The Best Mattresses for Back Pain, According to Experts

A bed can make or break how your body feels when you wake up in the morning, which is why the best mattress for back pain is so crucial. After all, back pain can lead to sleepless nights that can impact your work, relationships, and mental and physical well-being. Unlike other mattress types on the market, this one is generally on the firmer end of the spectrum to promote healthy spinal alignment and help prevent back aches as you sleep—or at the very least not make them worse.

Side sleepers who require cushioning don’t need to stress—pressure relief is also important for keeping your back free of kinks. We narrowed down the 10 best mattresses for back pain by vetting over 100 popular mattresses. Our top picks kept our testers’ spines aligned in a neutral position and had enough pressure relief to contour around their shoulders and hips. We also talked with pain management doctor Taher Saifullah, MD, for expert insight on how to find a mattress best suited for back pain and signs your mattress may be causing a sore back.

The Best Mattress for Back Pain: Helix Midnight Luxe

Besides being unanimously loved by our team, the Helix Midnight Luxe offers a balance of support and comfort that's ideal for back pain sufferers (and those avoiding the back pain club). Contributor Gabriela Ulloa called the Helix Midnight Luxe “the cradled hug we’ve all been craving.” While that may sound too good to be true, our other testers back up Ulloa’s claim: The Midnight Luxe demonstrates excellent spine alignment and pressure relief for testers with a wide range of body types and sleeping positions. Plus, the 13.5-inch loft looks high-end without being so tall that it requires deep pocket sheets.

The Best Mattresses for Back Pain: Our Top Picks

• Best Overall Mattress for Back Pain: Helix Midnight Luxe
• Best Memory Foam Mattress for Back Pain: Nectar Memory Foam
• Best Mattress for Lower Back Pain: Saatva Classic
• Best Hybrid Mattress for Back Pain: DreamCloud Hybrid
• Best Firm Mattress for Back Pain: The WinkBed
• Best Luxury Mattress for Back Pain: Saatva Rx
• Best Cooling Mattress for Back Pain: Nolah Evolution
• Best Mattress for Back Sleepers with Back Pain: Leesa Legend
• Best Mattress for Side Sleepers with Back Pain: Bear Elite Hybrid
• Best Softer Mattress for Back Pain: Brooklyn Bedding Aurora Luxe

Click the jump links below to go straight to our mini-review of each mattress.

Helix Midnight Luxe | Nectar Memory Foam | Saatva Classic | DreamCloud Hybrid | The WinkBed | Saatva Rx | Nolah Evolution | Leesa Legend | Bear Elite Hybrid | Brooklyn Bedding Aurora Luxe

• Mattress type: Hybrid
• Firmness: Medium-firm
• Trial Period: 100 days
• Warranty: 15 years

• Cradling foam top layer to support your joints
• Ergonomic support zones for targeted pressure relief and support
• Premium pillow top with optional cooling upgrade (costs $249)

Why should those with back pain choose this mattress? Not too soft, not too firm, the Helix Midnight Luxe offers the perfect middle ground with a medium-firm feel that allows you to sleep “on top” of the bed rather than sinking too deep into it (which can throw off the natural alignment of your spine and cause back pain). Its cradling pillowy top layer offers gentle comfort for achy joints while its zoned lumbar support sections provide targeted pressure relief up and down the spine.

What does this mattress feel like? Our product testers found this mattress to be equal parts plush and supportive with materials that felt luxurious and durable. Its tufted pillow top layer cradled our hips and shoulders while its balanced medium firmness felt like it was hugging our bodies. The Helix Midnight Luxe’s cool-to-the-touch cover kept us comfortable throughout the night (even our hot sleepers), which prevented that dreaded tossing and turning that can lead to next-day back pain. “I sleep next to a six-foot-nine athlete who sprawls across the bed like he’s the only one there, and I remained perfectly cool—not to mention I never felt him moving around in the middle of the night or waking up at the crack of dawn,” Ulloa said.

What do we love about this mattress? The coils add plenty of bounce to this hybrid mattress, and despite its soft pillow top, we felt we could easily switch between different sleeping positions, which isn’t always feasible when plush, pressure-relieving foams are involved. We also felt virtually zero pressure buildup along our backs, meaning that the zoned lumbar support was doing its job. The cushioning around our hips, shoulders, and necks was another bonus that helped eliminate pain while sleeping.

What would we change, if anything, about this mattress? Laying on the edge of the bed didn’t feel quite as stable as laying on the interior, and while sleeping along the perimeter of the Helix Midnight Luxe wasn’t exactly uncomfortable, it didn’t offer the level of edge support we expected for the higher price point.

• Support level: 4.5/5
• Durability: 5/5
• Motion control: 4.5/5
• Cooling: 4.5/5
• Edge support: 4/5
• Shipping, warranty, and trial: 4.5/5

• Mattress type: Memory foam
• Firmness: Medium-firm
• Trial Period: 365 days
• Warranty: Lifetime

• Cradling gel memory foam top layer
• Plush on top and supportive on the bottom with a firmness level that hovers between medium and medium-firm
• Hybrid version available for more edge support and bounce (ideal for couples and those who change sleeping positions)

Why should those with back pain choose this mattress? Nectar is one of our most-loved mattress brands—and for good reason. This mattress-in-a-box is made with cradling gel memory foam to relieve pressure from your hips and joints, as well as a buoyant foam transition layer that helps absorb energy, making it easier to move around on the bed and switch sleeping positions (in case you prefer rotating through sleeping positions throughout the night to alleviate any back pain).

What does this mattress feel like? Our product testers found the Nectar Memory Foam mattress to be soft to the touch despite its medium-firm build. Its slow-moving memory foam contoured to our bodies and gave a generous amount of cushioning to our joints, which we appreciated for side sleeping. Back sleeping, however, was our favorite on this mattress, as we felt almost no pressure buildup along our spines, helping us maintain a good sleep posture without too much sinkage. Sinking into the bed can throw off the natural alignment of your spine, resulting in back pain. “To my surprise, I'm actually sleeping better on this mattress than I was on my old one,” said features editor Nick Mafi. “My body sinks into the all-foam mattress a bit more than I had anticipated, but that’s likely due to the fact that it’s been over a decade since I’ve had any sort of memory foam mattress.”

What do we love about this mattress? We love Nectar’s gel memory foam, which not only kept us comfortable while sleeping, but also cradled our bodies like a cool hug. Nectar’s affordable price point—starting at $499 for a twin-size mattress—is also a major winning feature for us. Nectar may not be loaded with bells and whistles like more luxury buys, but the amount of support and pressure relief we experienced was well worth the price, as was the lifetime warranty and 365-day sleep trial.

What would we change, if anything, about this mattress? Sitting or laying on the edge of the Nectar mattress caused several inches of sinkage for us, so if you’re a side sleeper who loves curling up on the edge of the bed, you may want to seek out a mattress with more edge support or opt for the hybrid version of the Nectar (which performed better during our edge support tests).

• Support level: 3.5/5
• Durability: 4/5
• Motion control: 4.5/5
• Cooling: 4/5
• Edge support: 4/5
• Shipping, warranty, and trial: 5/5

• Mattress type: Innerspring
• Firmness: Plush soft, luxury firm, and firm
• Trial Period: 365 days
• Warranty: Lifetime

• Available in plush soft, luxury firm, or firm for various sleeping styles
• Extra support beneath your lower back promotes proper spinal alignment
• Two layers of coils and a pillow top help relieve tension along pressure points

Why should those with back pain choose this mattress? The Saatva Classic is an innerspring mattress that’s easily one of the most popular of its kind on the market. Its three-inch pillow top layer comes in plush soft, luxury firm, and firm options, allowing you to choose just the right amount of pressure relief for your needs. The Saatva Classic is also made with the brand's patented Lumbar Zone Technology in the second and third layers, which are the first to cradle your body beneath the pillow top surface. This additional lower back support helps promote proper spinal alignment and, in turn, reduce (or prevent) lower back pain since sleeping with your spine twisted or out of alignment can cause aches and pains the next day.

What does this mattress feel like? We tested the Saatva Classic Luxury Firm mattress and experienced excellent support that kept our hips lifted (which is very necessary for an aligned spine). The center third of the mattress is firmer than the rest to provide support under the lower back, which is also essential for keeping your spine naturally aligned. There was just enough contouring from the thick pillow top layer to cradle our shoulders, but we still felt as if we were resting evenly on top of the bed. Considering that the Saatva Classic is an innerspring mattress with mostly coils, we also stayed remarkably cool on this mattress.

What do we love about this mattress? Right off the bat, we noticed that the Saatva Classic feels highly structured. Our spines maintained a gentle, neutral S-curve while edge support was strong. Moving around and getting in and out of bed was easy, which is important for those with lower back pain who may have limited mobility or struggle to bend down. Support was a winning feature as well. “My partner and I joke about feeling like we’re floating on a sea of comfort. There’s little to no sag. I think any kind of sleeper—side sleepers, stomach sleepers, and back sleepers alike—would like this supportive pick,” contributor Bailey Berg said.

What would we change, if anything, about this mattress? The center third of the Saatva Classic, which has the lumbar support bar, is noticeably firmer than the head and foot of the bed. This unique feature may take some sleepers time to get used to, especially if you’ve never slept on a mattress with built-in lumbar support.

• Support level: 5/5
• Durability: 4.5/5
• Motion control: 3/5
• Cooling: 4.5/5
• Edge support: 4.5/5
• Shipping, warranty, and trial: 5/5

• Mattress type: Hybrid
• Firmness: Firm
• Trial Period: 365 days
• Warranty: Lifetime

• Eight layers of various foams and a coil base
• Quilted foam top layer helps prevent sinking into the bed, which can cause back pain
• Individually-wrapped coils boost edge support and airflow through the mattress

Why should those with back pain choose this mattress? The DreamCloud Hybrid is a firm mattress stacked with eight unique supportive layers that each target different needs, such as a gel memory foam layer that cradles your joints and a foam transition layer that offers pressure relief along your spine. Individually-wrapped coils also beef up edge support, so it’s easy to get in and out of bed.

What does this mattress feel like? Our product testers say the DreamCloud Hybrid is firmer than your average mattress, and even though our bodies stayed nicely supported on top of the bed, its slower-moving memory foam layers near the top gave us a bit of cushioning along our joints. We also felt plenty of pressure relief along our backs, making this hybrid mattress an excellent choice for back or stomach sleeping.

What do we love about this mattress? We love that the DreamCloud Hybrid was able to support combination sleeping (when you change positions while sleeping) for back and stomach sleepers, and thanks to its hybrid build, we found it easy to move around on the top of the mattress (its coil layer helps make this movement possible). Since the DreamCloud is a hybrid mattress (also available in an all-foam build), we didn’t find ourselves overheating like we might on a traditional memory foam mattress, which can be prone to trapping heat.

What would we change, if anything, about this mattress? While the DreamCloud Hybrid was, well, a dream for back and stomach sleeping, the same can’t be said about side sleeping. We felt a lot of pressure around the shoulders—likely due to the very firm nature of this mattress. Side sleepers should get the pressure relief they need on a softer bed like the Nectar Memory Foam or even the Helix Midnight Luxe.

• Support level: 4/5
• Durability: 4/5
• Motion control: 3.5/5
• Cooling: 4/5
• Edge support: 3.5/5
• Shipping, warranty, and trial: 5/5

• Mattress type: Hybrid
• Firmness: Softer, luxury firm, firmer, and plus
• Trial Period: 120 days
• Warranty: Lifetime

• Targeted pressure relief with firmer sections by the joints
• Cushioning, gel-infused foam Euro pillow top
• Individually-wrapped coils boost breathability and airflow

Why should those with back pain choose this mattress? The WinkBed is a hybrid mattress that comes in multiple firmness options, including luxury firm, which we tested and recommend for people with back pain. (Luxury firm is comparable to medium-firm.) It has five layers designed to help alleviate pain or discomfort, including a gel-infused foam Euro pillow top that helps ease tension along your joints, plus a thick coil layer for targeted pressure relief that gives you more or less pressure where needed.

What does this mattress feel like? We felt noticeable pressure relief along our lower backs when lying on the luxury firm WinkBed. Because of the mattress's firm build, we floated nicely on top of it and our spines stayed properly aligned. Its foam layers gave it a subtle touch of softness that left our sleep comfortable and joints gently cushioned. The coil system also gave a boost of support under the foam, making it easy for us to move around the bed and switch between sleeping positions. If you’re a combination sleeper, rest assured that the WinkBed’s gel foam layer won’t leave you feeling stuck and sunk into one sleeping position for the duration of the night, as our testers unanimously agreed.

What do we love about this mattress? The WinkBed’s zoned coil system feels durable and sturdy while its overall design has an air of luxury similar to sleeping on a high-quality hotel mattress. We especially love the firmness for back sleeping, and our pressure map test confirmed that back sleeping was the best option for experiencing pressure relief on this mattress. (Check out our methodology section below for more details on exactly how our pressure map test works.)

What would we change, if anything, about this mattress? The Luxury Firm WinkBed is much too firm for side sleeping, as we felt too much pressure along our hips and shoulders. Side sleepers will want to choose the softer variation of the WinkBed, which is much more plush.

• Support level: 5/5
• Durability: 4.5/5
• Motion control: 3.5/5
• Cooling: 4/5
• Edge support: 5/5
• Shipping, warranty, and trial: 5/5

• Mattress type: Hybrid
• Firmness: Medium-firm
• Trial Period: 365 days
• Warranty: Lifetime

• Designed for people with chronic back pain and joint conditions
• Core material contours to the shape of your body
• Plush surface helps cradle pressure points

Why should those with back pain choose this mattress? The Saatva Rx calls itself the first mattress of its kind designed specifically for people with chronic back or joint issues, such as arthritis, a herniated disc, or scoliosis. Its Lumbar Zone Technology, which offers targeted pressure relief along the spine, received a seal of approval from the Congress of Chiropractic State Associations. This luxury mattress is also made with special quilting along the lumbar zone to give more support in the center third of the mattress, which matches the natural curve of the spine.

What does this mattress feel like? The Saatva Rx has an impressive height of nearly 15 inches, so upon first glance, we got the impression that we’d sink right into its many cushioned layers. However, we rested perfectly on top of the bed, which we credit to its sturdy coil layer. We rated the support a solid 5/5, although product testers over 230 pounds noted slightly reduced pressure relief simply due to the effect of gravity and potentially bumping up against the coil system.

What do we love about this mattress? We love the Saatva Rx for its numerous pain-relieving properties, making it an excellent choice for those with more serious back pain. Between the Lumbar Zone quilting and micro coil layer (which has individual pieces of foam inside each coil for targeted pressure relief), we felt that the Saatva Rx honed in on and relieved the pressure from even our most sensitive joints.

What would we change, if anything, about this mattress? The Saatva Rx comes with a hefty price tag—starting at $1,995 for a twin-size mattress and going all the way up to $4,390 for a split king. Between physical therapy, medication, and doctor appointments, getting help for back pain is already expensive, so it’s a bummer to see a mattress for back pain cost so much.

• Support level: 4.5/5
• Durability: 4.5/5
• Motion control: 4/5
• Cooling: 4.5/5
• Edge support: 4.5/5
• Shipping, warranty, and trial: 5/5

• Mattress type: Hybrid
• Firmness: Plush, luxury firm, and firm
• Trial Period: 120 days
• Warranty: Lifetime

• Zoned support for targeted pressure relief
• Top layer of foam redistributes body weight to reduce tension around joints
• Comfort+ option with enhanced coil support system available for those over 300 pounds

Why should those with back pain choose this mattress? If you have back pain and sleep hot at night, we love the Nolah Evolution for its various cooling features, such as its moisture-wicking cotton cover, breathable perforated foam layer, and heat escape gusset (an extra layer of fabric) that allows cold air to circulate throughout the bed. This seven-layer hybrid mattress comes loaded with Zoned AirFoam, which is designed to take pressure off of joints by redistributing and essentially absorbing body weight. The foam around the shoulder area, which tends to be some of the most sensitive for many people, also has extra cushioning to further alleviate pressure.

What does this mattress feel like? The Nolah Evolution’s substantial coil layer kept us floating on top of the bed, yet its cooling Euro quilted pillow top hugged our sensitive joints where needed for pressure relief along the hips and shoulders. The cooling layer also did its job as promised—it started at 68 degrees and rose to 78.1 degrees after laying on the bed for five minutes, but the temperature quickly dropped to its starting point in just over two minutes.

“With multiple design features geared toward airflow for hot sleepers, like graphite-infused memory foam and fibers to release body heat, it’s a very cooling mattress that won’t leave you feeling uncomfortable or sticky,” said commerce editor Audrey Lee in her Nolah Evolution review. The mattress also feels supportive without being too firm, and moving around on top of the bed was a breeze—we never got stuck. It also absorbed a greater-than-average amount of motion for a hybrid mattress, which is a bonus for couples who share a bed.

What do we love about this mattress? Its 15-inch loft gives the Nolah Evolution a luxurious, hotel-mattress aesthetic, and the quilted pillow top doesn’t give the mattress a muffin-top look, maintaining its smooth and clean profile. The Nolah Evolution’s breathable gusset also did its job well, breaking up our body heat to keep us cool and comfortable. It worked well for all sleeping positions we tried, making it suitable for a variety of sleepers. “Easy setup, a generous sleep trial period, and emphasis on quality aside, with the Evolution, I genuinely look forward to bedtime,” said Lee.

What would we change, if anything, about this mattress? Edge support on the Nolah Evolution was average at best. While we didn’t feel like we would fall off the bed, we didn’t feel super supported, either. We would have liked to see a stronger edge support system, especially on the Luxury Firm model that we tested. As an alternative, sleepers can consider the Saatva Classic, which has excellent cooling features and an equally robust edge support system.

• Support level: 4/5
• Durability: 5/5
• Motion control: 4/5
• Cooling: 5/5
• Edge support: 3.5/5
• Shipping, warranty, and trial: 5/5

• Mattress type: Hybrid
• Firmness: Medium-soft
• Trial Period: 100 days
• Warranty: 10 years

• Moisture-wicking organic cotton and Merino wool cover
• Three-zone support system that can support the hips and low back
• Contouring memory foam layer that provides excellent pressure relief for back sleepers

Why should those with back pain choose this mattress? Back sleepers who tend to deal with back pain can benefit from the Leesa Legend’s balance of soft luxury and joint support. This hybrid mattress features a three-zone support system that lifts your hips and low back to keep your spine in neutral alignment—key to minimizing back pain. Meanwhile, its contouring memory foam layer provides both necessary pressure relief and the right amount of cradle-like contouring.

What does this mattress feel like? The Leesa Legend is the brand’s top-of-the-line mattress—and it definitely feels like it. Its organic cotton and merino wool cover is both sleek and cool to the touch, and the top layer of comfort foam gives the mattress the perfect balance of softness and bounciness. Meanwhile, we could feel the zoned support system doing its job throughout the bed, offering extra pressure relief along the shoulder area and more support under the hips and low back.

What do we love about this mattress? With a ventilated foam top layer that circulates air throughout the bed and two thick layers of coils that further push air throughout the mattress, the Leesa Legend is excellent at staying cool. And even though it’s a softer bed, we enjoyed its responsiveness—it’s easy to get up and down from a back-sleeping position. We also love that the Leesa Legend is made with high-quality, eco-friendly materials.

What would we change, if anything, about this mattress? The flip side of helpful bounce in this mattress is a lack of motion isolation, which may be an issue for couples or people who share a bed. And while we enjoyed its softer feel, a little more firmness is needed for heavier sleepers to feel truly supported by this mattress.

• Support level: 4.5/5
• Durability: 4/5
• Motion control: 3.5/5
• Cooling: 4.5/5
• Edge support: 4.5/5
• Shipping, warranty, and trial: 4/5

• Mattress type: Hybrid
• Firmness: Soft, medium, and firm
• Trial Period: 120 days
• Warranty: Lifetime

• Coil layer with five zones of support to accommodate different parts of the body
• Individually encased coils promote airflow through the mattress
• Additional lumbar support in center of the mattress

Why should those with back pain choose this mattress? The Bear Elite Hybrid comes in soft, medium, and firm options. We tested the medium firmness, which may be an ideal choice for side sleepers seeking just the right amount of pressure relief paired with a touch of softness to relieve tension. The mattress has individually encased coils that each react independently to different pressure points throughout your body, helping provide more or less targeted support where needed.

What does this mattress feel like? The medium variation of the Bear Elite Hybrid felt plush and contouring but still supportive enough to keep us resting on top of the bed. While side sleeping, we noticed great support along our spines, and the multi-zone coil layer provided generous contouring along the lumbar region. The mattress felt sturdy and well-built, leaving us confident in its ability to maintain its shape and structure for at least the average mattress lifespan of 10 years. Getting in and out of the bed was also a breeze, which is a bonus for folks with back pain who might find this task more difficult.

What do we love about this mattress? We loved how plush and airy the Bear Elite Hybrid felt, which was a bonus for our side-sleeping product testers. The cover was breathable and cool to the touch, which made climbing into bed something we looked forward to. It also did an excellent job isolating motion transfer, and while we felt our fellow product testers getting into and out of bed, we couldn’t feel them rustling around or changing sleeping positions.

What would we change, if anything, about this mattress? We had to put in more effort than average to go from one sleeping position to another. While the bed was generally easy to move around on, it didn’t hit those excellent marks we were looking for. A more responsive bed for side sleepers is the Helix Midnight Luxe, which has a sturdy coil system that provides plenty of bounce, making it easy to move around on top of the bed and switch sleeping positions.

• Support level: 4.5/5
• Durability: 4.5/5
• Motion control: 3.5/5
• Cooling: 4.5/5
• Edge support: 4.5/5
• Shipping, warranty, and trial: 5/5

• Mattress type: Hybrid
• Firmness: Soft, medium, and firm
• Trial Period: 120 days
• Warranty: 10 years

• Contouring plush pillow top
• Comfort foam layer adjusts to different sleeping positions
• Individually encased coils offer targeted pressure relief

Why should those with back pain choose this mattress? While most experts and research agree a medium-firm bed is ideal for people with back pain, those who love a plush bed want to consider the soft or medium variation of Brooklyn Bedding's Aurora Luxe, a hybrid mattress with six unique layers. Its two-inch contouring plush pillow top helps hug and cradle the joints while a firmer comfort foam several layers deep helps support your body in various sleeping positions.

What does this mattress feel like? We tried the medium version of the Brooklyn Bedding Aurora Luxe, which we found plush and soft to the touch. Even though this bed was significantly softer than most other mattresses for back pain that we tried, we still felt adequately supported, and our spines were in alignment. The Brooklyn Bedding Aurora Luxe was also very cool to the touch, and the temperature at the top of the mattress went up less than five degrees after laying on it for 10 minutes—a small increase that we deem to be excellent for cooling.

What do we love about this mattress? Although the Brooklyn Bedding Aurora Luxe is a hybrid build, we noticed the signature bounce of an innerspring mattress, making it extremely easy to move around on and switch to different sleeping positions. With this great responsiveness, tossing and turning became much less cumbersome.

What would we change, if anything, about this mattress? While responsiveness ranked high, we easily felt our product testers moving around on this bed. If you share a bed with a partner or you or your partner are sensitive to movement, you may want to seek out a mattress with stronger motion control, like the Nectar Memory Foam.

• Support level: 4/5
• Durability: 4/5
• Motion control: 3.5/5
• Cooling: 4.5/5
• Edge support: 3.5/5
• Shipping, warranty, and trial: 4.5/5

We chose what we deemed the best mattresses for back pain by gathering our mattress reviewers to test each mattress on our list (and many more—over 100 mattresses in total) while paying extra close attention to features that could contribute to or alleviate back pain, such as firmness and targeted pressure relief.

Lying on the mattresses, testers gauged the feel, firmness, comfort for various sleeping positions, support for those with different body types, and how well our spines stayed neutrally aligned (a key factor in preventing back pain at night, according to Dr. Saifullah).

We also employed several mattress tests that measure—and collect objective data for—factors that shoppers look for in a mattress for back pain, including:

• a cooling test that uses a thermal gun to detect temperature (tossing and turning all night from overheating can cause poor sleep posture, which may contribute to back or neck pain)
• a pressure relief test using a pressure map under our testers, specifically focusing on areas along the spine where back pain is common (such as the low back)
• an edge support test that measures how much a mattress sinks beneath various weights along its perimeter, as well as how easy it is to get on or off of the mattress (back pain may make it tough to climb into or out of bed)

Having multiple mattresses of different types from various brands in the same room helped us pinpoint their key differences, such as design, build, pressure relief, and overall feel. We were able to determine how much plushness led to sinking into the bed and more back pain, as well as what level of firmness went beyond actually being comfortable for our joints and our sleep.

Of course, we considered mattress return policies, trial periods, and warranties as well to determine if those buying a mattress for back pain could feel confident in their purchase in the event that their mattress came with a defect or ended up making their back pain worse.

For more information on how we test mattresses, check out our detailed sleep product testing methodology.

What You Should Look for in a Mattress for Back Pain

The best mattress for back pain should come loaded with features that reduce pressure, promote proper spinal alignment, and cradle sensitive joints. Here’s what to look for when shopping for a mattress for back pain.

Firmness tends to be subjective, as we often ran into during our mattress testing (there was much debate between mattresses being medium-soft or a true medium), but research often points to a medium-firm bed as the best choice for back pain and natural spine alignment. The medium firmness of the Helix Midnight Luxe kept us sleeping on top of the bed while softer variations of the Brooklyn Bedding Aurora Luxe may not be firm enough for back pain relief. Still, if you just love a soft and plush bed and it keeps you comfortable, that’s okay too.

Keep in mind that body weight and shape can also change how a mattress feels from person to person. For example, individuals over 230 pounds may sink further into a mattress simply due to gravity, which can cause it to feel softer or less supportive.

A hybrid or memory foam mattress is best for contouring around your body and cradling the most sensitive of joints. Alternatively, innerspring mattresses may not be pressure-relieving enough for those with aches and pains who require a bed that won’t cause additional pressure buildup. (Innerspring mattresses often feel firmer due to their lack of comfort foam.) The hybrid Saatva Rx has a balanced blend of contouring and pressure relief, especially for those with serious back pain, while the Saatva Classic, which is an innerspring mattress, may feel firmer and therefore increase pressure.

Support is one of the most important features to look for in a mattress for back pain, as it's what makes or breaks pressure relief. Keep an eye out for words like “zoned” or “targeted” support; this type of support offers more or less pressure relief in certain areas of the bed where your joints will be located. The Leesa Legend has three zones of pressure relief while the DreamCloud Hybrid has a more traditional support system without as much zoning.

Pressure relief, pressure relief, pressure relief—you’ve read all about it throughout our best mattresses for back pain guide. Pressure relief is what helps relieve tension from your joints, such as your hips or shoulders. It can come in the form of individually encased coils that provide independent pressure relief, cradling memory foam, or transition layers that keep your spine in a natural S-curve. One of our favorite mattresses for pressure relief is the Nolah Evolution.

If you sleep independently, this feature may not matter as much to you, but motion control in a bed is essential for people who share a bed with a partner or pet. Essentially, motion control, or motion isolation, helps prevent bed partners from feeling the other get in or out of the bed or shift into different sleeping positions. While motion control itself won’t cause or reduce back pain, a bed with poor motion control can leave one partner tossing or turning, which then can exacerbate pain. Our best mattress for couples with back pain is the Nectar Memory Foam.

Trial periods and warranties are both huge features to consider when shopping for the best bed for back pain. Since mattresses can take upward of three months to break in, a longer trial period can help you see how a mattress performs over time. Ideally, you want a trial period of 365 nights to test a mattress so you can also see how well a mattress stays cool in warmer months. A lengthy or lifetime warranty is important, too, as it helps protect you from manufacturer defects or other issues with your mattress. For a lifetime warranty, consider the Bear Elite Hybrid.

Mattress prices range dramatically. You can purchase a more budget-friendly mattress on Amazon, many of which are available for a few hundred dollars, or a luxury buy like the Saatva Rx that may cost upward of $4,000. More expensive isn’t necessarily always better, but a less expensive mattress may be made with less durable materials and might need to be replaced much sooner, which could end up costing you more money in the long run. The Nectar Memory Foam is one of our most affordable mattresses for back pain.

Different Types of Back Pain

Back pain can originate in several places, but the right mattress features may help alleviate that pain. We talked with Dr. Saifullah about how to find the best bed for back pain depending on where your pain is located. We also looked at what current research says about choosing a mattress for back pain.

Lower back pain is often caused by an injury to the muscles or tendons in the back. Such injuries could stem from lifting something too heavy, an accident or a fall, or even twisting the wrong way (such as while sleeping). Studies show that memory foam mattresses are best for alleviating back pain.

Less common than lower back pain, middle back pain can be the result of numerous causes, such as a pinched nerve, poor posture, or muscle injury. If your spine isn’t in neutral alignment while sleeping, you might experience middle back pain. Luckily, it can be alleviated by sleeping on a medium-firm mattress with supportive pillows that keep your body properly aligned. In addition to head pillows, Dr. Saifullah suggests sleeping with a pillow between your knees while back or side sleeping to help your spine maintain its natural curve.

Upper back pain is generally caused by the same factors as middle back pain and can include muscle tightness or stiffness. A supportive medium-firm mattress can help you maintain good posture while sleeping while a contouring memory foam mattress can offer pressure relief.

Common culprits of neck pain include sleeping with a pillow that’s too high or stiff or spending too much time stomach sleeping, which can leave your neck turned in one direction for too long. A mattress with targeted or zoned pressure relief may help prevent a sore neck the next day.

Signs Your Mattress Is Causing Back Pain

Back pain can be caused by a number of factors, including an accident, lifting something heavy, or structural problems in your spine, but sometimes, the culprit is as simple as an unsupportive mattress. Perhaps your mattress is old and has started to sag, or it might be too plush and causing you to sink into the middle of it while sleeping. Whatever the reason, a few telltale signs can help you identify whether your mattress is causing you back pain.

If you wake up with a stiff or achy back, your mattress might not be providing proper support anymore, says Dr. Saifullah. This is especially true if it happens frequently or over a long period of time or if you find your back pain improves throughout the day (only to worsen again at night). You might also find yourself sleeping better on other mattresses, such as at a hotel, which can be a sign that yours is contributing to the pain.

Noticing visible dips in your mattress or finding yourself sinking into one particular spot? “Visible dips or unevenness indicate a loss of support and potential for misalignment,” explains Dr. Saifullah. If your mattress is sagging, it’s time to invest in a new one.

Waking up often throughout the night or tossing and turning can indicate a problem with your mattress. Basically, it means your mattress just isn’t comfortable for you and could stand to be upgraded. Your mattress might be at the end of its lifespan or too firm or too soft for comfort.

Never feeling well rested? Your mattress could be to blame. Back pain might be keeping you up all night, or you could be having restless sleep due to pain without knowing it. If you constantly wake up feeling tired, check your mattress quality and talk to your doctor about addressing the source of your back pain.

How Your Sleeping Position Affects Back Pain

It may come as a surprise, but your preferred sleeping position can play a significant role in contributing to back pain. Dr. Saifullah says side and back sleeping are widely considered to be the best sleeping positions for back pain since they keep the spine in neutral alignment. “You can also place a pillow between your knees for added support,” he suggests. You can invest in a high-quality mattress for side sleepers for targeted pressure relief as well.

Whether you sleep on your back or side, Dr. Saifullah cautions that it’s important to have proper lumbar support, such as placing a pillow under your knees, which can help maintain neutral spine alignment. You might also find back sleeping more comfortable for back pain over side sleeping, or vice versa. Some experts suggest one position over the other, depending who you ask, but whichever position is most comfortable to you will be best for your individual needs.

As for the one sleeping position you should consider avoiding with back pain? Stomach sleeping. “Stomach-sleeping hyperextends the neck and strains the lower back,” says Dr. Saifullah.

Tips to Reduce Back Pain While Sleeping

While sleeping on a mattress with adequate support and comfort is probably the best way to reduce back pain while sleeping, there are a few lifestyle changes you can make (and ways to reduce pain before going to bed) that can help improve your quality of sleep as well.

You’ve probably heard by now that poor posture can lead to back pain, and while maintaining good posture during the day matters, so does good posture during sleep. While you may not be able to drop your shoulders or sit upright while sleeping, you can potentially reduce back pain by sleeping on your side or back, which Dr. Saifullah says are the preferred sleeping positions for back pain. “Avoid sleeping on your stomach, which strains your neck and lower back,” he says.

Investing in a mattress for back pain isn’t the only change you can make to your bed to help avoid achy, sleepless nights. Your pillows are just as important for reducing pain. “Choose a pillow that keeps your head and neck in proper alignment with your spine,” says Dr. Saifullah. Your head shouldn’t be elevated too high or too low. If you sleep on your side, look for a pillow with a higher loft designed with side sleepers in mind.

If purchasing a new mattress outright isn’t feasible or affordable for you, adding a medium or firm mattress topper to your existing bed can provide pressure relief if there is none. A memory foam mattress topper can also cradle your sensitive joints and contour to the unique shape of your body. If springs are poking out of your mattress or there’s noticeable sagging (signs your mattress should be replaced), a mattress topper won’t fix these issues and you’ll likely still feel discomfort while sleeping.

Taking a few minutes to apply heat before bed or ice upon waking up can be a great way to lessen any lingering back pain. Dr. Saifullah recommends applying a heating pad before bed to loosen tight muscles and an ice pack to reduce inflammation after waking up with pain.

Giving your body a good stretch isn’t just for before or after workouts. “Regular stretching before bed can improve flexibility and reduce back pain,” explains Dr. Saifullah. Lying on your back and pulling your legs close to your chest can provide relief for lower back pain, but be cautious about stretching if you have new pain (such as from an injury) since stretching could make it worse. And always follow the guidance of your physical therapist or doctor.

Your bedtime routine and sleep habits aren’t the only ways to reduce back pain while sleeping. The way you spend your daytime hours can also make a big impact. Eating a nutritious, well-balanced diet with complex carbohydrates like whole wheat toast or oatmeal can help you sleep better overall by increasing your body's production of melatonin, the hormone that makes you sleepy. And, of course, it’s important not to push yourself too hard if you have more serious back pain. Be sure to weave plenty of rest into your schedule and not just during nighttime hours.

FAQs

Memory foam, latex, or hybrid mattresses are the best choices for back pain relief, says Dr. Saifullah. Memory foam contours to your body while latex offers good pressure relief. Hybrid mattresses, meanwhile, combine the support of coils with foam or latex comfort layers for better sleep.

Most experts and research agree that a medium-firm mattress is the sweet spot for back pain relief or prevention. This firmness level tends to provide the best spine alignment and general comfort. Firmness can be subjective, so it’s important to seek out a mattress that ultimately feels comfortable to you (which may or may not be medium-firm).

Memory foam naturally conforms to the shape of your body, which can be a great way to get targeted pressure relief in areas causing you pain along your spine or shoulders. Keep in mind, though, that memory foam can trap heat, so you may want to look for a cooling variety or try a latex mattress if you tend to run hot while sleeping (latex is supportive yet more breathable).

Adding a memory foam mattress topper to your bed can amp up pressure relief and support if your current mattress is causing you back pain. It’ll also cost a fraction of the price of buying a new mattress. Just be sure that your mattress topper isn’t too soft, which can cause you to sink into the bed and throw off your natural spine alignment, potentially adding to any existing pain.

This article was medically reviewed by Soma Mandal, MD. Dr. Mandal is a board-certified internist who completed an internship and residency at NYU Langone Medical Center and a research fellowship in evidence-based medicine at the University of Oxford, England. She practices in Summit, New Jersey.

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