How Firm Mattress For Back Pain

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Best Mattress for Lower Back Pain

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If you have a bad back, you should buy the firmest mattress you can find — right? Not so fast. While that used to be the common wisdom, there’s no solid research behind it. The latest thinking is that there isn’t one type of mattress that’s best for everyone, including people with chronic back pain. Let personal preference guide you, and choose what feels most comfortable.

But making the right choice can be tricky. So many products are on the market, and just because a mattress feels good when you lie down on it in a showroom doesn’t mean you’re going to be happy sleeping on it for the next several years.

Here are a few tips to guide you:

It Needs to Keep Your Spine Aligned

You may not realize it, but good posture is important when you sleep. The muscles and ligaments (tissue that holds joints together) in your back need to relax and recover while you snooze. If a mattress is too firm — or too squishy — it won’t support your spine at your neck or lower back the way it needs to. What’s firm enough (but not too firm) is different for everyone: If you have wide hips, for instance, a slightly softer surface may be better. You need some more give in order to keep your spine in alignment. Someone with narrower hips might be better off with a firmer surface.

When in Doubt, Go ‘Medium-Firm’

Research is limited, but in one study, researchers assigned new mattresses to more than 300 people with low back pain. They used either "medium-firm" or "firm" mattresses for 90 days. Those in the medium group reported the least amount of discomfort.

You might consider getting a memory foam mattress (instead of a traditional innerspring one). The foam molds to your body. The downside: Some memory foam mattresses keep in heat; and the material might have more chemicals.

Take a Longer Test-Drive

If you have a great night’s sleep and wake up pain-free after staying at a hotel or in a friend’s guest room, copy down that mattress’s model number. Or choose a mattress that comes with a money-back guarantee: A growing number of companies will let you buy a mattress and use it for anywhere from 30 to 100 days and send it back for a refund if you’re not happy with it.

Continued

Just Buy Something

When researchers from Oklahoma State University randomly assigned 62 people to sleep in a variety of new beds for 28 days, they found that almost everyone started to sleep better. That was true regardless of which model they were given, though people who slept in the cheapest beds did report more lower back pain than those in the medium- and higher-priced beds.

The most important thing seemed to be that the beds were new. They noted that the average age of the participants’ old beds was 9.5 years. And they concluded that "sleep quality may be dependent on timely replacement of bedding systems." The takeaway: If you’ve been sleeping on the same mattress for 9 or 10 years (or more), it’s time to get a new one. Almost any new replacement is going to be better than the saggy foundation of an old mattress. But it may pay to spring for at least a mid-priced model.

Pillows and Positions Matter

Even if you have the right mattress, it’s not the only thing that counts when it comes to managing your back pain as you rest. Sleep position is important, as are the kind of pillows you use and where you place them.

Sources

Cleveland Clinic: "Is Your Sleep Position Causing You Back Pain?"

Consumer Reports: "Mattress Buying Guide."

Harvard Healthbeat: "What Type of Mattress is Best for People With Low Back Pain?"

Jacobson, BH. "Grouped Comparisons of Sleep Quality for New and Personal Bedding Systems."Applied Ergonomics, 2008.

Kovacs, FM. “Effect of firmness of mattress on chronic non-specific low-back pain."Lancet, November 2003.

Mayo Clinic: "Slide show: Sleeping positions that reduce back pain."

University of Utah Health Care: “Good Sleeping Posture Helps Your Back."

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How to Choose the Best Mattress for Back Pain?

Based on sleeping 8 hours per day, the average person will sleep for 229,961 hours in their lifetime. This is approximately one third of your life. If you are going to be spending so many hours on your mattress, it’s worth investing in a quality product so that you can have the most rejuvenating sleep possible.

When you have a high quality mattress that offers you restful sleep, it can have huge benefits for your health. People who toss and turn in the middle of the night, or find themselves stretching all morning to alleviate back pain, don’t always know that replacing their old mattress might just be the solution.

But with so many quality mattress brands out there – how can you choose the best one for you? The first step is to learn a little bit about the types of mattresses available and the differences between them. Here are some things to keep in mind when choosing your mattress.

Which Types Are Best for Back Pain?

There are many different styles of mattresses out there – so the first step is to familiarize yourself with the many options. As with many things, there is no one single type that fits everyone. However, when focusing on back pain, memory foam and latex mattresses are considered to be the best mattresses for back pain thanks to their pressure relieving qualities:

Memory Foam:These types of modern mattresses are made with a moldable material that responds to temperature and weight. So, when you lie on a memory foam mattress it will adjust to your unique shape- which might be helpful if you have a bad back or sore joints. However, not everyone enjoys the sinking sensation of the mattress molding around you and some people find that it can get quite warm.

Latex Mattress:This type of mattress is filled with high quality latex foam, which is very breathable and will keep you cool. It is considered to be a great option for anyone who has asthma or allergies.

How Firm?

The firmness of your mattress makes a big difference in how well you sleep. So, take some time to consider which firmness level is right for you. As a thumb rule, heavier people should opt for firmer mattresses that are able to provide better support. Lack of support due to an old mattress, or even the wrong type of mattress, could very well be sources of back aches, and lower back pain especially.

From a scientific standpoint, some studies have shown that medium-firm mattresses have a better chance of improving sleep and relieving pain. This supports the claim that the best mattress for back pain or lower back pain should be medium-firm. In the past, it was believed that firmer mattress are the way to go, but recent research favors the medium-firm. However, it is important to emphasize that what works for one sleeper won’t necessarily work for another. We would recommend getting a mattress with a long trial period (like the ones featured in here) in case the medium-firm doesn’t work out for you.

Why People Buy Mattresses Online

Lying down on a mattress for 30 seconds with your shoes on, in the environment of a department store, isn’t enough time to judge whether or not it is a good fit for you, let alone if it will relieve you of your back pain. You will need to actually sleep on the mattress, to see if it works well for you throughout an entire night.

For example, a mattress that feels fine in the store might become too hot after you sleep on it for a few hours, or may cause your back to ache in the morning. Yes, a bad mattress can actually worsen your back pain. Also, a mattress might feel fine for the first few days, but then the materials can shift and adjust and change the support it offers. That is why in order to find the best mattress for back pain we recommend on more than just a few minutes of trial in mattress store.

Fortunately, a lot of mattress brands offer you the option to try the mattress in your own home before you buy. Usually, the trial periods are anywhere between 30-365 days. You can order the mattress, sleep on it and if you don’t like it – you can return it for a full refund. This gives you plenty of time to determine whether the mattress you have chosen is right for you.

Also, make sure that the mattress has an extended warranty or protection plan before you buy it, just in case any issues come up.

*Our team of writers edited this article for informational purposes only. The content provided herein should not be considered or relied upon as a professional or expert advice.

How firm should a mattress be for lower back pain?

Research is limited, but in one study, researchers assigned new mattresses to more than 300 people with low back pain. They used either medium-firm or firm mattresses for 90 days. Those in the medium group reported the least amount of discomfort.

You might consider getting a memory foam mattress (instead of a traditional innerspring one). The foam molds to your body. The downside: Some memory foam mattresses keep in heat; and the material might have more chemicals.

Reviewed by Nayana Ambardekar on February 6, 2019

Cleveland Clinic: "Is Your Sleep Position Causing You Back Pain?"

Consumer Reports: "Mattress Buying Guide."

Harvard Healthbeat: "What Type of Mattress is Best for People With Low Back Pain?"

Jacobson, BH. "Grouped Comparisons of Sleep Quality for New and Personal Bedding Systems." , 2008.Applied Ergonomics

Kovacs, FM. “Effect of firmness of mattress on chronic non-specific low-back pain." , November 2003.Lancet

Mayo Clinic: "Slide show: Sleeping positions that reduce back pain."

University of Utah Health Care: “Good Sleeping Posture Helps Your Back."

Cleveland Clinic: "Is Your Sleep Position Causing You Back Pain?"

Consumer Reports: "Mattress Buying Guide."

Harvard Healthbeat: "What Type of Mattress is Best for People With Low Back Pain?"

Jacobson, BH. "Grouped Comparisons of Sleep Quality for New and Personal Bedding Systems." , 2008.Applied Ergonomics

Kovacs, FM. “Effect of firmness of mattress on chronic non-specific low-back pain." , November 2003.Lancet

Mayo Clinic: "Slide show: Sleeping positions that reduce back pain."

University of Utah Health Care: “Good Sleeping Posture Helps Your Back."

Firm and Soft Mattresses for Bad Backs

Grant Hughes, MD, is board-certified in rheumatology and is the head of rheumatology at Seattle’s Harborview Medical Center.

Soren Hald Collection / Stone

If you’re one of the over 70 million Americans who deals with daily back pain, a lot may be stacked against you at bed time. You likely know first-hand how pain can limit things—like the number of hours of you get per night, how restful the sleep you do get is, how well you function during your waking hours, and how satisfying, overall, sleep is to you.

Your Mattress and You

Sleeping on a mattress that is not right for you, given your individual condition, may be one of your biggest obstacles to rest and repose.

And this may mean you need to go shopping. If that’s the case, what type of mattress should you buy?

To a great extent, mattress choice is a highly personalized one. Likely the most important thing you can do is to match the firmness of your prospective mattress to your spine’s unique needs for support and comfort.

Dr. Michael Perry, M. D., Medical Director of the Laser Spine Institute in Tampa, FL, recommends staying away from either extreme of firmness when selecting a mattress, stating that studies generally find a medium-firm mattress does the trick for most types of back problems.  

A 2003 study published in Lancet confirms this, saying, "a mattress of medium firmness improves pain and disability among patients with chronic non-specific low-back pain."  

There’s nothing like a good dose of facts, so here’s a quick run down on mattress firmness research as it relates to back pain.

A Survey of Temporary Back Pain From Foam Mattresses

One hundred Indian medical residents who slept on foam mattresses were surveyed about the effects of this on their spines in a 2000 study published in theJournal of the Association of Physicians of India. The mattresses in question were 10 centimeters in thickness—the kind one might find in a youth hostel. The residents experienced temporary backaches from the mattresses, but not the generally more serious type that is also accompanied by nerve symptoms such as sciatica, radiculopathy, or paresthesia (pins and needles.)

The sleep-induced pain was relieved for most of the residents (61%) once they returned to their own beds, and it came back when they again slept on the foam.  

Firm vs Soft

In an effort to confirm that hard mattresses exert a positive effect on the sleep of people with chronic low back pain, as is commonly believed, participants in a study tested bedding with varying degrees of firmness.

The study, a randomized controlled trial, was published in the April 2008 issue of Spine.  

A “soft” mattress group slept on a water bed.

A second group slept on a Tempur-pedic mattress, which is known for its ability to conform to your body shape without sacrificing support.

And the “hard” mattress group slept on a futon.

Overall participants favored the water bed and foam (Tempur-pedic) mattresses the most in terms of pain relief, ability to function and number of hours slept per night. That said, the difference in scores between these two types of mattresses and the hard mattress was small.

"A Tempur-pedic with a dial-in firmness feature would be my top choice," Perry comments. "When you need more support, you can simply press a button and presto! The beauty of Tempur-pedic is that you can get support where you need it. You can also get on-demand softness."

He adds that a dial-in water bed also has advantages, clarifying that more water equals more firmness.

“Just remember not to dial in so much water that your mattress bursts,” he quips.

On the flip side, Perry says that if you don’t dial in enough water, your water bed mattress may surround and enclose your body, which can decrease the quality of your sleep.

In fact, he adds, “some of my patients report they feel smothered when their water bed isn’t firm enough. This is because the lungs have less room to expand when you’re sunken down. Of course, the cure is to firm it up by in dialing more water."

Even in light of this potential drawback, self-inflatable water beds may be the way to go. A 2015 review of studies published inSleep Healthconfirmed all of Dr. Perry’s opinions, concluding that a medium firm mattress with custom inflation capabilities proved the most optimal choice for spinal alignment and sleep comfort.  

Keep in mind that few studies have been conducted on this topic overall. But those that can be found in the medical literature point to achieving the right firmness in your mattress as a key to sound sleep—despite the back pain.

Choosing the Best Mattress for Lower Back Pain

Sleeping on the wrong mattress can cause or worsen lower back pain. Lack of support from a mattress reinforces poor sleeping posture, strains muscles and does not help keep the spine in alignment, all of which contribute to low back pain.

Sleep comfort is also sacrificed if a mattress does not match one’s individual preferences. A mattress that provides both comfort and back support helps reduce low back pain, allowing the structures in the spine to really rest and rejuvenate during the night.

With the vast variety of mattresses on the market, choosing the right mattress can be difficult. The following practical guidelines are designed to help patients with low back pain choose the best mattress for both back support and sleep comfort:

    Personal preference should ultimately determine what mattress is best.There is no single mattress style or type that works for all people with low back pain.Any mattress that helps someone sleep without pain and stiffness is the best mattress for that individual. Patients with low back pain should choose the mattress that meets their standards for comfort and support and allows them to get a good night’s sleep.

  1. Understand and inquire about the physical components of the mattress.The coils or inner springs of a mattress provide the support. Different mattresses vary in their number and arrangement of coils. Padding on top of the mattress comes in many different thicknesses. Mattress depths typically range anywhere from 7 to 18 inches deep. Choosing the number of coils, type of padding and mattress depth should be determined by individual preferences.

Find a mattress with back support.A good mattress should provide support for the natural curves and alignment of the spine. The right amount of back support also helps the patient avoid muscle soreness in the morning. While there is not much clinical data about mattresses, one study found that medium-firm mattresses usually provide more back pain relief than firm mattresses.

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