Firmness
The experts I spoke to generally agree that a medium to firm mattress is often best for back pain — although all of them emphasized there is no “one size fits all” firmness that works for everyone. The rule of thumb for dealing with back pain is that a firmer mattress is better than a softer one because it can provide more support for the natural curve of the spine. However, this doesn’t mean you necessarily need the firmest mattress you can find, nor is a super-firm mattress best-suited to all people with back pain. Many people will find very firm mattresses too uncomfortable (myself included), and your comfort is really important when it comes to choosing a mattress. “Support for the spinal curves is crucial, but it’s not just about the bones,” says chiropractor Dr. Sherry McAllister. “The muscles, often overworked and underappreciated, play a significant role.” So don’t count out some cushioning and pressure relief, especially if you have persistent joint pain or arthritis. Additionally, as chiropractor Dr. Sapna Sriram told me, factors like your body weight, sleeping position, and the underlying cause of your back pain will also affect what firmness is best for you.
As you’re shopping, take the experiences you’ve already had into consideration — if you often wake up feeling sore or with hot spots of pain after sleeping on a firm mattress, that’s a good sign you shouldn’t go for an evern firmer mattress. But if you aren’t sure what you like, Dr. Shah suggests trying out firm mattresses for about 15 minutes at a time in the position you find most uncomfortable, just to assess how it feels and affects you. That way, you can start to narrow your search.
Construction
As with firmness, the experts I consulted said the best type of mattress for back pain will vary from person to person, and that innerspring, all-foam, and hybrid models can all be appropriate.However, several of them did mention springs or coils as beneficial for support, so for this list, I’ve prioritized innerspring and hybrid mattresses. Hybrids in particular can vary in how soft or how firm they feel, but the springs or coils should still provide lots of sturdy support for the spine. A hybrid mattress might be an especially good option for people who don’t want an ultra-firm mattress, but still need plenty of spinal support. I’ve also included a few beds on this list that have “zoned support,” which is basically just a style of mattress construction where certain parts of the bed are softer to provide pressure relief, and others are firmer to provide support. These designs are intended to help with spinal alignment.
Trial period
Just about every expert I spoke to emphasized how important it is to try a variety of mattresses and to try before you buy, since everyone’s needs are different. But if you aren’t able to try a bed in person, most online mattress retailers offer a trial period that will let you return your new bed if it doesn’t work out for you. I consider 100 nights to be about the industry standard for trial periods, so I’ve also prioritized mattress brands that offer at least that long.
