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Shopping for the best mattress for lower back pain can be overwhelming. Soft or firm? Springs or foam? Here are our medically reviewed picks to help you narrow down your options.
If you experience aches and pains first thing in the morning and suspect your old, unsupportive mattress is the culprit, you might be right.
When your mattress is saggy, uneven, or even too hard, your spine may not get the support it needs to remain in a neutral position while you sleep. A lack of support can mean lower back pain in the morning, or even longer if not treated.
If you’re searching for a mattress to help prevent a sore lower back, our list can help you narrow down your search and give you tips and guidelines for what to look out for while you shop around.
Our Medical Standards and Insights team has carefully researched and vetted over 11,000 products and services. We fact-check health claims, evaluate materials, and look into each brand’s reputation before sharing products and services on Healthline.
To choose the products on this page, we considered all the mattresses that passed our vetting process. Then, we scored each mattress to narrow down our list even further.
*Prices correct as of September 2024
We asked two healthcare professionals for their advice on shopping for mattresses if you have lower back pain.
“You can blame your mattress for low back pain if you awaken with pain or have trouble getting comfortable because of pain,” Monica Moreland, physical therapist and owner of Moreland Physical Therapy, said.
“Your best bet is looking for a mattress that combines softness and support, so pressure points can be relieved and [the] spine can be neutrally aligned,” she said.
“A mattress that doesn’t hold up our body will cause pain in the lower back,” Dr. Lynelle McSweeney, a chiropractor in Reno, Nevada, explained. “We need support to keep our joints from going into a stress point, which puts pressure on nerves and strains the muscles.”
Taking this into consideration, here are some characteristics to remember as you decide on a mattress.
Firmness options
In general, hybrid or innerspring mattresses offer more support than all-foam options, which may be too soft.
“A good mattress is a medium-firm one that will allow for uniform pressure throughout the body and not cause excess pressure to bony prominences such as hips and shoulders,” Moreland said.
Soft or plush mattresses likely won’t provide enough support, but it’s also important to avoid mattresses that are too firm. The manufacturer’s firmness rating can help you zero in on a supportive option. Medium-firm mattresses, which have a rating of 7 to 8, are typically recommended for lower back pain.
Sleeping positions
Keep in mind that the best mattress will also depend on your preferred sleeping position, your body size and weight, and whether you share your bed with a partner or pet.
If you’re sleeping on your back, you may want a mattress that offers more support in the low back, hips, and shoulder area. Side sleepers may want slightly more plushness in the shoulder area. Stomach and back sleepers may benefit from a fairly firm mattress as this can help prevent their hips and pelvis from sinking.
Other things to consider
- Adjustability: Adjustable mattresses that let you choose your firmness level from one night to the next can be a good option, but be prepared to pay a premium for this feature.
- Zoned support: Some mattresses are designed with zoned support, offering stability and firmness in the lower back region.
It’s wise to make a point of checking reviews so you can see what previous purchasers have to say about any mattresses you’re considering.
Comfort is highly individual, so take advantage of the free in-home trials that manufacturers offer when they’re available to find a mattress that balances enough support for your lower back with overall comfort. You can check the return policy and warranty, too.
Still not sure where to get started?
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How we sleep can be a direct contributor to lower back pain.
“When we sleep, we can be in one position for a long period of time, 2 to 3 hours, before moving,” explains Moreland. “If this position is a compromised one, 2 to 3 hours could cause misalignment or pressure on a nerve.”
Moreland advises two sleeping positions. If you’re a side sleeper, use a pillow between your knees or a body pillow between your arms and legs. If you’re a back sleeper, lay with a pillow beneath your knees for a slight bend.
“Both of these positions keep the spine in a neutral position and are good for long time spans,” she says.
McSweeney agrees: “Sleeping on your back is generally considered best for the body, but supporting your body in your preferred sleep position can also work. Getting sleep is the most important thing for your health and well-being.”
To avoid low back pain, stomach sleepers can try using a pillow beneath the pelvis and lower abdomen. The extra support may relieve some of the pressure that can build in the lower back when sleeping on their stomachs.
Remember to switch sides to avoid imbalances. Note that if you find that arching your back relieves your symptoms (extension bias), then the fetal position won’t help with lower back pain.
If lower back pain is interfering with your ability to get a good night’s sleep and it persists, it’s time to see a healthcare professional. The same is true if your lower back pain is making daily activities difficult or if the pain is severe.
If low back pain accompanies other symptoms, such as pain that extends into other body parts, tingling or numbness, or a fever, it’s important to see a doctor, as this can indicate nerve irritation or an infection.
If a brand-new mattress isn’t within your budget, there are other things you can try to help alleviate lower back pain.
Use a mattress topper
Mattress toppers are a budget-friendly way to offer specific benefits, including relief from low back pain. If you suspect your mattress is contributing to your lower back pain because it’s too firm, consider trying a plush mattress topper to help reduce common pressure points.
Put your mattress on the floor
Support is critical for proper spinal alignment. Try putting your mattress on the floor to see if a firmer mattress is a better fit for you. This is an easy way to check whether a firmer mattress will help alleviate your lower back pain.
Slide a piece of plywood under your mattress
If moving your mattress to the floor isn’t an option, try sliding a piece of sturdy plywood between your mattress and your box spring or bed frame. This will help minimize movement and increase support.
Try an adjustable bed base
An inclined sleeping position may offer more relief from lower back pain than a flat sleeping surface. Swapping your standard base for an adjustable version gives you the option of elevating your upper body to alleviate lower back pain.
Use pillows
If you can’t invest in an adjustable bed base, a wedge pillow or a body pillow may help you adjust your positioning.
According to a 2021 systematic review, a medium-firm mattress is good for sleep quality, comfort, and spinal alignment.
This may be the best option for lower back pain. But you might also want to consider trying different options to ensure you get the best results.
Most mattress manufacturers recognize the importance of trying out a mattress and offer extended trial periods to their customers.
It’s possible. A mattress that’s too soft and doesn’t provide enough spinal support will cause pressure and pain in the lower back. But a mattress that’s too firm can also create lower back pain by not allowing enough give to pressure points, leading to misalignment.
Yes. If your mattress isn’t offering enough support because it’s too soft or too old, swapping your mattress for a medium-firm option can help improve lower back pain.
You can also try moving the mattress to the floor, using plywood beneath the mattress, or adding a supportive mattress topper designed to alleviate back pain.
Medium-firm, adjustable mattresses are most effective for minimizing lower back pain. Look for hybrid or innerspring models with zoned support that offer more firmness in the lumbar region.
Mattresses that are excessively soft or overly firm will worsen lower back pain. All-foam options that lack zoned support may not be good choices either.
Many people experience lower back pain. A mattress that doesn’t offer enough support can make it worse, no matter how you sleep.
Consider looking for a mattress that offers medium-firm support with layers of foam or a hybrid system, and always opt for a company that has a generous in-home trial period.