Emma Loewe is the Senior Sustainability Editor at mindbodygreen and the author of “Return to Nature: The New Science of How Natural Landscapes Restore Us.”
Scott Nass, M.D., MPA, FAAFP, AAHIVS is a family physician and HIV specialist in California. He takes a holistic approach to healthcare, incorporating principles of functional medicine and using food as medicine when working with patients.
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Last updated on August 8, 2022
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Of all the things that keep people up at night, back pain is one of the most common—and annoying. Up to a quarter of adults in the U.S. report having occasional low-back aches, and they tend to flare up in the early morning hours after all that lying in bed. And sleeping on the wrong mattress only makes matters worse.
Turns out, getting a supportive snooze is extra important for back pain sufferers, so we spoke with chiropractors to find out how to choose the best mattress for your needs. Rest assured that the following 10 picks will have your back.
Lower-back pain and sleep.
Low-back pain is one of the main causes of poor sleep quality. And the tricky thing is that if you’re not getting proper sleep, back pain becomes a whole lot harder to recover from.
“Without the healing benefits of a good night’s rest, the injury may last longer, and therefore pain levels last longer too,” says Jacinta Di Prinzio, D.C., of Open Space Healing in Western Australia. She adds that poor sleep is also associated with increased markers of inflammation, which only exacerbate pain.
On the other hand, when back pain sufferers are able to rest up, it’s super beneficial for their recovery. “Think of a good night’s sleep as our body’s way to reset from the wear and tear of the day and heal,” says Caitlin Redding, D.C., RYT, of Redding Chiropractic in Pennsylvania. There’s no part of the body that doesn’t benefit from a solid snooze, our backs very much included.
Lower-back pain and mattresses.
For low-back pain sufferers, the right mattress can mean the difference between nights of tossing and turning and snoozing comfortably. The key is finding one that’s just the right level of firmness to support a healthy sleeping posture and keep the spine neutral. Most often, that’s going to be a medium or medium-firm mattress.
“A too-soft mattress might allow your hips to sink deeper into the mattress, pulling your spine out of alignment,” explains Redding. “An overly firm mattress will create too much pressure on the hips and shoulders.”
Di Prinzio notes that in her practice, she sees a lot of people who come in with back pain because they’ve held on to their mattress for too long. If you notice that your mattress is sagging and doesn’t offer the support that it used to, it’s time to invest in a new one that’s just right for your needs. (And consider recycling your old one while you’re at it.)
How to choose a mattress for low-back pain.
Ultimately, Redding explains that people who have back pain should look for the same kind of mattress as people who don’t have back pain: a comfortable one!
Ideally, your mattress will allow your spine and head to remain in a neutral, relaxed position throughout the night. And you’ll want to opt for one that supports your weight and contours your body without sinking too deep, says Di Prinzio.
Your sleep position will also affect the mattress firmness that’s right for you. Everyone’s different, but here are some general tips on the firmness level that will be most comfortable for side, stomach, and back sleepers:
Side sleepers: Medium-firm. The best mattresses for side sleepers with back pain will be soft enough for hips and shoulders to sink into slightly. If it’s too firm and doesn’t have any give, you’ll wake up with soreness in these regions that you’re sleeping on. But if the mattress is too soft, it can allow hips and shoulders to sink too much, throwing off alignment.
Stomach sleepers: Medium-firm / Firm. Medium to firm mattresses tend to be most comfortable for stomach sleepers because they allow the spine to stay neutral. But heads up, Di Prinzio cautions that this is the worst sleep position for back pain sufferers since it can promote an excessive low-back curve (lordosis) and aggravate flare-ups.
Back sleepers: Medium-firm / Firm. Back sleepers can typically also benefit from a firmer mattress that provides a stable and supportive surface for the back.
Hybrid mattresses that stack a softer top (typically foam or latex) on a coil innerspring tend to provide the medium-firm feel that back pain sufferers are searching for. But Redding notes that “no two human bodies are alike, and therefore, no one size answer/mattress can fit everybody’s needs. Similar to running shoes, sometimes you just have to try them out and see which one is the most comfortable for you.”
Some other considerations to keep in mind on your search: If you tend to run hot in your sleep, you’ll want to look for a mattress material that’s more cooling and breathable, like wool, latex, or gel-infused memory foam. If you have allergies or respiratory sensitivities, opt for one that is made from natural materials, or at least tested for polluting VOCs. Finally, those with a bed partner who prefers a softer sleeping experience might want to look for a mattress with split firmness.
How we picked:
At the recommendation of chiropractors, we chose mattresses that fall into the medium-firm range. These offer the support that back pain sufferers need to keep a neutral spine throughout the night. While comfort is subjective, we scoured hundreds of customer reviews to see which ones are the highest rated for pain relief.
We prioritized beds made with materials like natural latex and wool over synthetics like polyurethane memory foams. Not only are these resource-intensive to make, they also can off-gas potentially harmful VOCs as you snooze.
We celebrate mattress companies that offset their shipping, use plastic-free packaging, or go above and beyond to practice sustainability in another way.
Since back pain sufferers need to be extra choosy about their mattress, we were sure to identify companies that offer sleep trials and make it easy to return a mattress if it’s not the right fit.
mbg’s pick of the best mattresses for lower-back pain of 2022:
Pros
Affordable
Tested for VOCs
Cons
Made using synthetic memory foam
Material: Memory foam
Firmness: Medium-Firm
Sizes available: Twin, Twin XL, Full, Queen, King, California King
Trial: 100 nights
Warranty: 10-year
This affordable mattress-in-a-box stacks three layers of foam for a comfortable yet supportive snooze for stomach sleepers (though it’s soft enough for side sleepers, too!). The top layer is a cooling foam for anyone who sleeps warm. Reviewers with back pain note that the foam distributes pressure beautifully, easing aches and promoting pain-free wakeups. While it’s made from synthetic memory foam, Leesa does test its mattresses to ensure they’re low in VOCs.
Leesa’s mattress comes with a 100-night free trial and 10-year warranty, and their customer service has a great reputation.
Pros
Made from natural materials
Reversible layers for customizable firmness
Cons
Pricier than other options on the list
Material: Latex, Wool
Firmness: Medium-Firm
Sizes available: Twin, Twin XL, Full, Queen, King, California King, Split King
Trial: 365 nights
Warranty: Lifetime
This luxurious bed is made from natural, organic materials and designed with comfort in mind. It contains layers of latex that can be flipped for different comfort levels (the firmer side will likely be best for those with back pain) and is topped with temperature-regulating wool for those who run hot. Saatva sleepers note that the ergonomic design of the bed means that every part of the body—head to toe—feels supported as they sleep. “My back has never felt better” is one review you’ll see quite a bit.
It’s Saatva’s commitment to safety and sustainability that make this one a real standout. The mattress doesn’t contain any synthetic, petroleum-based foams and it’s certified free of potentially harmful chemicals and pollutants. Considering its high-quality materials, the price point on this one is also pretty reasonable.
Pros
Affordable
Comes with optional cooling cover
Cons
Made from synthetic foam
Material: Memory foam, Innersprings
Firmness: Medium-Firm
Sizes available: Twin, Twin XL, Full, Queen, King, California King
Trial: 100 nights
Warranty: 10-year
This mattress uses multiple layers of poly memory foam to create plenty of cushion and take pressure off sensitive areas like the back and hips. While not the most sustainable option on the list, it’s a good pick for sleepers who like that sensation of sinking into memory foam—but still need some added firmness to keep their spine aligned.
While memory foam traditionally sleeps warm, this mattress comes with an optional cooling cover to take off some heat. Helix offers tons of other sleep accessories too (think weighted blankets and mattress protectors) for a convenient one-stop sleep shop.
Pros
Made from natural and organic materials
Made in the USA
Cons
Optional topper is expensive
Material: Latex, Wool, Cotton
Firmness: Medium-Firm
Sizes available: Twin, Twin XL, Full, Queen, King, California King
Trial: 100 nights
Warranty: 25-year
This medium-firm hybrid is just the right feel for side sleepers who need to cradle their hips and shoulders. You can also opt in to the accompanying topper to make it a bit softer for around $300. Free of polyurethane foams, this mattress contains organic wool, organic cotton, and natural latex, making it a nontoxic dream.
Pros
Customizable firmness levels
Cons
Made using synthetic memory foam
Material: Memory foam, Innersprings
Firmness: Medium, Medium-Firm, Firm
Sizes available: Twin, Twin XL, Full, Queen, King, California King
Trial: 120 nights
Warranty: Lifetime
This hybrid mattress gets high marks from those with back pain, thanks to its combination of supportive innersprings and soft, pillowy gel foam. Winkbed offers their signature bed in multiple firmness levels, and they make it easy to trade in one model for another if you end up needing something different. Those who sleep on their backs might want to start with the firmer model or the plus, designed for heavier sleepers.
Winkbed also offers a 120-night warranty, and they’ll pick your mattress up and refund you 100% if you’re not satisfied. Bonus: This mattress comes with a generous lifetime warranty (and is pretty affordable to begin with). One downside is it’s made with synthetic foam and doesn’t have many sustainability merits to its name.
Pros
Adjustable firmness level
Offers split bed option
Cons
Made using synthetic memory foam
Material: Memory foam, Innersprings
Firmness: Medium, Medium-Firm, Firm
Sizes available: Twin, Twin XL, Full, Queen, King, California King, Split King
Trial: 365 nights
Warranty: Lifetime
The Split King size of the Sparrow Signature Hybrid allows bed sharers to choose their own firmness level (medium, plush, or firm) using interchangeable layers you can swap for free. Four layers of foam and a layer of innerspring mean that any firmness you choose will comfortably distribute pressure. This is another option for hot sleepers, as the top foam layer is infused with cooling gel. Nest beds are made from synthetic foams, but they air out in the factory to decrease off-gassing a bit.
Nest offers free returns within one year, and their beds come with a lifetime renewal exchange program that lets you get a new comfort layer any time your current one is starting to sag—a plus for back pain sufferers who need the support.
Pros
Made from natural and organic materials
Carbon-negative company
Cons
Might be too firm for some sleepers
Expensive
Material: Latex, Innersprings, Wool, Cotton
Firmness: Medium-Firm
Sizes available: Twin, Twin XL, Full, Queen, King, California King
Trial: 365 nights
Warranty: 25-year
Avocado’s classic mattress is a hybrid with innerspring and certified organic wool, latex, and cotton. It features five ergonomic zones for back and spine alignment and even weight distribution. And while it might be slightly too firm for some sleepers, the optional topper makes it more inviting.
As a B Corp–certifiedcompany, Avocado is a standout in the sustainability space. When you shop with them, you can expect a commitment to ethical sourcing, donations to environmental nonprofits, and carbon negativity (meaning they offset more than 100% of their total emissions).
Pros
Thermoregulating
Tracks your sleep quality
Cons
Expensive
Comes in limited sizes
Made from synthetic foam
Material: Memory foam
Firmness: Medium-Firm
Sizes available: Full, Queen, King, California King
Trial: 100 nights
Warranty: 2-year
Prepare to wake up in the future with Eight Sleep’s smart mattress equipped with sensors that track your sleep through the night, and adjust accordingly. Log into the accompanying app to set your personalized sleep temperature, track your nightly heart rate, and have your mattress wake you up with a gentle vibration. The ultimate sleep gadget, this one is sure to please anyone tech-obsessed.
The Pod 3 Mattress itself is made from layers of poly foam that offer gentle pressure relief for the back and hips.
Pros
Affordable
Made from natural and organic materials
Free shipping
Has split king option
Cons
Might be too soft for some with back pain
Material: Latex, Innersprings, Wool, Cotton
Firmness: Medium
Sizes available: Twin, Twin XL, Full, Queen, King, California King, Split King
Trial: 120 nights
Warranty: Lifetime
“Affordable” and “latex” often don’t belong in the same sentence, as the natural bedding material is more expensive than synthetic foams. But Nolah’s hybrid latex mattress, which also features organic wool and an organic cotton cover, starts at less than $1,000. It’s a great option for anyone curious to try the plush, cozy feel of natural latex without shelling out a ton. Its medium feel is a bit softer than other beds on the list, but it’s ideal for side sleepers who need a little added softness. And it’s still firm enough to be supportive, as evidenced by many reviewers who say it’s helped their pesky back pain.
Pros
Made from natural & organic materials
Breathable for hot sleepers
Material: Latex, Innersprings, Wool, Cotton
Firmness: Medium-Firm
Sizes available: Twin, Twin XL, Full, Queen, King
Trial: 100 nights
Warranty: 10-year
This mattress contains organic latex, wool, and cotton for a cozy natural feel that’s a dream to sleep in. Plus, a layer of innerspring lends the support that back pain sufferers crave. Its wool is super breathable (and OEKO-TEX certified to have no harmful substances), making it a good pick for sleepers who tend to sweat at night. Pssst…hot sleepers on a budget can also check out these cooling mattress toppers to place on their existing mattresses.
FAQ
Can a mattress cause lower back pain?
Many factors can cause or exacerbate lower-back pain—including the wrong mattress. Redding notes that if your back discomfort is greater first thing in the morning, it’s possible that your mattress is to blame. That being said, if your pain worsens, lasts more than a few weeks, or begins interfering with your life, it’s worth seeing a doctor.
What firmness is best for people with back pain?
While it depends on the person, medium to medium-firm mattresses are typically considered best for those with back pain. Softer mattresses don’t usually lend enough spinal support, while hard mattresses can lead to soreness upon waking.
What sleeping position is best for people with back pain?
Side sleeping and back sleeping can be comfortable for those with back pain since they allow for a neutral spinal position. Di Prinzio suggests not sleeping on your stomach if you have back pain because of the way it strains the spine.
The takeaway.
If you suffer from lower-back pain, investing in a medium-firm mattress that supports a healthy sleep posture can help you find some relief as you snooze. Be sure to integrate practices like yoga and stretching into your nighttime routine to set yourself up for your best rest.
