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Best Mattress for Back Pain

Written by David Rubin

Reviewed by Dr. Michael Breus

Expert tested
Updated Regularly

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.

opening quote icon Sleepers with persistent back pain often need a mattress with cushioning for sore spots along the spine paired with a sturdy base to improve sleep posture. I recommend looking for a hybrid mattress since most offer thicker comfort systems over a supportive coil core. opening quote icon
Dr. Michael Breus, Clinical Psychologist, Sleep Medicine Expert and Combination Sleeper

Sleep Doctor’s Picks

Best Overall

SpineAlign Luxury Foam Hybrid

Sleep Doctor



  • Trial Length 60 nights

  • Warranty 5 Year, Limited

  • Trial Length / Warranty

    60 nights / 5 Year, Limited

  • Type Hybrid

  • Firmness Medium (5), Medium Firm (6)

  • Price $1,325 – $2,900

Sleep Doctor’s Take

The SpineAlign Luxury Foam Hybrid’s adaptive foam layers and supportive coils create a balanced sleep surface that alleviates back pain and pressure. The mattress is available in two firmness levels, so most people should find a suitable option regardless of sleep position or body type.


  • Foam layers adapt to the body and alleviate pressure along the spine
  • Two firmness options to accommodate different sleeper types
  • Reinforced perimeter strengthens the edges


  • Foam layers have potential to trap heat
  • High potential for harsh initial off-gassing

Sleepers with back pain often benefit from a mattress with a balance of cushioning for the spine and robust support. The SpineAlign Luxury Foam Hybrid offers even contouring for pressure points while a coil system keeps the body on an even plane. You can choose between medium (5) or medium firm (6) designs to meet your sleep needs.

How Does It Feel?

The Luxury Foam Hybrid’s comfort system begins with a layer of memory foam to provide surface-level cradling. The softer model features an extra memory foam layer to enhance plushness. Beneath the memory foam is a polyfoam layer that delivers more cushioning, but has a denser composition to push back against your weight. Pocketed coils further stabilize the sleep surface to prevent your body from sinking too deeply. Thicker coils along the perimeter help protect the edges when you get on and off the mattress.

The memory foam is infused with cooling materials — cooling gel in the softer model, copper in the firmer model — intended to dissipate heat and keep you cool. The medium model contains thicker foam layers, resulting in a slightly higher profile than the firmer model. Both models carry the same price-points in all sizes.

Why We Like It

Most of our testers found at least one of the Luxury Foam Hybrid’s firmness levels comfortable, but their favorite design depended on factors like primary sleep position and body type. Back sleepers between 130 and 230 pounds and most side sleepers enjoyed the deeper contouring of the plusher model, while the firmer model was better suited to our testers who need less cushioning and extra support to sleep comfortably.

Compared to other hybrids we’ve tested, the Luxury Foam Hybrid performed quite well in our motion isolation tests. The foam layers absorb a good amount of motion transfer, so you and your partner should notice fewer nightly disturbances. Other test results varied by firmness. The softer model performed well during pressure relief tests, while the firmer model earned higher marks in categories such as edge support, ease of movement, and temperature control.

SpineAlign offers free shipping to customers living in the contiguous U.S., as well as a 60-night sleep trial. The Luxury Foam Hybrid is backed by a 5-year warranty against structural defects.

Best Value

Level Sleep Mattress

Sleep Doctor



  • Trial Length 365 nights

  • Warranty Lifetime, Limited

  • Trial Length / Warranty

    365 nights / Lifetime, Limited

  • Type Foam

  • Firmness Soft (3), Medium (5), Firm (7)

  • Price $799 – $1399

Sleep Doctor’s Take

The Level Sleep Mattress features multiple firmness zones to reinforce your midsection and cradle lighter areas of the body. This design ensures an even surface and limited sinkage for your entire body, and this can help reduce back pain in the process.


  • Zoned comfort system offers targeted pressure relief
  • All-foam design cuts down on motion transfer
  • 365-night sleep trial


  • Foam layers can cause uncomfortable heat buildup
  • May not provide adequate support for back or stomach sleepers

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.

How Does It Feel?

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.

Why We Like It

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.

Best Luxury

Loom & Leaf

A picture of the Loom & Leaf mattress in the Sleep Doctor's test lab.
A picture of the Loom & Leaf mattress in the Sleep Doctor's test lab.
A picture of the Loom & Leaf mattress in the Sleep Doctor's test lab.
A picture of the Loom & Leaf mattress in the Sleep Doctor's test lab.

Sleep Doctor



  • Trial Length 365 Nights ($99 Return Fee)

  • Warranty Lifetime, Limited

  • Trial Length / Warranty

    365 Nights ($99 Return Fee) / Lifetime, Limited

  • Type Foam

  • Firmness Medium Firm (6), Firm (8)

  • Price $1,195 – $3,150

Sleep Doctor’s Take

Saatva’s Loom & Leaf features dense foam layers that contour evenly, promote proper alignment, and alleviate upper and lower back pain. You can choose between medium (5) and firm (8) designs based on your sleep position, body type, and firmness preferences.


  • All-foam design reinforced with dense transitional and support layers
  • Two firmness options
  • 365-night sleep trial


  • Above-average pricing for an all-foam mattress
  • High potential for uncomfortable heat absorption

The Loom & Leaf by Saatva is a thoughtfully constructed all-foam mattress well suited to people with back pain. Dense foam layers contour evenly to promote proper alignment and help you wake up without pain or soreness.

How Does It Feel?

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, medium firm (6) and firm (8).

Why We Like It

During our tests, we found that side and back sleepers weighing up to 230 pounds 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.

Our tests also show the Loom & Leaf’s all-foam design 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 $100. You’ll also receive a 365-night sleep trial and lifetime warranty with your purchase.

Best Pressure Relief

FloBeds vZone 12″ Natural Latex Mattress

Sleep Doctor



  • Trial Length 100 nights

  • Warranty 20 Year, Limited

  • Trial Length / Warranty

    100 nights / 20 Year, Limited

  • Type Latex

  • Firmness Soft (3), Medium (5), Firm (7), Extra Firm (8)

  • Price $2,299 – $4,399

Sleep Doctor’s Take

The FloBeds vZone 12” Natural Latex Mattress stands apart from other latex mattresses with an option to pick different firmness levels for each half of the bed. It’s a great solution for co-sleepers with different firmness preferences.


  • 100% Talalay latex construction balances support with gentle contouring
  • Available in four firmness options
  • Sleepers can pick different firmnesses for each side of the bed


  • Carries a higher price-point
  • Not suitable for sleepers with latex allergies

The FloBeds vZone 12” Natural Latex Mattress is an all-latex mattress that offers superior support without compromising pressure relief. The bed offers customizable features that make it well suited for a wide array of body types and sleeper preferences.

How Does It Feel?

The mattress is composed entirely of Talalay latex, which gives the surface a responsive and buoyant feel that conforms gently to your body’s joints and curves. Latex does not compress as readily as foam, so you won’t need to worry about sinking too deep into the bed. Shoppers can customize the feel of each side of the bed, choosing from four firmness options: soft (3), medium (5), firm (7), and extra firm (8).

Back sleepers up to 230 pounds and side sleepers across all weight categories will find the soft and medium options most comfortable, thanks to the stronger cushioning in the shoulders and hips. Back sleepers over 230 pounds and most stomach sleepers will gravitate toward the firm and extra firm options, since these sleep positions typically need more support.

Why We Like It

Few beds offer the degree of customizability as the FloBeds vZone 12” Natural Latex Mattress. Since you can pick a different firmness level for each side of the bed, we highly recommend this mattress for couples with different firmness preferences. The mattress is also an excellent choice for hot sleepers, thanks to the natural coolness and breathability of latex. The all-latex design results in minimal heat retention.

FloBeds offers a 100-night sleep trial and a 20-year warranty for sleepers who decide to keep the bed. Shipping is free to addresses in the contiguous U.S.

Most Comfortable

Helix Midnight Luxe

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  • Trial Length 100 nights (30-night requirement)

  • Warranty 15 Year, Limited

  • Trial Length / Warranty

    100 nights (30-night requirement) / 15 Year, Limited

  • Type Hybrid

  • Firmness Medium Firm (6)

  • Price $1,199 – $2,499

Sleep Doctor’s Take

The Helix Midnight Luxe is a Euro-top hybrid with deep foam layers and zoned pocketed coils. The mattress is geared toward side sleepers, but our tests show its balanced feel is also comfortable and supportive for many back and stomach sleepers.


  • 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


  • May not provide enough reinforcement for people over 230 pounds
  • Deep foam layers may hinder movement across the surface

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.

How Does It Feel?

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.

Why We Like It

The coils are sturdier along the perimeter to make you feel secure when sleeping near the edges or getting in and out of bed. This allowed the mattress to perform well during our edge support tests. Steady airflow through the coils and a breathable, moisture-wicking cover make the Midnight Luxe an excellent choice for hot sleepers, as well. Our temperature control tests detected minimal heat buildup on the surface.

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.

Best for Spinal Alignment

Leesa Original Hybrid

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  • Trial Length 100 nights (30 night requirement)

  • Warranty 10 Year, Limited

  • Trial Length / Warranty

    100 nights (30 night requirement) / 10 Year, Limited

  • Type Hybrid

  • Firmness Medium Firm (6)

  • Price $1,049 – $1,799

Sleep Doctor’s Take

One of the most balanced hybrids on the market today, the Leesa Original Hybrid pairs adaptive foam layers with robust pocketed coils to create a medium firm feel. This combination of cushioning and support helps ensure less back pain without too much sinkage.


  • Adaptive foam layers cushion the body and reduce pressure along the spine
  • Thick coils reinforce the perimeter to prevent excessive sinkage
  • Below-average pricing for a hybrid and two free pillows included with each purchase


  • Design limited to one profile and firmness level
  • May feel too soft for stomach sleepers over 230 pounds

Many people — side sleepers in particular — experience upper or lower back pain because their mattress does not promote even alignment. If the neck, shoulders, or hips are not in line with the spine, aches and pressure points can quickly build up in these areas. The Leesa Original Hybrid is a medium firm (6) mattress with foam layers that gently contour and a strong coil system to reinforce your body. This balanced design helps ensure optimal alignment for most people regardless of their body type or primary sleep position.

How Does It Feel?

The Original Hybrid’s comfort system features a top layer of memory foam and a second layer of transitional polyfoam. As you get into bed, you’ll notice some plushness as the memory foam conforms to your body’s unique curves. The polyfoam also adds cushioning while serving as a buffer between your body and the support core, preventing deep sinkage in the process.

Pocketed coils and high-density base foam make up the Original Hybrid’s support system. Thick coils line the perimeter to reduce sinkage when you lie close to the edges of your mattress or get in and out of bed. A poly-viscose cover styled with Leesa’s signature stripe pattern encases the entire mattress.

Why We Like It

During our hands-on tests, the Original Hybrid earned favorable ratings from our side sleepers weighing at least 130 pounds, back sleepers up to 230 pounds, and stomach sleepers under 130 pounds. That said, ratings were positive across the board — though our stomach sleepers over 230 pounds did not receive sufficient support from the mattress. The coils provide enough bounce to generate some bounce to help you move across the surface, but the foam layers also provide decent pressure relief and motion isolation.

Temperature control was another testing highlight. The foam layers have an open-cell composition, making them less likely to trap heat, and the coils promote enough airflow to keep the mattress interior cool. The cover is also breathable, and the viscose fibers give the fabric blend moisture-wicking properties.

The Original Hybrid is competitively priced, and Leesa offers free ground shipping to customers in all 50 states. Your order includes two pillows at no extra cost and a sleep trial that runs for 100 nights. If you decide to keep the mattress after the trial ends, it’s further backed by a 10-year manufacturer’s warranty.

Best Extra-Firm

Plank Firm


Sleep Doctor





  • Trial Length 120 nights (30-night requirement)

  • Warranty 10 Year, Limited

  • Trial Length / Warranty

    120 nights (30-night requirement) / 10 Year, Limited

  • Type Foam

  • Firmness Firm (7), Extra Firm (9)

  • Price $749 – $1,532

Sleep Doctor’s Take

Brooklyn Bedding’s Plank Firm is a flippable all-foam mattress with firm (7) and extra firm (9) sides. Both surfaces provide excellent support, especially for people who weigh more than 230 pounds and tend to sink too much on softer foam mattresses.


  • Exceptionally firm and supportive on each side
  • Both surfaces resist overheating and sleep cool
  • Fairly lightweight and easy to flip as needed


  • Mattress is too firm for most side sleepers and people under 130 pounds
  • Limited motion isolation due to above-average responsiveness

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).

How Does It Feel?

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.

Why We Like It

Since very little sinkage occurs on either side, the mattress also sleeps quite cool and earned high marks during our temperature control tests. 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 mattress was most popular among back and stomach sleepers on our testing team who weigh more than 230 pounds. These types of sleepers often struggle to find comfortable mattresses. Many of our lighter testers did not feel comfortable on the mattress, which we somewhat expected. If you weigh up to 230 pounds or sleep on your side, a softer mattress may be preferable.

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.

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.

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.

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 TypeDescription
Lower Back PainLower 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 PainThis 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 PainNeck 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.  


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. 

Man sleeping on mattress

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. 


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 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. 


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. 


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. 


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.

Zoned SupportMattress 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 FirmnessSince 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 MaterialsA 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 MovementPeople 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

David Rubin

Certified Sleep Science Coach, Director of Product Testing

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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