The Ultimate Guide to Buying a Mattress for Back Pain
Original article published by VeryWellHealth, November 17, 2020 on verywellhealth.com
By Rachael Schultz
It’s easy to overlook the importance of something you use every day. But anything that plays into sleep quality should be high on your list of priorities. Proper sleep influences everything from your physical health to your mental health, so fostering a good night's sleep is a must. If you suffer from back pain, finding a mattress that alleviates that pain is crucial to health and happiness.
“Just like trying to maintain good posture while standing and sitting, it is important to keep the components of the back—vertebral bones, intervertebral disks, and all associated ligaments—in healthy positions while sleeping,” says Harrison Linder, M.D., pain management specialist with The Center for Interventional Pain Medicine at Mercy Medical Center in Baltimore.
However, there’s a reason there are hundreds of different mattresses on the market right now—there is no one size fits all to the most comfortable and supportive mattress. What’s more, there is no single best option for what’s best for back pain, says Dr. Linder.
“The main thing to ensure is that the new mattress will keep the spine in proper alignment,” he explains.
One thing that certainly compromises spinal alignment is an old or structurally unsound mattress. “Beds are not meant to last forever. If yours is between seven to 10 years old, it’s probably time to start looking—especially if you are having trouble sleeping or waking up stiff and sore,” says Steve Knauf, D.C., executive director of chiropractic and compliance for The Joint Chiropractic.
The catch: This depends on your sleeping position, body habits, subjective ideal firmness, and many other factors. But when looking for the best option for your spine, you should also take your lifestyle into consideration. Budget, ordering method, delivery method, and overall sleep hygiene are all factors to consider when purchasing a new mattress.
Mattress material and firmness are personal, but generally, your sleep position influences how hard feels comfortable. “The goal is to achieve pressure relief for adequate rest and renewal, while still keeping the spine and important structures in proper alignment,” says Dr. Linder.
Firm mattresses aren’t usually comfortable for side sleepers—they can cause pressure to build in your shoulder and hip joints, delivering restless sleep and stiff and sore muscles the next day, says Knauf. But people who sleep directly on their backs or stomach tend to like it more.
Meanwhile, if you sleep on your front or back, soft mattresses can cause areas of your body that are heavier (like the pelvis) to sag, pulling your upper body out of alignment, Knauf explains. Softer mattresses help relieve pressure from the hips and shoulders for those that sleep on their sides, Dr. Linder adds.
Mattresses come in every level of firmness from squishy soft to hard as concrete. Though a lot of people think harder is better, surprisingly there is no one ideal firmness to help ease back pain, Dr. Linder says. In fact, one study found when people were given seven different firmness to try, there was no collective favorite.2 Some people like to sleep on a harder surface, others on one that’s soft. Dr. Linder says in general, people usually prefer a “medium-firm” option. “They tend to be firm enough to offer support for back and front sleepers, but still offer some cushion from those that prefer to sleep on their sides.”
In fact, a 2015 study analysis in Sleep Health found medium-firm mattresses were most ideal for sleep comfort, quality, and spinal alignment.3 However, that level of firmness was subjective, so really it's still about what feels most comfortable to your body. Your best bet is to test beds out in person.
While ideal firmness is subjective, support is not. What’s important for your back is the curves: “The spine has a natural curve to it and your mattress needs to be supportive of that natural curve as well as the entire body,” Knauf explains. When you’re laying down, there should be no place where your body is not touching the bed.
There is a seemingly endless list of materials your mattress could be constructed of—and every material has its own advantage: Coil beds provide good bounce and cooling; memory foam provides even support, says Knauf. There’s also latex, waterbeds, and hybrids of different materials.
Beds can—and should—be an investment. “Sleeping well and waking refreshed can be invaluable. A good bed should last close to a decade, so this is money you’re investing into yourself,” Knauf says.
You can easily drop a full paycheck or two (or three!) on a new mattress. But with so many brands and models on the market, there are also some quality options that can help support your spine without breaking the bank.
If you suffer bad allergies, especially to mold or dust, you should take a closer look at which material you buy. Traditional beds can be more prone to unhealthy mold growth because moisture and air can circulate among air or coil mattresses, while natural latex and foam are resistant to fungal growth. Knauf explains.
Mattress toppers are an opportunity to add another layer to the base you will be sleeping on. This gives you a chance to either further enhance characteristics of your current mattress or attempt to change some of the dynamics, Dr. Linder explains.
For example, if you feel like your firm mattress is supportive but leaving you achy, you can get a soft topper to allow your body to sink in more and find relief from painful pressure points while still benefiting from the more firm base underneath. On the flipside, if your mattress is too soft, adding a firmer topper might help cancel out some of that effect and lead to a more comfortable, healthier sleep, Dr. Linder explains.
Note that if your mattress is old and structurally broken—sagging in the middle, coils that no longer compress—a mattress topper won’t help. But if the base is still in good shape yet it’s causing pressure points or bodily pains, a topper can help make your bed more comfortable without a complete overhaul.
In addition to sleeping pain free, you also want your mattress to maximize your sleep hygiene—that is, your overall quality of sleep. The factors that affect how often you’ll wake up in the night and how well you sleep include your partner or pet moving in the night, body temperature regulation, noise in the room (like bed coils squeaking when you roll over), and pressure points outside just your back like the hips and pelvis.
These are important considerations, but adequate support and comfort definitely take priority over any other features, Dr. Linder adds.
“It’s important to try out a mattress for a while before you know if it will provide the support you need,” says Knauf. “Make sure you have a window of time in which you can give it a test run at home, or a return option if it doesn’t provide what you need to keep your spine healthy.”
Some companies offer a worry-free trial period, while others will charge a return fee, so make sure you check before you buy—especially if you’re ordering online and haven’t tested it out yet.
Memory foam has become enormously popular. Though most of us associate the material with the Tempur-Pedic brand, it's widely used by other mattress brands.
Aptly named, memory foam sinks in wherever you put pressure and molds to that shape, bouncing back when you take it away. Because of this, these mattresses provide even support all along your spine, Knauf says. It’s also great for isolating motion—that is, not being disturbed when your partner or dog moves in the middle of the night. Plus, it’s hypoallergenic.
Memory foam mattress can be made of a few different materials which come with their own pros and cons:
Traditional memory foam is petroleum-based polyurethane. It's temperature sensitive so it softens with your body heat and stays hard where it's cool, making it great for not only cradling your body shape but also isolating movement. However, it also retains that body heat which can interrupt sleep for some.
Plant-based memory foam is made from coconut, soy, and other plant materials so it has the perk of being vegan, sustainable, and environmentally friendly.4 These materials often spring back more quickly, too, so they're great at shaping around your body as you move in the night.
Gel-infused are memory foam mattresses finished on top with a layer of gel. This adds both comfort and breathability. While full memory foam can be quite hot from your body heat, the gel allows air to circulate more, making for a cooler sleep surface. They also spring back to their initial shape very quickly after weight is removed.
Coil mattresses (also called innersprings) are the most traditional and most common type available. That's largely because they've been the leading type of mattress for nearly forever.
The mattress is comprised of a series of steel coils that compress when you sit or lay on them. The shape, size, and number of coils all vary from mattress to mattress, as well as the different coil options—continuous, Bonnell, offset, pocketed coil. But in general, the more coils, the higher the quality and support.
The main draw of this type of mattress is that it's the most affordable option (other than an air mattress). It's also very bouncy and keeps you cool because there’s more room for air to circulate, Knauf points out.
However, coil beds also usually wear out faster so while you may get it cheaper, you'll have to replace it sooner to maintain sufficient spine support. Also, coil beds can be squeaky, so it's not an ideal choice if you or your partner move a lot in the night.
Like mattresses, toppers in themselves are made in a variety of materials, densities, and thicknesses. Polyester blends are a decent option and usually the cheapest, but they don't provide a ton of support and degrade quickly over time. Feather toppers, often called featherbeds, feel extremely soft and luxurious but they don't offer much support for your spine (and a lot of people are allergic to them).
For more spine support, latex and memory foam are typically best. They add either softness or firmness, good support for your joints, and motion control for others on the bed.
Natural latex comes from the sap of a rubber tree, so it's a great option for those concerned with chemicals and environmental footprint.
In a mattress, it performs similarly (but to a slightly lesser extent) to memory foam with its ability to contour to your body and bounce back. But it offers a little more bounce than full memory foam, so it's nice if you don't want that full sinking feeling. It also retains less heat than memory foam which can be good for sleep hygiene. Plus, it’s hypoallergenic.
Nowadays, there are dozens and dozens of boutique mattress brands in addition to the companies that have been making beds for decades. Some of the top manufacturers include:
Casper has become one of the best online sleep brands. For starters, their mattresses are highly rated. And the company makes bed buying convenient: If you live near New York or LA, you can pop into a showroom to test different models. Otherwise, their mattresses are all sold online and come with free shipping, delivery in a box (great for apartment deliveries), and a 100-night trial. If you don't like it, you can return the mattress for free.
Beautyrest is a classic mattress producer still following the classic bed-buying method: Their models are available to test out in specialty sleep chains, furniture stores, and department stores like Sears. They can get pricey quick—the cheapest model is still about $500—but the name is synonymous with quality.
Tempur-Pedic is the original memory foam mattress and, while others are now on the market, they still retain their proprietary foam blend that has given them high customer satisfaction ratings for years. They're on the expensive end of memory foam options, starting at $1,200. But they have the brand loyalty to back it and offer in-person testing at showrooms around the country.
Novaform is a line of memory-foam mattresses, toppers, and pillows sold exclusively at Costco and online. Most of their beds are a medium firmness so would be pleasing to most. Novaform follows Costco's return policy of a full refund if brought back in a reasonable amount of time.
It is another heritage brand with a long-standing reputation for quality beds available at stores like Sears and furniture stores. They make all types of beds, but their unique angle is offering beds to try in person but starting at a lower price point—about $200 entry level.
Sleep Number beds are best known for their dual-adjustable features, which lets the owner customize the degree of firmness on the right and left side of the bed separately. They're air beds, which is what controls the firmness or softness of your number. They run pricy, starting at $900 and running through to nearly $5,000. But they're sold nationally, are established as high quality and reliable, and offer a unique fix for couples that can't agree on what firmness level is best.
The Original Mattress Factory
The Original Mattress Factory makes both innerspring and foam mattresses, sold at their brick-and-mortar stores. This is a great option if you're in one of the nine states that has stores, but online orders get a little tricky: The company offers free shipping, but if you don't love your mattress, you can only exchange, not return—and for a fee of 25 percent of the cheapest of your exchange.
Sealy is one of the largest manufacturers of mattresses and has a Posturepedic line billed specifically as orthopedic, back-friendly beds. The brand is available nationwide at big box stores like Sears, speciality sleep stores, and furniture stores. Most of their mattresses start at $500 and can get up into four-digits quick. But the brand is well-established and widely available if you want that in-store experience.
Mattresses are an investment, so you want to be sure to take care of them. A mattress should last you seven to 10 years, says Knauf. You can maximize that lifespan by:
- Rotating your mattress every six months. Moving your head to your feet every so often can help avoid lumps or compression in specific places.
- Don't jump on the bed. Obviously, this can speed up the taxing of your coils or encourage compression of foam and latex.
- Put a waterproof mattress cover between your mattress and the sheets to prevent dirt or water from getting in and creating mold.
“Finding features that allow you to settle into bed comfortably rather than having to toss and turn throughout the night are usually worth the money for troubled sleepers,” Knauf says.
Adjustable beds, for example, can be great for people with lower back problems, he says. Usually, this allows your head and shoulders to elevate at a slight angle and your knees to bend slightly. This can help relieve pressure from your low back.
And when you’re thinking about keeping your spine in alignment, make sure you’re keeping your neck supported by quality pillows.
There is no one size fits all for an ideal mattress for people with back pain. Side sleepers will likely prefer softer mattresses while those who sleep on their front or back will be more comfortable on a firmer mattress. If you sleep in every position, you'll want to test different beds out for yourself to see what's most comfortable. If you're ordering online and don't know what you prefer, opt for medium-firm which studies and experts agree is most commonly preferred, and check to see if the company offers a trial period before purchasing.
*Offer valued at $39. Valid for new patients only. Initial visit includes consultation, exam and adjustment. NC: IF YOU DECIDE TO PURCHASE ADDITIONAL TREATMENT, YOU HAVE THE LEGAL RIGHT TO CHANGE YOUR MIND WITHIN THREE DAYS AND RECEIVE A REFUND. (N.C. Gen. Stat. 90-154.1). FL: THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS THE RIGHT TO REFUSE TO PAY, CANCEL PAYMENT OR BE REIMBURSED FOR ANY OTHER SERVICE, EXAMINATION OR TREATMENT WHICH IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED OR REDUCED FEE SERVICES, EXAMINATION OR TREATMENT. (FLA. STAT. 456.02). Subject to additional state statutes and regulations. See clinic for chiropractor(s)’ name and license info. Clinics managed and/or owned by franchisee or Prof. Corps. Restrictions may apply to Medicare eligible patients. Individual results may vary. ©2019 The Joint Corp. All Rights Reserved.