For those that struggle with lower back pain, an uncomfortable mattress is not a desirable thing. Some mattresses can potentially make a bad health situation worse and exacerbate the issue.
The good news is there are a number of mattresses that can help alleviate and even prevent lower back pain. An especially durable, medium-firm option with the right balance of comfort and support could be just the right type of mattress.
In this article, I will provide my top picks for mattresses to help with back pain and will go in depth on what I enjoy about each mattress and why each of the mattresses are especially ideal for people who are worried about or experience back pain. I will also address some of the causes of lower back pain and explain what someone should look for when purchasing mattresses.
[Editor’s Note: The information provided should not be considered a substitute for professional advice. Please consult a medical professional or another medical expert if there are any health related questions.]
7 Picks For Best Back Pain Mattress
While there are a plethora of comfortable options out there, these seven seem definitely fit all the criteria people should look for when choosing a mattress to alleviate back pain. They are durable, supportive in the right areas, and have just the ideal firmness to keep the spine in proper alignment.
Saatva's construction was smartly designed to help relieve back pain.
Made Specifically To Relieve Back Pain
Level Sleep was designed to relieve back pain and credible studies show that they have been effective in doing so.
Best For Side Sleepers
Nolah's pressure-relieving AirFoam makes it a great match for side sleepers with back pain.
Good For All Three Sleeping Positions
Purple's gel material makes it great for back pain for people sleeping in any position.
Loom & Leaf
Loom & Leaf uses high-density memory foams, which help promote optimal spinal alignment.
Best For Larger People
The Helix Nightfall was built specifically for larger people and is a better choice for bigger people with back pain.
Best For Stomach Sleepers
The Plank is a very firm, flippable mattress that should be a good choice for stomach sleepers.
Top Picks Compared
The Saatva is a high-quality innerspring mattress with a pillow-top construction. Fans of traditional innerspring mattresses should find what they are looking for on this mattress.
It has the great support of coils and the soft pressure relief of a pillow-top. This helps give the mattress a medium firmness, which is what people should be looking for in a mattress for back pain.
This mattress a fairly complex construction that incorporates two layers of coils. There is one layer of high-grade coils with a layer of micro-coils. The micro-coils do a very nice job of contouring to the shape of your body. There is a layer of memory foam in the middle third of the mattress that also assists with contouring. Both these features help keep your spine in neutral alignment by contouring to the individual curves of your body.
Finally, the Saatva is, for the price, one of the more durable mattresses out there. This is another consideration when buying a mattress for back pain. As a general rule, pillow-tops are known to sag over time, which can lead to uneven support. However, this should not be an issue on the Saatva.
What Makes The Saatva Stand Out?
- It could be a great choice for hot sleepers. The two layers of coils allow for some great airflow, so people generally shouldn’t be overheating.
- The Saatva should be a good fit for numerous sleeping positions and combination sleepers. The dual coil system helps make this a supportive mattress for sleepers of really any weight. Most stomach sleepers should feel proper support, and back sleepers should feel their hips sinking into the pillow-top just the right amount. Side sleepers should feel the mattress conform to the curves of their body. In all three positions, the spine should stay in alignment.
- Those looking for a great value should like the Saatva. It features high-quality materials, so this should be a good long-term investment and great for those with pecuniary thoughts on their mind.
Check out our full Saatva mattress review.
Made Specifically To Relieve Back Pain
Level Sleep TriSupport Mattress
The Level Sleep mattress is designed specifically to deal with back pain issues. “Tri-Support” refers to a zoned construction featuring three zones with different firmnesses.
The first zone is in the hip area down to the foot of the mattress. This zone feels like a 7/10, or medium-firm. The lumbar zone is the firmest part of the mattress and feels like an 8/10. Finally, the shoulder zone feels like a 5/10, which is softer than average and allows for great pressure relief for side sleepers.
These zones ensure that the spine stays neutrally aligned. The shoulder sinks further into the mattress to allow for maximum pressure relief. The lumbar zone gives extra support to the lower back, and the bottom zone allows the hips to sink in just the right amount.
If back pain and lumbar issues is a high criteria for people, then the Level Sleep can potentially be a great choice.
What Makes The Level Sleep Stand Out?
- It features a zoned construction, designed to offer the right balance of comfort and support. It should be a good match for all three sleeping positions and for combination sleepers.
- The lumbar zone supports the lower back and could ameliorate back pain.
- The mattress was created using 10 years of research and clinical trials. The company provides research on how the Level Sleep prevents and lessens back pain.
Check out our full Level Sleep mattress review.
Best For Side Sleepers
The Nolah mattress is an all-foam mattress that features a proprietary AirFoam not previously seen on the market. It is designed to be more pressure relieving than memory foam without some of the drawbacks associated with visco-elastic foam. While some may disagree, I did personally feel fantastic pressure relief on the Nolah.
For those that sleep on their side and struggle with back pain, the Nolah could be potentially a great option. The soft AirFoam should conform to the curves of the body and ensure that the spine stays in proper, neutral alignment. This can help reduce or potentially ameliorate back strain.
The Nolah is also a durable value because the proprietary foam shouldn’t sag too quickly and should ensure the mattress continues to relieve pressure. The mattress costs less than a traditional memory foam mattress, so the value is really apparent in our opinion.
What Makes The Nolah Stand Out?
- The Nolah is a comfortable mattress and a great match for side sleepers.
- It should keep the spine neutrally aligned, potentially alleviating back issues.
- The AirFoam is durable, so it should be longer-lasting and a great investment overall.
- The Nolah is more affordable than many mattresses on this list.
- The AirFoam is also designed not to trap heat so overheating shouldn’t be an issue on the Nolah.
Read my full Nolah mattress review
Good For All Three Sleeping Positions
The Purple is one of the most unique mattresses out there. It features a proprietary, hyper-elastic gel polymer grid. This grid is designed to stay flat and supportive until enough pressure is applied. Once that happens, just that part of the mattress collapses, while the rest of the mattress stays flat and supportive. It features a feel that is pretty fascinating and hasn’t been replicated yet on the market.
This makes the Purple a great fit for all three sleeping positions and combination sleepers. When back sleeping, the gel collapses under the hips and butt, but the body is held up everywhere else. When side sleeping, the gel grid will collapse under the hips and shoulder. There is also the feeling of great support when reversing positions onto the stomach. In all three positions, the Purple should keep the spine in proper neutral alignment and alleviate back issues.
The Purple is both firm and pressure-relieving at the same time, so this makes it difficult to describe the mattress’s firmness. That being said, overall, it feels like a 7/10, that medium-firm sweet spot that is ideal for people generally concerned about back pain. In addition, the fact that the comfort layer is only 2″ ensures the body doesn’t sink too far into the mattress.
Finally, this is going to be one of the longer-lasting mattresses on this list and potentially ones of the best values. The hyper-elastic gel polymer is a very durable material and shouldn’t sag over time. This means it should stay properly supportive even after years of use.
What Makes The Purple Stand Out?
- The hyper-elastic gel polymer grid makes it a great fit for a number of sleeping positions and combination sleepers. The mattress has a great amalgamation of comfort and support.
- It does a great job of addressing the issue of sleeping hot. The gel grid promotes amazing airflow, creating a truly temperature-neutral sleeping surface.
- The comfort layer is only 2″ thick, which is ideal for those who struggle with back pain.
- The Purple is a very durable mattress, so any concerns about sagging should be alleviated.
Check out our full Purple mattress review.
Loom & Leaf
The Loom and Leaf is a memory foam mattress that incorporates two layers of high-density and high-quality foams. These foams do an excellent job of conforming to the shape of each specific body. This makes the mattress a great match for those who encounter back pain, because the foams fill in the gaps of the body and keep the spine properly aligned.
These foams give the mattress a firmness of about 6.5/10. This medium-firmness equates to a mattress that should be an excellent match for combination sleepers. The Loom & Leaf should potentially be supportive for back and stomach sleepers and comfortable for side sleepers.
In general, one of the main issues with pure memory foam mattresses is the tendency to sag over time. This shouldn’t be a problem with the Loom & Leaf because the foams are high-density, so they are quite durable and long-lasting. The foams should retain their shape and continue to conform particularly well to the body for a long duration.
What Makes The Loom And Leaf Stand Out?
- The foams do a particularly fantastic job of contouring. They conform to the curves of the body and assist in keeping the spine supported and properly aligned.
- This should realistically be a durable mattress that lasts for a long duration. The high-density foams shouldn’t sag, so the mattress should remain comfortable and supportive.
- The Loom and Leaf should be an excellent mattress for combination sleepers. It offers a good balance of comfort and support, so no matter what position people sleep in, they should feel proper spinal alignment.
Check out our Loom and Leaf mattress review.
Best For Larger People
Helix made the Nightfall specifically for heavier-weight sleepers. It carefully incorporates high-density foams and tall, high-grade coils to provide the right amount of support for larger people.
The comfort layer on this mattress is only 2″ thick, and there is a carefully crafted transition layer right beneath this. After this 8″ of individually wrapped coils, where the majority of the support of the mattress comes from.
When Marten (the largest person on our team) tried out the Nightfall, he felt the top foam layers pressing into his lumbar area, keeping him especially supported there. He also felt like the mattress was a 7/10 in terms of firmness, right in that ideal medium-firmness range.
The mattress is designed to be especially durable and to fight sagging over time. Even larger people should feel confident that this mattress will support them for an especially long duration of time.
What Makes The Helix Nightfall Stand Out?
- It is made specifically with heavier-weight sleepers in mind. It features taller coils and high-density foams to ensure larger people in particular don’t bottom out.
- It should potentially be an excellent match for heavier-weight sleepers with back pain issues. The foam should support the lumbar area while still allowing your hips to sink in the right amount into the mattress.
- The Helix Nightfall should definitely be a longer-lasting mattress. The high-density foams and high-grade coils were carefully selected to stop wear and tear. The foams shouldn’t sag or allow any specific body indentation.
Check out our full Helix Nightfall review.
Best For Stomach Sleepers
For those that have particular struggles with back pain, they will want to be especially careful to find a mattress that supports them.
This is especially important for stomach sleepers and combination sleepers who potentially end up on their stomach. A mattress that is too soft could potentially allow the hips to sink into the mattress. When this happens, the spine could potentially get out of alignment and cause strain in the lower back.
For stomach sleepers and those who have a particular desire for an extremely firm mattress, the Plank mattress should offer excellent support. The Plank is produced by Brooklyn Bedding and is the firmest mattress I have ever reviewed.
The mattress is also flippable, meaning there is a firm side and an ultra firm side. This provides two equally good chances to identify the correct firmness suitable to each person’s needs.
Stomach sleepers who are looking for a very firm mattress and want to avoid or alleviate back pain should definitely take a look at the Plank.
What Makes The Plank Stand Out?
- The Plank is a very firm mattress that should potentially be able to support people of many weights.
- The mattress is a particularly excellent choice for stomach sleepers.
- The Plank is flippable, meaning there are two firmnesses in one mattress.
- The firm side could also be a potentially good match for back sleepers.
Read the full Plank mattress review
Marten is a staff writer for us and generally has a slightly different perspective from me. He has a significantly different body type than I do, which is something you want to consider when looking at a mattress: He is 6’7″ and weighs about 230 lb; I am 5’9″ and 160 lb. Here is what he thought about this selection of mattresses:
The Helix Nightfall is made specifically for larger people like myself and has taller coils and higher density foams. A particularly big problem that I have with other heavier people mattresses is that they are too firm, especially when I am on my back. It’s ideal to be able to sink in just the right amount so that the foams conform well to the curves of the body and the lumbar area is properly supported. As Joe was saying, it’s ideal to find something in the medium-firm range. The Helix Nightfall is a medium-firm mattress and definitely a good match for a heavier person, especially for those with significant back pain concerns.
Looking at the other mattresses, I want to discuss the Loom and Leaf first. When lying down on this mattress, I potentially need a little more support when I am on my back. I’m falling into the mattress a little bit more than I would ideally like. When I’m on my side, I’m sinking slightly into the mattress and feeling good pressure relief on my shoulders and hips. When I’m on my stomach, I definitely need more overall support and probably want something a little firmer. Overall, this is probably not the best match for a heavier person of my weight or greater.
It’s my opinion that the Purple feels good in multiple sleeping positions. When I’m on my back, I feel especially good support on my lumbar area and my hips are sinking in just the right amount. On my side, I feel good pressure relief and it has a nice comfortable feel overall. On my stomach, I feel particularly good overall support, as the gel material does not collapse.
I also feel pretty good support on the Saatva. When I’m on my back, my hips sink into that pillow-top layer just the right amount. When I’m on my side, I feel pretty good pressure relief, and on my stomach, I feel well supported.
The Level Sleep features a smartly crafted zoned construction that has a unique overall. The lumbar area is actually probably too firm for me. I’m sinking into the mattress more than Joe does, so it definitely feels firmer to me than it does for him. The shoulder area does not support me enough, and I feel myself falling into the mattress.
It is always worth considering one’s weight when buying a mattress, as this can have a great effect on the feel overall. This can be even more important when dealing with back pain issues. Larger people might want to consider the Purple, Saatva, or Helix Nightfall if back pain is an especially major issue.
What Is Back Pain?
Most of us know when our back is giving us issues, but what is really happening here behind the scenes?
According to the National Institute of Arthritis And Musculoskeletal And Skin Diseases, back pain is “one of the most common medical problems in the U.S. It can range from a dull, constant ache to a sudden, sharp pain that makes it hard to move.”
Surveys from the National Institute of Neurological Disorders and Stroke found that about 80 percent of Americans will struggle with back pain at some point in their lifetimes. This potentially helps explain why back pain is the fifth most common reason people go to the doctor. At the same time, many who struggle with back pain do not see a doctor because of pride, money issues, or other reasons.
The Mayo Clinic describes back pain symptoms as:
- Muscle ache
- Shooting or stabbing pain
- Pain that radiates down the leg
- Pain that worsens with bending, lifting, standing, or walking
- Pain that improves with reclining
The Mayo Clinic also defines two types of back pain: acute and chronic. Acute back pain occurs when symptoms last between a few days and a few weeks. If the symptoms last for over 12 weeks, this is considered chronic back pain.
What Causes Back Pain?
Just as the symptoms of back pain can vary, there are numerous reasons someone might be be feeling back pain. Here are some of the most common explanations for lower and upper back pain available:
- Strain. If someone works a job that requires him/her to lift especially heavy objects, the repetition of this action can potentially lead to muscle and ligament strain. Also, simply lifting a heavy object without using the legs can potentially cause immediate strain in the lower back area. If someone is in poor physical shape, it increase the likelihood of pulling a muscle in the lower back area.
- Ruptured or herniated discs. This is one of the major causes of lower back pain and can be particularly debilitating. The Academy of Orthopedic Surgeons says, “A disk begins to herniate when its jelly-like nucleus pushes against its outer ring due to wear and tear or a sudden injury. This pressure against the outer ring may possibly cause lower back pain. If the pressure continues, the jelly-like nucleus may push all the way through the disk’s outer ring or cause the ring to bulge. This puts pressure on the spinal cord and nearby nerve roots. In addition, the disk material releases chemical irritants that contribute to nerve inflammation.”
- Arthritis or scoliosis. Arthritis can definitely have a direct impact on the lower back area in multiple ways. Arthritis can lead to spinal stenosis, wherein the spaces in the spine narrow and begin to put pressure on the nerves. Scoliosis, on the other hand, is an unnatural curvature of the spine. This can affect posture, stretching muscles and pinching nerves, and thereby cause back pain issues.
- Serious injury. Car accidents, sports-related injuries, and workplace falls can all lead to pulled muscles, pinched nerves, and herniated discs. These are all associated with back pain and are very common occurrences in America.
- Sciatica. The sciatic nerve goes through the buttocks and down the back of the leg. If this nerve is compressed, people could potentially experience back pain or numbness in the leg.
What Increases The Chances Of Experiencing Back Pain?
There are also a plethora of factors that could make it more likely to develop back pain.
- Age. As we grow older, we have a significantly higher chance of dealing with back pain. Aging can cause degeneration of spinal discs so they aren’t as effective at absorbing shock. It’s also possible to develop Spondylolisthesis, where one vertebra moves into another vertebra.
- Lack of exercise. If we don’t exercise, our bodies can become susceptible to back pain. Also, if our back muscles are weak, the back pain can potentially become more severe. Many studies have shown that exercise can help alleviate back pain. In fact, one 2012 study from Informed Health Online found that exercise can prevent a recurrence of acute back pain in 1 out of 3 people (1).
- High bodyweight. For those that are overweight, back pain becomes more likely. A higher weight could also exacerbate the pain and generally make things harder to manage. One 2016 study, which was published in the journal Medicine, found that “higher BMI and waist-hip ratio were associated with high-intensity low back pain and/or high disability” (2).
- Depression and/or anxiety. According to the Anxiety and Depression Association of America, people with these disorders are more likely to struggle with back pain than people who don’t experience anxiety and/or depression.
- Smoking. The Mayo Clinic states that smoking cigarettes cuts down on blood flow to the lower back area and reduces the nutrients that are delivered to the spine. Also, for those with acute back pain, nicotine can slow the healing process.
What Should Someone Look For In A Mattress?
So, now that we know what back pain is and what causes it, how can a mattress deal with this pressing issue? And for those looking for a mattress to alleviate and prevent back pain, what should they consider?
- Lumbar support. For those excessively worried about back pain, it’s important that the lower back area be properly supported. One 2005 study, which was published in The Journal of the Canadian Chiropractic Foundation, found that good lumbar support “limit[s] unfavorable compressive and shearing forces acting on the lumbar spine” (3). Mattresses such as the Level Sleep have a special system to ensure the lumbar area has extra support. Other mattresses, such as the Casper, also feature a zoned construction so the middle part of the mattress is firmer than the rest.
- Comfort layer thickness. Along with lumbar support, people should think about just how thick the mattress’s comfort layer is. While a thick comfort layer can feel great at first, it might not give the proper support. There’s the chance of sinking too far into the mattress and not getting the proper support. The Harvard Medical School says, “You might also sink in so deeply that your joints twist and become painful during the night.” That said, it’s important to consider one’s sleeping position when taking comfort layer thickness into account. For side sleepers, a thicker comfort layer could be a better match.
- Firmness. The overall firmness of a mattress comes into play when thinking about back pain. Doctors once recommended that patients with back pain opt for a firm mattress. However, that has now changed, and doctors recommend a medium-firm mattress. A 2015 study from the journal Sleep Health found that “a mattress that is subjectively identified as a medium-firm mattress and is custom inflated (self-adjusted) is optimal for promoting sleep comfort, quality, and spinal alignment” (4). It’s best not to let the hips sink in too far. If the mattress is too soft, falling into the mattress becomes more likely. For side sleepers, the mattress should be soft enough for the shoulder to compress the mattress. If it is too firm, the shoulder will be pushed up, and the body will also get out of alignment.
- Weight. For those considered a larger person, definitely take this into account when choosing a mattress for back pain. One’s weight can affect how firm a mattress feels, as well as much support it can offer. It might be necessary to choose a mattress that would feel firm to a lighter person. Also, there is a risk of “bottoming out” on a mattress, so a thick comfort layer might not be ideal.
- Durability. After finding that perfect medium-firm mattress with just the right amount of comfort, people still want to know that the mattress will handle back pain for a good duration of time. People want to pay particular attention to the density of foams and the quality of other materials such as coils and pillow-tops. If the mattress begins to sag, this could make the back pain even worse.
Armed with this information, people should have all the knowledge they need to choose the right mattress for preventing and alleviating back pain. Experiencing back pain is never fun, but these excellent choices can definitely make the situation a little better.
[Editor’s Note: The information provided should not be considered a substitute for professional advice. Please consult a medical professional or another medical expert if you have health related questions.]
Featured image: SOPRADIT/Shutterstock
- Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Exercise and physiotherapy for chronic low back pain. 2012 Feb 9 [Updated 2015 Dec 2].
- Chou, Louisa, et al. “The Association Between Obesity and Low Back Pain and Disability Is Affected by Mood Disorders.” Medicine, vol. 95, no. 15, Apr. 2016
- Normand, Martin C et al. “Biomechanical effects of a lumbar support in a mattress” Journal of the Canadian Chiropractic Association vol. 49,2 (2005): 96-101.
- Radwan, Ahmed, et al. “Effect of Different Mattress Designs on Promoting Sleep Quality, Pain Reduction, and Spinal Alignment in Adults with or without Back Pain; Systematic Review of Controlled Trials.” Sleep Health, vol. 1, no. 4, Dec. 2015, pp. 257–267.
Joe Auer is the editor of Mattress Clarity. He mainly focuses on mattress reviews and oversees the content across the site.
He likes things simple and take a straightforward, objective approach to his reviews. Joe has personally tested nearly 250 mattresses and always recommends people do their research before buying a new bed. He has been testing mattresses for over 5 years now, so he knows a thing or two when it comes to mattress selection. He has been cited as an authority in the industry by a number of large publications.
Joe has an undergraduate degree from Wake Forest University and an MBA from Columbia University.
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