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The right mattress can help ease back pain and aid in muscle recovery. The wrong one can exacerbate pain or even be the source of back discomfort.
The best mattress for back pain depends on your sleep position and body type. Back and stomach sleepers typically require a medium firm to firm mattress with minimal contouring. Side sleepers, on the other hand, often need a plusher surface to ease tension on the hips and shoulders.
We’ll discuss our picks for the best mattresses for back pain, as well as how mattress type and firmness play a role in back conditions. We’ll also share general tips for reducing back pain when sleeping.
The Sleep Doctor's Picks
How to Buy a Mattress for Back Pain Video
Watch our in-depth video for guidance on how to find the best mattress for back pain.
Best Overall
SpineAlign Luxury Hybrid
Details
Type: Hybrid
Firmness: Soft (3), Medium (5), Firm (7)
Sizes: Twin, Twin XL, Full, Queen, King, California King, Split King
Price Range: $1,249 – $2,250
Warranty: 10 Year, Limited
Highlights
- Cooling infusions and phase change material engineered to regulate temperature
- Foam layers adapt to the body to relieve pressure
- Reinforced perimeter strengthens the edges
Ideal For
- Hot sleepers who like the feeling of foam
- People with sharp pressure points
- Couples who prioritize motion isolation
Sleepers with back pain often benefit from a mattress with a balance of cushioning for the spine and robust support. The SpineAlign Luxury Hybrid is a quintessential hybrid that offers even contouring for pressure points while a coil system keeps the body on an even plane. You can also choose between three firmness levels to fit your unique sleep needs.
The Luxury Hybrid’s comfort system begins with a layer of polyfoam that adds surface cushioning. This layer is infused with copper, which is meant to conduct and dissipate heat away from the surface to keep you cool. Next is a thicker layer of polyfoam that enhances pressure relief, while a gel infusion designed for cooling. A memory foam transitional layer acts as a buffer between your body and the support core.
Pocketed coils reinforce the sleep surface to prevent your body from sinking too deeply. You can comfortably lie or sit near the edges of the mattress thanks to a sturdy perimeter reinforcement. The cover is infused with phase change material, which is engineered to react to your body heat and regulate the surface temperature throughout the night.
Our testers had differing opinions on the Luxury Hybrid depending on the firmness level. The mattress comes in soft (3), medium (5), and firm (7) feels, so most of our team found a comfortable model. Our side sleepers weighing less than 130 pounds enjoyed the softest model’s plush cushioning. The medium model saw its highest ratings from side sleepers up to 230 pounds and back sleepers weighing less than 130 pounds. The firmest model’s supportive feel best suited our side sleepers weighing more than 230 pounds, as well as back and stomach sleepers between 130 and 230 pounds.
Compared to many other mattresses with foam layers we’ve tested, the Luxury Hybrid performed quite well in our temperature control tests. This is largely due to steady airflow through the coils and the phase change material cover. We also recommend this mattress for couples who prioritize motion isolation. The foam layers absorb a good amount of motion transfer, so you and your partner should notice fewer nightly disturbances.
SpineAlign offers free shipping to customers living in the contiguous U.S., as well as a 120-night sleep trial that allows you to return the mattress anytime after the 30-night break-in period. The Luxury Hybrid is backed by a 10-year warranty against structural defects.
“The SpineAlign Luxury Hybrid’s balanced feel made it a great choice for our testers with sharp pressure points along the spine. Three firmness levels also make this mattress appealing to many different sleeper types.”
Best Value
Level Sleep Mattress
Details
Type: Foam
Firmness: Soft (3), Medium (5), Firm (7)
Sizes: Twin, Twin XL, Full, Queen, King, California King
Price Range: $799 – $1399
Warranty: Lifetime, Limited
Highlights
- Zoned comfort system offers targeted pressure relief
- All-foam design cuts down on motion transfer
- 365-night sleep trial
Ideal For
- Side sleepers
- Those with sharp pressure points
- People who share the bed with a restless sleep partner
The Level Sleep Mattress offers great pressure relief for the upper and lower back at an affordable price. Three firmness zones, as well as a 365-night sleep trial and lifetime warranty, make this a deal you don’t want to miss.
A layer of polyfoam begins the comfort system, offering gentle cushioning for sore spots. Underneath is a thicker layer of Energex foam that’s divided into three zones with different feels: soft (3), medium (5), and firm (7). The soft feel is zoned near the head of the mattress to reduce pressure in the shoulders. The firmer feel reinforces your midsection to prevent sinkage, while the medium feel offers balanced cushioning and support for your hips and legs. High-density polyfoam in the support core reduces sinkage and keeps your body on an even plane. A polyester-nylon blend cover encases the mattress.
Our testing found the Level Sleep Mattress best suited for side sleepers, particularly those between 130 and 230 pounds. Sleepers in this category should enjoy cushioning for sore spots. Back and stomach sleepers weighing less than 130 pounds may also feel comfortable. The all-foam construction also makes the mattress an excellent choice for couples who value motion isolation. We noticed little-to-no motion transfer when we moved across the mattress.
Level Sleep offers free shipping to the contiguous U.S. and a generous year-long sleep trial. The company backs the mattress with lifetime warranty against structural defects.
“The Level Sleep Mattress is a high-value model at a competitive price-point. Our team enjoyed the strategic firmness zoning, helping reduce sinkage while cushioning pressure points.”
Best Luxury
Loom & Leaf
Details
Type: Foam
Firmness: Medium Firm (6), Firm (8)
Sizes: Twin, Twin XL, Full, Queen, King, California King, Split King, Split California King
Price Range: $1,195 – $3,150
Warranty: Lifetime, Limited
Highlights
- All-foam design reinforced with dense transitional and support layers
- Two firmness options
- 365-night sleep trial
Ideal For
- Couples
- Hot sleepers
- Shoppers who would like their mattress set up for them
The Loom & Leaf by Saatva is a thoughtfully constructed all-foam mattress well suited to people with back pain. The top memory foam comfort layer features extra cushioning around the lumbar region to prevent sinkage and alleviate discomfort in the lower back and hips. A second memory foam layer along with high-density polyfoam transitional and base layers provide additional conforming while stabilizing the mattress and keeping your body on an even plane.
Saatva offers two firmness options for the Loom & Leaf. Side and back sleepers weighing up to 230 pounds should receive sufficient support from the medium firm (6) model, while the firm (8) feel is the better choice for people who weigh more than 230 pounds — especially those who sleep on their back or stomach. The Loom & Leaf’s all-foam design also excels at motion isolation, making the mattress a good pick for couples. Durability is another strength, as the dense foam layers resist impressions, indentations, and other types of wear and tear that often affect all-foam mattresses.
All Loom & Leaf orders within the contiguous U.S. qualify for free White Glove delivery. After scheduling a delivery date and time with you, White Glove couriers will assemble the mattress in a room of your choice and haul away your old mattress and box spring upon request. This service normally starts at around $100. You’ll also receive a 365-night sleep trial and lifetime warranty with your purchase.
“I really enjoyed the Loom & Leaf's thoughtful construction and extra cushioning for the lower back. The mattress offered relief for my sore spots while the firmer-than-average feel prevented me from sinking too deeply.”
Most Comfortable
Helix Midnight Luxe
Details
Type: Hybrid
Firmness: Medium Firm (6)
Sizes: Twin, Twin XL, Full, Queen, King, California King
Price Range: $1,199 – $2,499
Warranty: 15 Year, Limited
Highlights
- Euro-top with two memory foam layers creates a luxuriously plush surface
- Zoned coils reinforce the midsection to keep body on an even plane
- Coils promote strong airflow
Ideal For
- Sleepers who experience painful pressure buildup
- People who sleep hot
- Side sleepers between 130 and 230 pounds
Helix Sleep’s mattress lineup includes more than a dozen models, all of which are specifically designed for certain types of sleepers. We’ve tested every Helix Sleep mattress, and the Midnight Luxe is one of the company’s most balanced models. Although it is designed for side sleepers weighing 130 to 230 pounds, the medium firm (6) feel and Euro-top cushioning makes the Midnight Luxe an appealing option for many back and stomach sleepers as well.
Two layers of memory foam over a polyfoam transitional layer make the surface feel invitingly plush, but deep sinkage shouldn’t be an issue for most people. The coil system provides extra reinforcement thanks to a zoned design with extra support for the torso and hips, which are areas of the body where people tend to carry a disproportionate amount of weight. The coils are also sturdier along the perimeter to make you feel secure when sleeping near the edges or getting in and out of bed. Steady airflow through the coils and a breathable, moisture-wicking cover make the Midnight Luxe an excellent choice for hot sleepers, as well.
As popular as the Midnight Luxe was with our testing team, this mattress might feel too soft or too firm for you. We encourage all readers to complete Helix Sleep’s online questionnaire, which narrows down the best mattress options based on body type, sleep position, and personal preferences.
The Helix Midnight Luxe comes with a 100-night sleep trial and 15-year manufacturer’s warranty. Shipping is free of charge to customers in all 50 states.
“The Helix Midnight Luxe's adaptive foam layers are great for relieving pressure points. Our testers who tend to sleep on their side felt little to no pressure buildup in their shoulders and hips.”
Best Extra-Firm
Plank Firm
Details
Type: Foam
Firmness: Firm (7), Extra Firm (9)
Sizes: Twin, Twin XL, Full, Queen, King, California King, Split California King, Short Full, Short Queen, Olympic Queen, Short King, RV King
Price Range: $699 – $1,499
Warranty: 10 Year, Limited
Highlights
- Exceptionally supportive on each side
- Phase change material promotes cooling
- Reversible design offers versatile firmness options
Ideal For
- Back and stomach sleepers over 230 pounds
- Hot sleepers
- Shoppers on a budget
Back and stomach sleepers who weigh more than 230 pounds need extra reinforcement from their mattress compared with other sleeper types. The Plank Firm by Brooklyn Bedding is one of the firmest mattresses we’ve tested in our lab. This flippable all-foam model features two sleep surfaces: one that’s firm (7) and another that’s extra firm (9). Those who prefer light cushioning will probably prefer the firm side, while the extra firm surface is ideal for anyone who needs enhanced support and little to no contouring.
A shared support core of high-density polyfoam rests in the middle of the mattress between both comfort systems. At 70 pounds in a queen size, the Plank Firm is relatively lightweight and easy to flip with a lifting partner. Since very little sinkage occurs on either side, the mattress also sleeps quite cool. Exceptionally hot sleepers can also order a panel of phase change material (PCM) to be sewn onto both sides of the mattress. PCM is engineered to capture and release heat before it reaches the surface of your mattress, allowing you to remain comfortable regardless of the room temperature.
The Plank Firm is budget-friendly, especially for a flippable mattress, and shipping is free of charge for all orders in the contiguous U.S. Brooklyn Bedding offers the Plank Firm in 14 sizes, including a split California king for couples who use adjustable beds, an Olympic queen, and several options designed for RVs. All Plank Firm purchases include a 120-night trial period and 10-year manufacturer’s warranty.
“The Plank has a firm feel, making it one of the firmest mattresses we've tested. Our back and stomach sleepers, especially those over 230 pounds, greatly appreciated the even and supportive sleep surface.”
Why You Should Trust Us
Our sleep specialists have tested hundreds of mattresses using rigorous methodology. This includes physical testing and body-mapping tools to measure pressure relief and support. Our testers have a range of body types, preferred sleep positions, and comfort preferences so that we can assess a mattress’ suitability for different types of sleepers.
Back Pain and Sleep: How Are They Related?
Sleep and back pain are intertwined: Existing back pain can disrupt sleep, while fragmented sleep slows down healing. Your sleep position can also create pressure points that lead to back soreness.
Can a Bad Mattress Cause Back Pain?
A cheap or unsupportive mattress can strain the back if it doesn’t promote good sleep posture. Even a high-quality mattress can worsen back pain if it’s not compatible with your sleep position and body weight.
How Do You Prevent Back Pain When Sleeping?
Maintaining neutral spine alignment when sleeping is key to avoiding back pain. A suitable mattress needs to limit sagging below the lumbar region while also cushioning pressure points.
Which Mattresses Are Best for Avoiding Back Pain?
Any type of mattress can prevent back pain as long as it supports your sleep position and body type. The best hybrid mattresses can help with back conditions because they blend pressure relief with sturdy support.
What Else Can You Do to Alleviate Back Pain?
Changing your sleep position to promote better spine alignment can ease back pain. Adjustable beds and body pillows can also provide relief by improving sleep posture.
Sleeping With Back Pain
Back pain has many causes and manifestations. Symptoms range from shooting pain to lingering stiffness.
Acute, or short-term, back pain is often caused by physical injury or overexertion. Back pain is considered chronic when it lasts for three months or longer. Underlying medical conditions can cause both acute and chronic back pain.
Back pain is the most common site of pain in U.S. adults, with lower back pain being the most prevalent. Each sleep position is vulnerable to back strain based on how the body is aligned. A mattress that improves weight distribution can minimize back pain.
Signs Your Mattress Is Causing Back Pain
A cheap or aging mattress can strain the back if it doesn’t support spinal alignment. Even a high-quality mattress can cause back pain if it’s not compatible with your sleep position and body type.
- You wake up with back pain: Your mattress may be to blame if you consistently wake up with back pain that improves as the day goes on.
- Your mattress is past its prime: The average mattress remains supportive for about six to eight years. A mattress that noticeably sags probably isn’t providing proper back support.
- You have difficulty staying comfortable: Your mattress may be a poor fit if you struggle to maintain a comfortable sleep position. A soft mattress with excessive sinkage can distort the spine. An excessively firm mattress can cause sharp pressure points on the back.
Types of Back Pain
Acute back pain is often caused by a sudden accident or strain. Lifting a heavy object or sleeping on a lumpy couch can cause acute back pain.
Chronic back pain lasts for three months or more. Acute back pain may become chronic if it’s left untreated. Continually sleeping on an unsupportive mattress can contribute to chronic back pain. Always speak to your doctor if back pain persists, as it could be a sign of an underlying medical condition.
| Back Pain Type | Description |
|---|---|
| Lower Back Pain | Lower back pain occurs below the rib cage in what’s known as the lumbar region. It’s the most common type of back pain. Causes include muscle strain, nerve compression, and traumatic injury. About 20% of people with acute lower back pain will develop chronic back pain after a year. |
| Upper Back Pain | This less common form of back pain is located in the thoracic region, which extends from the base of the neck to the start of the lumbar region in the lower back. Upper back pain can stem from structural or nerve issues. Since the thoracic spine is connected to the rib cage, injuries to the ribs can contribute to pain in the upper back. |
| Neck Pain | Neck pain is often caused by poor posture while sitting, standing, or sleeping. Arthritis, osteoporosis, and injuries such as neck sprains and whiplash can also lead to pain in this area. A mattress that doesn’t promote neutral spine alignment can strain the neck. The right pillow height can help prevent neck pain by aligning the upper body with the hips. |
How to Sleep With Less Back Pain
Maintaining neutral spine alignment while sleeping is key to minimizing back pain. Each sleep position has different mattress requirements for supporting good sleep posture. Your body weight also determines firmness and contouring needs.
Balance the Comfort and Support of Your Mattress
Sleepers with back pain require a mattress that balances contouring with support. Adequate cushioning relieves pressure buildup, while a robust support core promotes good sleep posture.
Your sleep position determines how much contouring is needed from a mattress to align the spine. Side sleepers typically need a softer mattress that evenly conforms to the hips and shoulders. Back and stomach sleepers generally prefer a medium firm to firm mattress that reinforces the heavier torso area.
Body weight should be factored in when deciding on mattress firmness. Side sleepers under 130 pounds don’t sink too deeply into a mattress’ surface, so they generally need a softer model to ease tension. A mattress with a sturdy core and minimal compression helps the spine stay level for sleepers over 230 pounds.
Firmness
We rate mattress firmness using a 10-point scale, with 1 being the softest and 10 the firmest. A soft mattress may feel plush initially, but it could eventually cause back pain if it doesn’t allow for proper spine alignment. A mattress that’s too firm won’t ease pressure points on the spine and shoulders.
Pressure Relief
Side sleepers tend to experience pressure points in the shoulders and hips, while the lumbar region is a sensitive area for back sleepers. Stomach sleepers can experience neck and lower back pain if they sink too far into a mattress’ surface. While side sleepers generally need the most cushioning and pressure relief, all sleepers benefit from a mattress that promotes proper spinal alignment.
Use a Mattress That Matches Your Sleep Position
Poor spinal alignment while sleeping eventually takes its toll on the back. If body weight isn’t evenly distributed, tension can develop in the lumbar region and upper back.
Side Sleepers
Side sleeping can strain the lower back unless the spine stays neutral. A mattress should be supportive enough to prevent the hips from sinking lower than the shoulders. One that’s too firm could cause sharp pressure points in the hips and shoulders. Hybrid and foam mattresses with fairly close contouring are typically a good match for side sleepers.
Back Sleepers
The spine aligns most naturally while sleeping on your back, but an appropriate mattress is still needed to prevent deep sinkage. A too-soft mattress can create an unnatural curve to the spine, in turn straining the lower back.
Most back sleepers do well with a medium firm to firm mattress that minimizes deep sinkage. Placing a small pillow under the knees can reduce lower back strain for back sleepers.
Stomach Sleepers
Stomach sleepers have to fight against gravity in order to maintain good sleep posture. A sinking midsection strains both the lower and upper back. Most stomach sleepers therefore need a firm mattress to prevent deep sinkage.
Pillow height is especially critical for stomach sleepers with back pain. A very thick pillow arches the spine, which strains the neck and upper body. A thin pillow helps the shoulders and pelvis stay on the same plane.
Maintain a Healthy Sleep Posture
If your weight isn’t evenly distributed while sleeping, your muscles and joints aren’t able to relax. Poor spinal alignment can cause new back pain or prevent preexisting conditions from healing. The right mattress firmness and pillow height for your sleep position and weight can improve posture and pressure relief.
Choose the Correct Pillow Height
Since a pillow’s thickness determines the angle of your head and upper body, it’s crucial to proper spine alignment. The best pillow for avoiding neck and back pain depends on your sleep position and mattress firmness.
Side sleepers generally need a high-loft pillow to keep the upper body level with the hips. Back sleepers often do well with a medium-loft pillow that doesn’t raise the head too much. A thin pillow or no pillow at all prevents a curved spine for stomach sleepers.
Choosing the Right Mattress for Back Pain
To prevent or minimize back pain, a mattress needs to reinforce neutral spine alignment while cushioning pressure points. Any type of mattress can alleviate back pain if it meets certain comfort and support requirements. The best mattress for you depends on your sleep position, body type, and comfort preferences.
Is a Firm or Soft Mattress Better for Back Pain?
A moderately firm mattress generally balances contouring and support for most sleep styles. A common misconception is that an ultra-firm mattress is best for back pain. While a mattress needs to be supportive enough to align the spine, one that is too firm won’t cushion pressure points. Very soft or very firm mattresses can both be problematic for back health.
Studies suggest that a medium firm mattress can help prevent or alleviate lower back pain. That said, a mattress’ feel and support depends on your sleep position and body weight. A medium firm mattress might feel rigid for a side sleeper under 130 pounds yet too soft for a stomach sleeper over 230 pounds.
Which Mattress Types Are Best for Back Pain?
How a mattress feels and performs depends on its materials and construction. Some types of mattresses offer better pressure relief and support than others. A sturdy hybrid with thick comfort layers, for example, can reinforce the lumbar region while cushioning pressure points.
Similar to firmness level, sleepers should consider their body weight, sleep position, and comfort preferences when choosing a mattress type.
Hybrid
Hybrids are popular among people with back conditions since they blend pressure relief with sturdy support. Thick foam or latex comfort layers ease tension, while their coiled support cores limit deep sinkage. Hybrids usually have strong edge support, which makes getting in and out of bed easier if you have back pain.
Foam
Foam mattresses contour and cushion sleepers, so they help ease tension along the back. They use foam comfort and support systems, but different types and densities of foam are typically combined. Those with memory foam comfort layers tend to deliver notable pressure relief. The support core often uses high-density polyfoam to minimize sagging.
Foam mattresses that evenly conform to the hips and shoulders can be especially beneficial for side sleepers with back pain.
Latex
A latex mattress is made entirely from either natural or synthetic latex, or a combination of the two. Latex is responsive and durable, so it minimizes deep compression below the lumbar region. Springier latex is commonly used in the comfort system to alleviate tension. Denser varieties in the support core limit sagging. The natural bounce of latex makes adjusting positions easier for those with back pain.
Airbeds
If you have back pain and a flexible budget, you might want to consider an airbed. This mattress design features inflatable air chambers that allow sleepers to adjust its firmness and fine-tune comfort and support based on their needs. The comfort system may use any number of materials, including memory foam, polyfoam, latex, and wool.
Many airbeds also have adjustable upper and lower sections, which can alleviate tension for some back conditions. Sleepers with chronic or acute back pain have more control over managing their comfort level on an airbed.
Innerspring
An innerspring mattress may help with back pain, assuming it meets certain support and comfort requirements. This mattress type has a coiled core like a hybrid but a thinner comfort system, so pressure relief is sometimes marginal. Stomach and back sleepers may prefer an innerspring’s firmer surface, but side sleepers usually need a model with thicker comfort layers.
Additional Features to Help With Back Pain
Certain mattress features can improve spinal alignment and help you manage back pain.
| Feature | Description |
|---|---|
| Zoned Support | Mattress zoning is designed to provide ergonomic support. Often, the center of a mattress is sturdier to reinforce the lumbar region. The hips and torso receive greater pushback, while the legs and upper body sink more. Zoning can alleviate back pain by promoting neutral spine alignment. |
| Adjustable Firmness | Since back pain isn’t always constant, an adjustable mattress can accommodate varying comfort and support needs. Your back condition might require firm support at certain times and extra cushioning during others. Mattresses with dual adjustability are particularly helpful if you share a bed. Co-sleepers rarely have identical body types and sleep styles, so dual firmness gives each person control over the feel of their side. |
| Quality Materials | A mattress’ lifespan directly relates to its quality of materials. A mattress made with inferior materials will sag sooner, which compromises spinal alignment. Quality mattresses are sometimes more expensive, but the tradeoff is better and longer support. |
| Ease of Movement | People with back pain often have impaired mobility. A responsive mattress makes changing positions easier, which is especially important if you’re a combination sleeper. Movement is generally easiest on coil-based models, but latex mattresses also have notable responsiveness. |
More Ways to Reduce Back Pain When Sleeping
While a mattress plays a large role in spine health, other factors can influence back pain.
Try a New Mattress on a Sleep Trial:
It can take time to adjust to a new mattress, which is why most models purchased online include a sleep trial with free returns during a set period. This gives sleepers time to determine if a different mattress style or firmness level improves their back pain.
Use a Pillow That’s More Supportive:
The right pillow can make a big difference in alleviating neck and back pain. A suitable pillow loft depends on your mattress firmness, sleep position, and body weight. Side sleepers typically require a thicker pillow to align the spine, back sleepers often benefit from a medium-loft pillow, and stomach sleepers usually prefer a thinner style.
Improve Your Sleep Posture:
Reinforcing good sleep posture with a body pillow can help alleviate back pain. Back sleepers can reduce lumbar tension by placing a small pillow beneath the knees. Side sleepers can square the hips and level the spine by using a pillow between the knees.
An adjustable bed may relieve back pain by letting sleepers adjust the angle of their upper and lower body. The best incline depends on your sleep position and back condition. Back sleepers, for example, tend to benefit from a zero gravity position.
Maintaining good sleep posture is the most difficult for stomach sleepers. While changing habitual sleep patterns isn’t always easy, sometimes it’s all that’s needed to relieve back pain. Stomach sleepers can try sleeping on their side or back to see if symptoms improve. For committed stomach sleepers, placing a thin pillow beneath the pelvis can remove pressure at the lower back.
Try a Mattress Topper:
Replacing a mattress isn’t always possible, even if it’s not serving your needs. A mattress topper can be a budget-friendly alternative to modify the feel and support of your bed. Some toppers are designed to soften an overly firm mattress, while others give beds more structure.
Speak With Your Doctor:
Consult your doctor if your back pain persists despite making sleep adjustments. A physician can help determine the underlying cause and provide treatment options.
About The Author
Certified Sleep Science Coach, Lead Product Tester
David is a Certified Sleep Science Coach with a lifelong passion for well-being and health optimization. His interest in sleep developed with the arrival of his son, when sleep suddenly became a precious commodity.
- Position: Side Sleeper
- Temperature: Hot Sleeper
- Chronotype: Lion
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