Home Improvement Magazine

Is Your Mattress Causing You Back Pain: Choosing the Right Mattress

By Richard Morse @insidebedroom

Is your mattress causing you back pain? How do you tell, and what can you do about it. Back pain is one of the most common reasons for people visiting their doctor or taking time off work. We shall discuss how to tell whether or not your bed is causing you back pain, what you can do about it and offer some tips on choosing the right mattress.

Table of Contents

Is Your Mattress Causing You Back Pain: Signs to Look for

There are signs that can be used to establish whether or not your bed or mattress is responsible for your back pain. There are several other reasons why your back may feel painful, so don't immediately start blaming your bed.

It is entirely possible that your mattress can give you a bad back but not affect your partner. If you have a partner, and he or she has no back pain, that doesn't mean that the mattress is not the cause of your pain.

Common Mattress Issues

Try switching sides for a couple of nights, and if your pain reduces then that gives you a clue. This is particularly so if your partner starts to feel pain when there was none before. A lot may have to do with your sleeping position, so check out these signs of the more common mattress issues that can lead to back pain, particularly lower back pain.

  • You can't get comfortable in your normal sleeping position.
  • You toss and turn during the night.
  • You feel too much pressure on your pressure points: shoulders, hips, knees, depending on sleeping position.
  • Your bed seems flat and hard.
  • You seem to be sinking into the mattress more than you like.
  • You frequently wake up during the night for no apparent reason.
  • You wake up with back pain, but it goes away quickly once you get up.
  • Your mattress is more than 10 years old.

If your mattress is more then 10 years old, then that may be the issue. Many mattresses can last longer than 10 years, but if you are having back pain that you never has before consider a new mattress. Heavier weight people can wear out a mattress faster than lightweights.

A Medium Hard Mattress Seems Best

If you have any of the above symptoms along with your back pain, then your bed may well be responsible. A study published in the Lancet in 12003 concluded that those lying on a medium hard mattress suffered less pain or rising, less overall disability and less pain during the day than those sleeping on hard mattresses.

The trial was conducted over 90 days with 313 adults suffering chronic non-specific lower back pain who complained of a backache while lying in bed and when rising. It was a double-blind multicenter trial that was properly controlled. Other sources have also concluded a hard bed or mattress to be more responsible for lower back pain than a medium hard mattress.

Bed or Mattress? Which is the Culprit?

While your mattress will likely be the main culprit, it may also be the bed itself. It can make a difference some whether your mattress lies on a solid base or a box spring. However, the same principles apply. Irrespective of the base, if your bed feels hard to lie on, it may be responsible for your lower back pain. It could be that a mattress that feels good on a box spring base might feel harder on a solid base.

Various tests and studies have not generally recommended any specific mattress brand or even mattress type that is better than any other for back pain. What appears to be important that the mattress should support your frame, but should also have enough 'give' in it to allow your spine to maintain its natural 'S' shape. Any bed that is too hard to allow your spine to maintain its natural curvature while sleeping is liable to cause back pain.

So, when comparing bed vs. mattress, it is ultimately the mattress that has the most effect on spinal alignment and back pain. A hard base can easily be overcome by using a slightly softer mattress. On the other hand, you may have been sleeping on a particular mattress over a box spring base without any problems. You then switch to a slatted or solid wood base and find yourself developing a pain in your lower back. What you may need is a slightly softer mattress to compensate for the harder base,

What Type of Mattress is Best for People with Back Pain?

What type of mattress is best for people with back pain? Think of the information provided above. You have to think about what causes your back pain, particularly if your back feels painful when you wake in the morning. It is usually because of the way your spine is aligned when you are sleeping. If you sleep on your back, your mattress may be too hard and doesn't allow your spine to retain its natural curved shape.

A softer mattress does allow this, but if your mattress is too soft then your shoulders and buttocks will sink too far in. The small of your back (the part of your spine that curves in from just below your ribs down to your hip area) might not be properly supported. Your spine can not then maintain its natural 'S' shape when you are sleeping.

Here is a brief discussion on the types of mattress available and their pros and cons regarding their suitability for those that suffer back pain.

Innerspring Mattresses: This is still the most commonly used type of mattress. Avoid the softer low spring count type that you tend to sink into. You need good support, but not too hard. A medium hard innerspring mattress is a good choice for people who suffer back pain. Some find the enclosed or pocketed coil type best for them since they tend to absorb pressure on your hips, buttocks, and shoulders while supporting the rest of your body. This helps to maintain the natural shape of your spine.

Memory Foam Mattresses: Memory foam responds to your body temperature and your weight by softening slightly to mold to your body shape. This reduces pressure on your pressure points while helping to maintain the natural alignment of your spine. Memory foam mattresses come in a range of hardness ratings so select one that gives you good support when you try it.

Latex Foam: Latex foam is more bouncy than memory foam and does not conform to your body shape as memory foam does. If you prefer a firmer type of mattress that compresses less when you lie on it, it can help to reduce back pain. However, some people don't like the feel of a bouncier type mattress, in which case this is not for you.

Air Beds: Air beds constructed from multiple air chambers can help people suffering chronic back pain. They can be very comfortable, particularly when topped with a layer of foam. They are often used for people with spinal injuries who are unable to move for long periods. Their benefit is that they can be inflated to just the right level of hardness to help alleviate your pain. However, many people do not like the feel of sleeping on an air bed, although those constructed with multiple small air chambers can be very comfortable. You could wake up with a backache if you don't inflate it enough.

Irrespective of the type of bed you choose, it should not be too hard; as if you were sleeping on a board. It should have some give in it while providing good support. You can't always get the full effect of a memory foam bed if you lie on it fully clothed since it responds to body temperature.

Side Sleepers: It is important for side sleepers that they get enough support for their shoulders, hips and knees without the bed being too hard. Many side sleepers prefer a memory foam mattress for this reason.

Conclusion: How to Shop for a Mattress

What is the conclusion then? Not all beds are the same with regard to the support base and the type of mattress. When shopping for a mattress, the experts say you may have to consider your support (box spring, solid wood or a slatted base) and the type of mattress you prefer (innerspring, latex foam or memory foam). However in the real world:

  • The mattress should not be so firm that it is too hard for your spine to assume its normal alignment without collapsing between your buttocks and your shoulders. This leads to significant back pain.
  • It should not be so soft that your body sags into it without any support for your hips and shoulders. Your spine will again tend to straighten out when you sleep. Your natural spinal curvature may then be forced straight, causing significant pain in your back.
  • Your ideal mattress will offer support to your main pressure points: hips, buttocks, shoulders while being firm enough to prevent your spine from straightening out. This is just as true for side sleepers as for back sleepers.


According to the Santa Monica UCLA Medical Center associate professor of orthopedic surgery and neurosurgery, Arya Nick Shamie MD, your mattress should support your body in a neutral position. That's one where the body is supported in a natural position, with a good curvature of the spine and the head, shoulders, buttocks and heels in an equally proper alignment. Arya states on the Web MD website that:

  1. If the mattress is too hard or firm, then it will push against the pressure of these prominent features of your body, and the center will collapse, leading to misalignment of your spine and subsequent back pain.
  2. If your mattress is too soft, then your entire body will just flop into it and again, your natural spinal curvature will be compromised - leading to back pain!

Fundamentally, your mattress should be hard enough to support your weight without you losing the curvature of your spine when sleeping. Those who sleep on their back need to be aware of this - as do side sleepers. Those that sleep on their sides also need support to prevent any lateral movement of their spine. Front sleepers require a firmer mattress to keep the spine in its natural shape.

Finally: What Type of Mattress is Best to Prevent Back Pain?

We have provided advice on:

  1. What to look for if your mattress is causing you lower back pain
  2. Difference between the bed and mattress - and which is the culprit for your back pain.
  3. The difference between various types of mattress and the materials they are constructed from.

No matter what surface you sleep on, or the type of mattress you choose, it is essential to get enough sleep. Getting only 4 - 5 hours each night is not enough - and will do very little for your back pain, except maybe cause it.

Look for a mattress that is neither too hard nor too soft. Each of these extremes can create bad posture while you are asleep - pushing your spine out of alignment. With the perfect mattress, you should feel no pressure anywhere - you should feel like you are floating on air.

If you have back pain or feel sore when you wake up each morning, then consider a new mattress. A mattress's life can be 10 years or more, but it is recommended by many that you change every eight years. If you are developing back pain, and have had your mattress for over 8 years, then buy a new one. It could make a huge difference to your life.

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