Is a firm mattress better for your back?

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The best mattress for back pain is one that feels comfortable and provides proper support. It should allow the body to sink into it while providing adequate cushioning. Firmer mattresses are often better for heavier individuals or those with certain medical conditions. However, lightweight individuals may find firm mattresses uncomfortable and experience aches, pains, and pressure points.

A common misconception is that you should buy a firm mattress if you have a bad back.

In the past, medical professionals often recommended firm mattresses to help reduce back pain. Some suggested placing a board underneath the mattress to make it feel firmer. These recommendations were based on the belief that a firmer mattress would prevent excessive sinking, misalignment, and discomfort rather than on scientific evidence.

However, this advice has since changed based on further research exploring the relationship between mattress firmness and back pain. The consensus is that a mattress should conform to the body, allowing the heavier body parts like the shoulders and hips to sink into the mattress while keeping your spine aligned.

man waking up with back pain pressing down on mattress

Can a firm mattress cause back pain?

It is often difficult to establish the exact cause of back pain. It could be muscular or due to medical conditions, such as a slipped disc or sciatica. However, sleeping on a mattress that is too firm and does not support you properly can also contribute to back pain.

An overly firm mattress can also cause discomfort, pressure points, numbness, aches, pains, and poor circulation.

Discomfort

Struggling to sleep or frequently tossing and turning during the night could be due to an uncomfortable mattress.

Pressure points

A mattress that is too firm will not conform to the body or provide adequate cushioning. It may push back against the body instead, creating painful pressure points, particularly around sensitive areas like the shoulders, hips, and lower back.

Poor circulation

A firm mattress with little to no cushioning can restrict circulation, leading to issues like pins and needles or numbness.

You wake up feeling tired or groggy

Waking up feeling tired, groggy, sore, achy, or stiff could indicate your mattress is not supporting you properly.

Who is a firm mattress suitable for?

The ideal mattress firmness differs for each person depending on their needs and comfort preferences. While many medical professionals recommend a mattress that supports the natural curvature of the spine, a firmer mattress may be more suitable for some sleepers.

Heavier individuals

Correct support depends on factors such as body weight, build, height, and preferred sleeping position. Generally, the heavier you are, the firmer the mattress you need. Heavier individuals who weigh more than 16 stone (102kg +) usually require a firm or extra firm mattress that can help distribute their weight more evenly and prevent them from sinking too far into the mattress.

In contrast, a softer mattress may cause excessive sinking, putting the spine in an awkward, unnatural position, which may result in back pain.

Body weightRecommended mattress firmness
Someone who weighs up to 11 stone (70 kg)Soft
Someone who weighs between 11 and 16 stone (70 to 102 kg)Medium
Someone who weighs 16 stone and above (102 kg +)Firm

Back and stomach sleepers

Back and stomach sleepers may prefer a firmer mattress that prevents the midsection from sinking too deeply and keeps the spine aligned.

People with mobility issues or back problems

People with mobility issues or back problems may benefit from a firmer mattress. A firmer sleeping surface can make it easier to get in and out of bed and change sleeping positions during the night.

Advantages of a firm mattress

Although many sleepers are switching to mattresses that conform and cradle the body, sleeping on a firm mattress has several benefits.

Spinal alignment

Firmer mattresses provide a more even and flatter sleeping surface. They help keep the spine aligned and prevent the body from sinking too far into the mattress. The firmer sleeping surface also makes it easier to change sleeping positions.

Durability

Firmer mattresses are typically made with durable materials that retain their shape well over time and are less prone to sagging.

Edge support

Firmer mattresses usually provide good edge support because they compress less under pressure.

Cooler sleeping surface

Firmer mattresses are less likely to trap heat because they do not closely conform to the body. This allows air to circulate more freely, helping you stay cooler in bed.

How to tell if a mattress is too firm

To determine if a mattress is too firm, lie on your back and slide your hand between the mattress and the lumber region of your back. If your hand slides underneath easily, the mattress is too firm. The mattress is likely too soft if you cannot slide your hand underneath. When you slide your hand underneath, there should be some resistance, indicating the mattress supports you correctly.

incorrect body support when sleeping on a firm mattress
Too firm: Spine is misaligned, causing pressure around the shoulders and hips.
incorrect body support when sleeping on a soft mattress
Too soft: The body slouches, causing pressure around the hips.
correct support when sleeping on a mattress
Correct support: The shoulders and hips sink into the mattress, and the body is correctly supported.

What type of mattress is best for back pain?

There isn’t one type of mattress that suits everyone, even for those with back pain. Although research is limited, some studies suggest that a medium-firm sleeping surface may benefit those with back pain.

There are several types of mattresses that may help alleviate back pain, each with its benefits and drawbacks. However, some are labelled as ‘orthopaedic’ or ‘posturepedic’, terms manufacturers use to describe firm mattresses and make them more appealing. These mattresses have not necessarily been medically endorsed, and there is little evidence to support the claims that they can improve back pain or sleep.

Pocket springs

Pocket springs are small springs encased in fabric and stitched together. They work independently to better conform to body shape, provide targeted support and distribute weight evenly.

Pocket spring mattresses are often available in soft, medium, firm, and extra firm spring tensions, allowing you to choose the right firmness for your body weight and preference. Some pocket spring mattresses come in split tensions, which are ideal for couples with significantly different body weights, as each person can have their preferred firmness on their side of the bed.

Memory foam

Memory foam gently cradles and conforms to the body. It offers excellent pressure relief and can help alleviate aches, pains, and numbness. The material can also help improve circulation.

Memory foam is a temperature-sensitive material that slowly softens in response to body heat, a sensation some describe as ‘sleeping on a cloud’. However, as the material softens, some sleepers may feel stuck and find it difficult to turn over in bed. Another drawback is that memory foam can trap heat, making it feel warmer than other mattresses. 

Latex

Like memory foam, latex contours to the body and provides excellent pressure relief. However, it has a bouncier feel and quickly regains its shape when pressure is removed, making it easier to turn over in bed. Its pinhole structure allows better airflow, helping it stay cooler than memory foam.

Hybrid

Hybrid mattresses combine foam with springs, offering the feel of a traditional mattress with the cushioning and pressure-relieving benefits of memory foam or latex.

Try before you buy

To help ensure you choose a mattress that is comfortable and supports you properly, visit your local store to test different models. A salesperson can also recommend suitable mattresses based on your needs and preferences.

If you prefer to shop online, choose a mattress with a generous trial period, allowing you to return it if you are unsatisfied.

Final thoughts

A comfortable and supportive mattress can help alleviate back pain and improve sleep. Whilst a firm mattress promotes spinal alignment and allows easier movement during sleep, correct support depends primarily on your body weight. This should be a key factor when choosing a mattress.

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About the author

Tony Brown is the founder and creator of The Bed Consultant. His career in the bed industry began in 2002. After graduating from university with a degree in Business Administration, Tony joined one of the largest independent furniture retailers in the UK as a bed consultant. Tony has helped thousands of customers find the perfect mattress.

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