a box spring/foundation that is not made to go with the mattress, as this may decrease the life of the new mattress (1).

[9]

• J. Talbot Sellers, DO [10]

May 7, 2008