Best mattress for back pain 2024: what to look for & what to avoid

Looking for the best mattress for back pain in 2023? Then you have our sympathies. Back pain can be physically, mentally and emotionally draining, and so it's not surprising you'd want to do everything you can do to reduce it. Replacing your mattress is likely your best option; particularly if your current one is old, saggy and past its best.

In this article, we look at which kind of mattress can help alleviate back pain, not to mention prevent it occurring in the first place. Once you've found a model you like, head to our roundup of the best cheap mattress deals to take advantage of any current discounts.

• Stretch it out with one of the best yoga mats
• Make sure your guests are comfortable, too with our list of the best sofa beds 
• Complement your new mattress with a brand new, season-ready duvet 

1. It has to be comfortable

It sounds like a no-brainer, but stick with us a moment. Getting a good night’s sleep, consistently, is essential for our health and wellbeing, because it gives our body a chance to reset and repair itself. So the most important way a mattress can help to solve your back pain problem is by giving you a good night’s sleep. If that isn't happening, there's no point in thinking about anything else.

We can't emphasise this enough: your priority is choosing a mattress you know you’ll be comfortable on. People might tell you, say, that a firm mattress or a memory foam mattress is "best for your back". But if you truly hate these types of mattress, it's still better to stick with what you know.

2. It needs to provide good spinal alignment

The other way a mattress can help your back is to keep you in good spinal alignment. This means your body maintains a broadly straight line from your head down to your shoulders and back, all the way through to your hips, knees, and feet. If your mattress is too soft, you'll sink in the middle, and your spine will eventually become misaligned, causing you significant problems over time. 

Spinal misalignment is surprisingly common, and signs that you’re suffering from it include finding the heels of your shoes wear out unevenly, being unable to turn your head or hips easily, and experiencing numbness and tingling in the feet.

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• ... and the best kids mattresses, specifically designed for growing bodies

3. It needs to provide good pressure relief

If the aim is to align your spine in a straight line, then surely the firmest mattress is the best? Actually, no. There needs to be some give in the mattress to allow other parts of your body like your hips and shoulders to sink in, particularly if you're a side sleeper. Otherwise, you'll experience pain and discomfort in these areas, and because the body is a single system, that will swiftly transfer to your back and elsewhere. In short, too firm a mattress can be just as damaging as one that's too soft.

4. Getting the right balance

So how do you know what the correct level of firmness should be? Unfortunately, that’s a tricky one to answer, because it varies from person to person. For example, someone with wide hips will benefit from a softer mattress that provides more give, particularly if they’re side sleepers, while someone with narrower hips will require a firmer one. 

In general, experts recommend a medium to medium-firm mattress for back pain sufferers, based on studies such as this one. But there’s no suggestion that this will work for everyone. Your weight will make a big difference to whether a soft, medium or firm mattress is best, as will your normal sleeping position. Plus, of course, there’s very little consistency amongst mattress brands over what constitutes a ‘medium’ anyway. 

For these reasons, it's best to consider this recommendation a jumping-off point rather than the final word on the subject. In practice, you know your body better than anyone else. So take note of your posture in bed, and whether your spine feels like it's stretched out in something approaching a straight line (what experts call ‘neutral alignment’).

If you find instead that your body is dipping or curving, it’s worth trying out a different firmness level to see if that makes a difference, either in a store or by taking advantage of the free trial periods offered by online retailers. 

Alternatively, you could try adjusting your current mattress to make it softer (by adding a mattress topper) or firmer (by placing a piece of wood underneath it), and go from there.