Sleeping 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 low back pain.

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.

See Mattresses and Sleep Positions for Each Back Pain Diagnosis

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:

  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.

    Read more: Chronic Pain and Insomnia: Breaking the Cycle

  1. 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.

    See Mattress Guidelines for Sleep Comfort

  2. 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.

    Read more about Posture to Straighten Your Back

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  1. 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.
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  1. 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.

Dr. J. Talbot Sellers is a physiatrist specializing in the diagnosis, treatment, and management of spine pain at NeuroSpine Center of Wisconsin. He has decades of experience using physical therapy, rehabilitation, and injections to treat painful musculoskeletal conditions.

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