Mattresses and (Back) Pain Relief
Unbiased Comparisons Based on 27,204 Owner Experiences
Some mattresses perform significantly better than others in preventing / relieving pain, including back, hip and shoulder pain.
Before discussing which are best, three interrelated terms are important to understand: support, conforming ability, and firmness.
Mattress Support
Support refers to how well a mattress keeps the sleeper's body on a flat and level plane.
Owner experience data shows that support is a key factor in preventing and alleviating pain, especially back pain.
Support can be undermined by excessive softness and excessive firmness – but it is most often undermined by sagging of the mattress. Sagging is the top complaint of mattress owners overall with at least 30% reporting a significant problem.
Sagging occurs when part of a mattress, usually the middle, becomes compressed and lower than the rest. Sagging often puts a person's spine into an unnatural position – especially for side and stomach sleepers. Consequently, mattress owner experience data shows a clear connection between sagging and pain, especially back pain.
The greater the sagging depth the more likely it is that sagging will cause a person to have discomfort or pain in bed and possibly out of bed.
* especially for side and / or stomach sleepers.
It should be noted that despite the fact that back pain for many people may occur with less than 1.5 inches of sagging depth, many mattress warranties cover sagging only if it has a depth greater than 1.5 inches.
Mattress Conforming Ability
Conforming ability refers to how well a mattress conforms or molds to the contours and curves of a person's body. A mattress has good conforming ability if all of one's body is supported equally by the mattress.
A lack of conforming ability means there are gaps in support. The result can be that at least one part of the body – such as the lower back – is placed in an unsupported, unnatural and therefore stressed position which can cause discomfort or pain.
A lack of conforming ability also often results in some parts of the body – namely the shoulders and hips of side sleepers – feeling more pressure than other parts because of unequal support. Such pressure can be a source of significant discomfort.
Mattress Firmness
Having the right firmness is an important factor in preventing / relieving pain.
- MEDIUM firmness (medium-soft to medium-firm) tends to be firm enough to provide support but soft enough to provide conforming ability for average- to small-sized people. Large people (230 lbs+) may find that medium lacks adequate support and allows them to sink too far into the mattress.
- FIRM provides support but little conforming ability for small- and average-size people. Firm is often best suited for larger people (230 lbs+) as they tend to exert enough pressure on the mattress for it to adequately conform to them; a firm mattress also tends to provide the extra support they need. In general, however, excessive firmness is a top complaint of mattress owners (second only to sagging) because the firmness can cause discomfort due to clearly felt pressure points especially for side sleepers.
- SOFT tends to provide both adequate support and conforming ability for smaller-sized people (those under 130 lbs). Average- to large-sized people may find that soft lacks adequate support, especially if they are stomach sleepers.
Learn more: Mattress Firmness Guide & Comparison.
Mattress Types & Pain Relief / Prevention
The graph below shows the pain-relieving ability of the different mattress types based on actual owner experiences. The types that are better at reducing (back, hip and shoulder) pain are more supportive, less likely to sag and more likely to have effective conforming ability. Keep in mind that the chart represents what is often but not always the case; a particular brand, model or individual mattress may go against these findings somewhat.
Air
Sagging and loss of support (barring mechanical breakdown) is usually less of a problem with airbeds compared to most other bed types. And the air chambers inside an airbed provide at least fair conforming ability and allow for adjustable firmness / support to suit personal preference and sleep position. Airbeds, however, with little or no comfort layer can be too firm on hips and or shoulders especially of small- to average-sized side sleepers.
| Support | Good |
| Conforming Ability | Fair to Good |
| Firmness Options | Good |
Memory Foam
While memory foam mattresses can develop problems (sagging, excessive softness, and loss of support) these problems tend to not be as common or serious as they can be with innerspring-based mattresses (memory foam's main competition). Memory foam also provides good conforming ability for average- to large-sized people. Firmness levels tend to be mostly medium to medium-firm. Smaller-sized people may experience excessive pressure points as they tend to not exert adequate weight on the mattress to benefit from the foam's conforming ability.
| Support | Fair to Good |
| Conforming Ability | Good |
| Firmness Options | Fair to Good |
Latex
The support level of a latex mattress can depend on whether it uses Dunlop or Talalay latex in the support layer; Dunlop often provides better support. Latex can develop body impressions and soften over time thereby undermining support. Latex often conforms moderately to the body. Firmness tends to be medium to firm (but soft varieties are available).
| Support | Fair to Good |
| Conforming Ability | Fair to Good |
| Firmness Options | Fair to Good |
Hybrid (Memory Foam / Spring)
Hybrid mattresses often provide above-average support, but such support breaks down for at least 18% of owners within three years due to sagging. Conforming ability tends to be good if at least two inches of memory foam is present. A variety of firmnesses are available.
| Support | Fair to Good |
| Conforming Ability | Fair to Good |
| Firmness Options | Fair to Good |
Innerspring
Innerspring mattresses often provide at least fair support, but such support breaks down for at least 20% of owners within three years due to sagging. Models with a significant comfort layer often provide fair conforming ability, while models with a minimal comfort layer often provide poor conforming ability especially for small- to average-sized people.
| Support | Fair to Good |
| Conforming Ability | Fair |
| Firmness Options | Fair To Good |
Futon
Futon mattresses offer mostly fair support and conforming ability. Futons tend to be more firm than soft.
| Support | Fair |
| Conforming Ability | Fair |
| Firmness Options | Fair to Poor |
Pillow Loft and Pain
While mattress support, mattress conforming ability, and mattress firmness are crucial factors for preventing / relieving pain, they are not the only factors. One's choice of pillow is important as well. If your pillow – specifically its loft or height – is not compatible with your mattress – specifically its firmness level – then neck, upper spine, head and shoulder discomfort or pain are possible.
See our pillow loft guide and calculators to learn how much loft may be best for you.
Sleep Like The Dead's mattress research in The News –
About Our Mattress and Back Pain Research
Our research findings are based on over 27,200 actual mattress owner experiences collected from diverse, credible sources.
The findings report what is true for people as a group; some individuals may have different or even opposite experiences than what our findings describe.
Keep in Mind
– Owner experience data suggests that adjustable beds, especially those with memory foam, latex or air mattresses, can help at least somewhat in relieving back pain and other discomfort. See our Adjustable Bed Reviews & Ratings for details.
– Innerspring mattresses often have good initial comfort and pain relief, but they tend to have the most reported issues regarding sagging and loss of support.
– Considering one's size and sleeping position(s) is important when choosing a mattress. Having a firmness level that does not suit one's personal needs can result in discomfort and pain, including back pain.