Overview

It is estimated that over 75% of adults experience lower back pain at some point in their lives. Lower back pain can have many causes ranging from acute injuries to chronic musculoskeletal disorders. In many cases, though, it can be related to or exacerbated by posture issues that can be directly related to sleep.

Finding a mattress that offers comfort and proper spinal alignment can go a long way to preventing and resolving lower back pain. People who have concerns about lower back pain should take great care in selecting a mattress that can contribute to being well-rested and pain-free.

In this guide, we’ll provide an overview of the types and causes of lower back pain, the types of mattresses available, the key considerations for people with lower back pain, and tips for selecting a mattress. For more about those topics, keep reading through this guide, or you can click here to skip straight to our choices for the best mattresses for people with lower back pain.

Types and Causes of Lower Back Pain

Lower back pain is one of the most common ailments in the United States and, according to MedlinePlus, a service of the National Library of Medicine, it is the second most common reason why people go to see their doctor.

Lower back pain may be accompanied by other symptoms such as stiffness and/or decreased range of motion. It can generally be classified as either acute or chronic.

  • Acute lower back pain arises suddenly and is typically related to a specific incident. It usually lasts for a few days to a few weeks. The most common cause is an injury to the muscles and/or ligaments of the back. For example, lower back pain that comes after lifting a heavy object is acute back pain. Other causes of acute back pain can include muscle spasms, herniated disks, spinal stenosis or curvatures, and other health conditions. More about the causes, symptoms, diagnosis, and treatment of acute back pain is available from the MedlinePlus Medical Encyclopedia at https://medlineplus.gov/ency/article/007425.htm.
  • Chronic lower back pain is experienced over the longer-term and is not usually caused by one single incident. Often, chronic back pain is flared up or exacerbated by a single incident, but the underlying wear on the spine was preexisting. Some conditions that can cause acute back pain, such as a herniated disk or spinal stenosis or curvature, can also cause chronic back pain. More about the causes, symptoms, diagnosis, and treatment of chronic back pain can be accessed from MedlinePlus at https://medlineplus.gov/ency/article/007422.htm.

Both acute and chronic back pain can be caused by a range of different conditions, and some of these conditions can be very serious. As a result, it is important for anyone experiencing serious back pain or back pain that does not go away to talk with a doctor who can help address its most likely cause and treatment.

Finding a supportive and comfortable mattress can help to prevent and to reduce back pain, but it is not a substitute for seeing a medical professional who can conduct an appropriate evaluation and diagnostic process.

Types of Mattresses

You can read a lot more detail about the different types of mattress options that are on the market in our Buyer’s Guide, but we’ll provide a quick refresher here. You can classify almost all mattresses into the following categories:

  • Foam: these mattresses are built with several layers of foam, and the exact foam composition and specifications can vary. One of the most common types of foam mattress construction involves a base of support foam with one or more comfort layers on top. The comfort layers are most often composed of memory foam or another type of foam with a similar feel. Specifically, this type of comfort layer responds to the amount of pressure applied in each specific place, which helps to provide appropriate support to each part of the body.
  • Innerspring: these mattresses use coils inside the mattress to provide spring and support. This is the most traditional type of mattress, and the innerspring coils often have a slightly softer top layer, such as a pillowtop, that can provide some additional plushness and comfort. There are numerous types of innerspring construction that can affect the support and performance of an innerspring mattress.
  • Hybrid: Hybrid mattresses include elements of memory foam, innerspring coils, and/or latex. A common type of hybrid has a layer of memory foam, latex, or a similar type of foam on top of a base of innerspring coils. The goal of a hybrid is usually to try to capture both the benefits of an innerspring and a foam mattress. That said, the benefits and downsides of a hybrid mattress depend in large part on the layering and materials involved in the construction of the mattress.
  • Latex: these mattresses are made from either natural or synthetic rubber. Latex tends to be a heavier and more expensive material, so it is not uncommon to see all-latex mattresses sell for thousands of dollars. Latex offers a high level of responsiveness, but it also tends to be bouncier and more resilient than many foams on the market.

Mattress Considerations for People With Lower Back Pain

  • Firmness: the comfort layer is made up of the top layer or layers of the mattress, and it largely influences the “feel” of the mattress. Firmness is an important element of this feel. On a mattress that is too soft, a person may sag into the bed and contort their body. On a mattress that is too firm, there may be too much pressure placed on key joints and on the spine. As a result, for most people with back pain, a medium-firm mattress, which falls between a 5-7 on the typical firmness scale, is the most comfortable and supportive choice. That said, some people have a track record of comfort and pain-free sleep on firmer or plusher mattresses. If a mattress of this type helps you avoid back pain, most experts recommend sticking with what works.
  • Spinal alignment: not every part of the body needs the same amount of support. Everyone has certain pressure points — for example, for many people it’s the hips and shoulders — that require more support. When each part of the body is adequately supported, it helps maintain a natural spinal curve that can prevent back stiffness and pain.
  • Resilience: resilience refers to how quickly a mattress regains its original shape after pressure is removed from it. A mattress with high resilience helps prevent feeling “stuck” in the bed and is easier to change sleeping positions on. Some people who move around more in their sleep need a mattress that can facilitate this motion without causing them to twist or torque their spine.
  • Sleeping position: a factor that has a great deal of influence on spinal alignment is a person’s preferred sleeping position. Each sleeping position can be related to lower back pain issues:
    • Side sleepers: side sleeping is the most common position, but it tends to exacerbate pressure points at the shoulders and hips.
    • Back sleepers: back sleepers distribute their weight more evenly over the mattress, but this flattened position can fight against the spine’s natural curvature in the lower back.
    • Stomach sleepers: as with back sleepers, stomach sleepers are at risk of misaligning the lower back. Many stomach sleepers also struggle with neck pain related to their pillow selection.
  • Durability: when a mattress starts to wear out, it usually tends to sag and to lose its ability to provide the necessary amount of support. This is problematic for any sleeper, but it is especially troublesome for people with lower back pain. For this reason, durability is an important consideration as people with low back pain want to make sure to buy a mattress that is likely to hold up well over many years of regular use.

Mattress Features to Look For

  • High-quality materials: nothing determines the performance of a mattress more than the quality of the actual components that are used to make it. You’ll come across a lot of fancy marketing terms for different features, but sometimes this is just window dressing to cover over a mattress built with shoddy internal parts. When looking at the materials, here are some questions to think through:
    • Does the company provide detailed specifications? For example, do they list the actual thickness of each layer of the mattress? If it’s a foam layer, do they publicly share the density and/or ILD of the foam? If it’s an innerspring layer, do they tell you about the type of innerspring construction? The more vague the details, the more skeptical you should be that perhaps the company cut corners in choosing their materials.
    • Is there a weak spot? Some mattresses may use great materials in the comfort layer but use a low-quality foam for support. Remember that one weak layer can dramatically reduce the overall performance of the mattress.
    • How thick is the comfort layer? An extremely thin comfort layer may degrade the feel and performance of a mattress and may limit its long-term durability as more pressure will be put on the supporting layers. In general, people with lower back pain should look for a comfort layer that is at least 3” thick.
  • Shopping for two?: many people with lower back pain share a mattress with someone else who may not have the same issues or who may have a different comfort preference. It is extremely important to talk these issues through before starting to home in on potential mattress choices. Check out our guide to the Best Mattresses for Couples for more in-depth tips on finding the best mattress for two.
  • Price and value: you can find mattresses for bargain basement prices and for thousands and thousands of dollars. The cost of a mattress is often not reflective of its overall quality. That’s why we suggest inspecting the design of the mattress and doing your best to comparison shop. For more about getting the best deal, you can review our Guide to Mattress Sales and Discounts.
  • Free shipping: it’s important to consider the total cost of buying a mattress and not just the price of the mattress itself. Most online mattress companies offer free shipping. If you’re enticed by a mattress that has a shipping charge, just make sure to factor that into your total assessment of the value of the mattress.
  • Free and no-hassle returns: many people get concerned about buying a mattress online because they don’t have an opportunity to scope the mattress out in a store. Thankfully, most direct-to-consumer mattress companies offer an extended sleep trial that allows you to try the mattress out in your own home for several months. If you realize during the sleep trial that the mattress isn’t right for you, you can return it at no charge and with no hassle from the company. We suggest choosing a mattress that has this type of sleep trial and return policy to help protect your investment in case you find that the mattress just isn’t the right fit.
  • Solid verified reviews: as we’ve stated, there’s a lot of marketing that takes place in the mattress industry, and one of the best ways to cut through the noise is to only rely on trusted reviews. We’ve tried to do a lot of this legwork for you, and you can read more about any specific mattress in our brand reviews.

Other Considerations

  • Pillow selection: the neck is part of the spine, so proper spinal alignment requires a quality pillow in addition to a quality mattress. A pillow that is too tall or too short can cause neck pain or can exacerbate spinal misalignment. Finding a pillow that is comfortable, supportive, and fits with your preferred sleeping position should be considered part-and-parcel of the mattress buying process.
  • Pillow positioning: there are ways that pillows can also be used to help foster good spinal posture. For example, back sleepers can use a small pillow underneath their knees to account for the curvature of the lower back. Side sleepers may find it helpful to place a pillow between their knees in order to reduce pressure on the hips. Stomach sleepers can use a very thin pillow underneath their abdomen to keep the lower back from dipping out of line with the rest of the body. Each sleeper can experiment with these options to find the most comfortable and supportive options.
  • Compatibility with an adjustable frame: adjustable frames can be moved so that the mattress is not simply flat but is instead positioned at an angle. Some people with back problems find that this partially-reclined position is more comfortable and more supportive. Many mattress options can be used with an adjustable bed, but some aren’t built for that type of adjustment. If you think you may want to try out an adjustable frame, make sure you select a compatible mattress.

Our Choices

Foam

The Novosbed is our pick for the best all-foam mattress for people with low back pain.

  • Why? The Novosbed is offered in three models with different firmness options, which helps ensure that you can find a choice that fits your comfort preference. Each model has at least 4” of foam in the comfort layers, and all of these layers have foams with a density of 3.7 PCF or higher. The result is a mattress with more durability and support than many competitors. Finally, the Novosbed is made by a company that has a strock track record and reputation for customer service.
  • Why not? The Novosbed is somewhat more expensive than other all-foam mattresses, and their sleep trial is more complicated than that of most other online, direct-to-consumer mattresses.
  • The Bottom Line: For people looking for an affordable all-foam mattress built with quality materials that can offer a high level of support and comfort, the Novosbed is an excellent option to consider.

Novos 2.2

Foam-Latex Hybrid

Our selection for the best latex hybrid for people with low back pain is the GhostBed.

  • Why? This mattress has a comfort layer with 3.5” of foam including both memory foam and latex. The support layer has foam with a density of 2 PCF, which is higher than many competitors. Its combination of foams helps improve resiliency while also maintaining the responsiveness needed for good spinal alignment.
  • Why not? The mattress is only available in one firmness option, so it may not be a fit for people with a preference for very firm or very plush mattresses.. In addition, while Nature’s Sleep has been selling mattress for over 15 years, the GhostBed has only been on the market since 2015, which means that we have less data about its long-term durability.
  • The Bottom Line: For the price, the GhostBed uses a combination of quality materials layered in an arrangement that can be expected to provide a supportive and comfortable option for the majority of people with lower back issues.

ghostbed4

Innerspring

The Saatva mattress is our choice for the best innerspring mattress for people with lower back pain.

  • Why? The Saatva is built with excellent components, including multi-layered coils, which gives an extra boost to the support and resilience of the mattress. The Saatva has received solid reviews from customers, and the company has a reputation for a high level of customer service.
  • Why not? Unlike many competitors, the Saatva comes with a charge for shipping that is not refundable if you decide to return the mattress.
  • The Bottom Line: While you can find innerspring mattresses out there for a much lower cost, they simply won’t deliver the kind of mattress performance offered by the Saatva.

Saatva 3

Hybrid

Our top pick for the best hybrid mattress for people with lower back pain is the Tuck mattress.

  • Why? The Tuck is made with high-quality materials including latex, gel-infused memory foam, and solid innerspring coils. In addition, the company builds each mattress to fit the customer based on the response to a sleep quiz. For people with lower back pain, this helps to ensure that the mattress is built in a way that is tailored to optimize their comfort.
  • Why not? The Tuck mattress is still new to the market, and while early signs are good, we do not have long-term data about the durability of the mattress or the company’s overall track record.
  • The Bottom Line: The Tuck mattress offers a combination of materials quality and customization that usually comes at a much higher price tag. This represents an excellent option to consider for people with lower back pain.

Tuck 1

All-Latex

Our choice for the best all-latex mattress for people with lower back pain is the Sleep On Latex Pure Green Mattress.

  • Why? The Pure Green Mattress is built with natural latex that gets excellent reviews for its performance. With its combination of resilience and responsiveness, latex can offer a great blend of comfort and support to enhance spinal posture. Sleep On Latex also offers several different options for mattress firmness.
  • Why not? Sleep On Latex doesn’t provide quite as much detail about the mattress specifications as we would like. For example, they do not list the density or ILD of the latex used in their mattress.
  • The Bottom Line: Even without knowing every detail of the build of this mattress, we can safely say that it includes a considerable amount of high-performance latex at a price that is a fraction of what these types of mattresses are often sold for.

Sleep on Latex 2

Additional Resources