7 Best Mattresses for Back Pain, According to Medical Professionals

• Mattresses with a medium-firm feel and zoned support could be the best option to combat back pain, although this may not be true for everyone.
• Multiple factors contribute to back pain, and a new mattress may not always help your pain, so consult a health care professional for advice.
• The best mattresses for back pain in our review range from $995 to $3,999 for a queen size.

Is there an ideal mattress for treating back pain? Research suggests the perfect mattress doesn’t exist yet, but if your doctor recommends exchanging your mattress for a new one, some options may provide temporary relief.¹
A 2021 review of 39 studies concluded that medium-firm mattresses promote comfort, relieve chronic low-back pain, and improve sleep quality.² While brands differ in how they rate the firmness of their mattresses, most rate them on a scale of 1–10, with 1 being the softest and 10 being the firmest option.

I wrote this review from a physical therapy perspective. Chester Wu, MD, a psychiatrist and sleep specialist in Houston, Texas, contributed his professional advice to help create the most informed review possible.

Everyone’s pain is different, and the right mattress for one person may not work for another. Always consult a health professional before committing to a purchase meant to address a medical condition.

• Best Overall: Saatva Classic Mattress
• Best Affordable: The Casper Mattress
• Best for Pressure Relief: Avocado Green Mattress and Pillowtop
• Best for Side Sleepers: Puffy Lux Hybrid Mattress
• Best for Stomach Sleepers: Nest Bedding Finch Natural Latex Mattress
• Best for Combination Sleepers: GhostBed Flex Mattress
• Best for Sciatica: Sleep Number m7 Smart Bed

Our Reviews Team recommends products and services we believe provide value in the lives of our readers. We’ve spent more than 300 hours carrying out in-depth research on mattresses to give you the most accurate review. To make our selections, we:

• Researched more than 150 different mattress models
• Mystery shopped more than 30 mattress brands in-person and online
• Engaged with each brand’s customer service to gauge responsiveness and helpfulness
• Developed a scorecard that compared mattress costs, features, and consumer policies
• Consulted sleep specialists, geriatric nurse practitioners, occupational therapists, and physical therapists to understand how to choose the best mattresses
• Read real reviews from verified customers on trusted third-party sites, including the Better Business Bureau (BBB) and Trustpilot

* Only option available in this model

Pros

• Zoned memory foam and coil support
• Lifetime limited warranty
• One-year trial period
• Free white-glove delivery
• Excellent customer satisfaction
• Available discounts for older adults

Cons

• Returns cost $99
• 14.5-inch option isn’t compatible with adjustable bases
• Must rotate every six months

Cost: $1,995 for queen

Trial period: 365 nights

Warranty: Limited lifetime warranty

Weight: 110 pounds for queen-size 11.5-inch model, 120 lbs for queen-size 14.5-inch model

Delivery: Free shipping, free in-home delivery and setup

Mattress height: 11.5 inches or 14.5 inches

The Saatva Classic Mattress gets our best overall pick because its composition helps alleviate back pain using research-backed zoned support while offering free in-home delivery and setup (also known as white-glove delivery), a lengthy warranty, and a one-year trial period at a competitive price. As a bonus, Saatva uses eco-friendly materials, including CertiPUR-US certified foam made without damaging the environment.

This mattress offers foam, coil, and quilted lumbar support to reinforce the low back, keeping the spine neutral. Research shows that lumbar support is particularly relieving for back sleepers.³ Zoned support can also relieve pain for those who like to lay on their side, particularly if the mattress is medium or soft at the hips and shoulders, according to a recent 2022 study.¹

We also like that Saatva offers two mattress heights of 11.5 and 14.5 inches. The 14.5-inch option accommodates taller individuals with low back pain when standing up from short surfaces, but it’s not compatible with adjustable bases.

Be aware that this mattress is the second-heaviest pick on our list at 110–120 pounds, and Saatva recommends rotating your mattress once every six months to prevent wearing one side. The Avocado Green Mattress is the heaviest, at 142 pounds for a queen.

Based on our research, Our Reviews Team suggests picking the luxury-firm feel (a medium-firm equivalent at 5–7 out of 10) to help relieve the low back while providing enough cushion at the hips and shoulders for side-lying positions. You can always supplement with a mattress topper if you need more cushion, particularly at the shoulders. Before doing so, note that many customer reviews report the luxury-firm running slightly softer than it’s rated. Stomach and back sleepers may feel more supported by choosing the firm comfort level (8 out of 10).

Customer service

If you need to contact Saatva customer service, you can do so via:

• Phone (877-672-2882), available 24/7
• Email (info@saatva.com)
• Live chat, available 24/7 on the website

We highly recommend visiting a Saatva showroom to test different comfort levels and ask questions about your sleeping position preferences.

Payment options

Saatva accepts Visa, Mastercard, Discover, American Express, Google Pay, and PayPal. If you’d like to finance, Saatva offers it through Affirm.

Be sure to look through Saatva discounts to see if you qualify. Adults 65 and older, active duty military, veterans, health care professionals, first responders, government employees, teachers, and students can get $225 off purchases totaling $1,000 or more.

Customer reviews

Saatva has excellent ratings across review websites. At the time of our research, it had an A+ grade and a 4.74 out of 5-star rating with more than 1,600 reviews on BBB. On Trustpilot, it had a 4.5 out of 5-star rating with more than 1,000 reviews.

Nearly all reviews are positive, citing good experiences interacting with customer service, even during the return process. One review stated that Saatva offered a mattress topper at no charge when the mattress they purchased was too firm for their liking. A few negative reviews mention unhappiness with the mattress’ feel because it runs softer than expected.

Pros

• Budget-friendly medium-firm option
• Two memory foam layers made to offload pressure and support the body
• Two breathable foam layers cool you off

Cons

• In-home setup costs $199
• Short warranty and trial period

Cost: $995 for queen

Trial period: 100 nights

Warranty: 10 years

Mattress height: 10 inches

Delivery: Free shipping, in-home delivery and setup available for $199

Weight: 69 pounds for queen

The Casper Mattress is a budget-friendly option for all types of sleepers who want a medium-firm mattress and enjoy the cradling of memory foam.

Its four layers of CertiPUR-US-certified memory foam have different functions. The first layer is a cozy knit designed to stretch with you. The second layer cools your body since memory foam tends to run warm. The next layer accommodates your body and offloads pressure, allowing you to sink slightly into the mattress. The bottom layer provides support to prevent sagging over time.

This pick is the only full memory foam mattress in our review because of the important trade-off those with back pain and larger body types need to consider: Foam contours to your curves and offers pressure relief, but it’s also known to sag and wear over time, offering less targeted pressure relief after extended use. If you’re looking for long-term durability, you may want to consider latex, although it’s relatively more expensive. Latex offers the hug-like feel of memory foam, but its material is more resilient.

Note that Casper offers one of the shortest trial periods and warranties of our picks, so you can’t test its durability for a year like you can with Saatva before committing to the mattress long-term.

The Casper Mattress comes in a medium-firm comfort level, the preferred firmness for back pain. But larger people may want to invest in a latex or hybrid option like the Avocado Green Mattress and Pillowtop for long-term relief.

Customer service

If you need to contact Casper customer service, reach out one of the following ways:

• Phone or text (888-498-0003), available Monday through Friday from 9 a.m. to 9 p.m. ET and weekends from 9 a.m. to 6 p.m. ET
• Email (support@casper.com)
• Live chat on the website, available Monday through Friday from 9 a.m. to 9 p.m. ET and weekends from 9 a.m. to 6 p.m. ET

You must keep your mattress for 30 days to allow your body to adjust to the new surface before initiating a return.

Payment options

Casper accepts Visa, Mastercard, Discover, American Express, and PayPal. Casper also offers financing through Affirm.

Customer reviews

On BBB, Casper had an A+ grade and a 1.1 out of 5-star rating from 29 customer reviews at the time of this writing. Trustpilot offered more insight into customer satisfaction, with a 3.7 out of 5-star rating and more than 6,000 reviews.

Negative reviews cited bad experiences with Casper customer support and difficulty with the returns process. A few stated that the mattresses sagged over time, which is sometimes expected with memory foam. On the other hand, some customers reported great interactions with customer service and praised product quality.

Pros

• Latex offers relief and durability
• Five zones of support
• One-year trial period

Cons

• In-home setup costs at least $249
• Not good for latex allergies
• Strict returns policy with $99 fee
• Must rotate once per month for the first six months

Cost: $2,499 for queen (including $400 for sewn-in pillowtop)

Trial period: 365 nights

Warranty: 25 years

Mattress height: 11 inches, 13 with pillowtop

Delivery: Free shipping, in-home delivery starts at $249

Weight: 142 pounds for queen

The Avocado Green Mattress and Pillowtop is our pick for “Best for Pressure Relief” because its latex material offers the relief of memory foam, but it bounces back quicker after pressure is released. The responsiveness of latex prevents sagging better than memory foam, allowing it to relieve pressure properly throughout the mattress’ lifetime.

This mattress has five zones of support that redistribute pressure in all positions. When lying on your side, the zones around the shoulders and hips are forgiving, while the zone in-between firmly supports your midsection. The same zone that supports the midsection provides similar support while laying on your stomach or back, preventing your spine from excessively sagging into the mattress and causing discomfort.

The pillowtop is sold separately from the mattress, but we highly recommend adding it if you’re a combination sleeper or share the bed with a partner. The mattress alone is best for back and stomach sleepers because it runs on the firmer side (7 out of 10 on the firmness scale), but the pillowtop’s extra cushioning (6 out of 10 on the firmness scale) can accommodate all positions and help distribute pressure better than the mattress alone. When you select the pillowtop with your mattress, it’s sewn into the build so that it doesn’t shift as you move.

Our Reviews Team recognizes that a latex mattress may be a controversial pick for this superlative, but we’ve added it with good reason. Although memory foam is known throughout the industry for pressure relief, research suggests that latex is better at dispersing pressure.⁴ As discussed with the Casper mattress, memory foam is less durable than latex and could be a poor choice for long-term back pain relief.

It’s also important to consider how easy it is to move on your mattress. Forgiving surfaces like foam make turning, getting out of bed, and engaging in sex more difficult, which could exacerbate symptoms. Latex’s responsiveness provides a little more boost than foam when you’re in motion, which gives your back a break.

Our Reviews Team also likes Avocado for its sustainable manufacturing and material sourcing practices. You can read about the brand’s environmental efforts in its most recent Impact Report.

Avocado offers in-home setup services, but you’ll need to pay at least $249 at checkout. The exact cost depends on the mattress size and weight. You’ll also need to rotate your mattress once per month for the first six months to avoid early wear as the materials adjust to your body. Avocado mattresses run heavy, so recruit help. Failure to rotate as instructed voids returns under the trial period and warranty.

Customer service

You can reach Avocado customer service in the following ways:

• Phone (657-385-8849), available Monday through Friday, 9 a.m. to 8 p.m. ET and weekends from 10 a.m. to 6 p.m. ET
• Email (support@avocadomattress.com)
• Live chat on the website, available Monday through Friday, 9 a.m. to 8 p.m. ET and weekends from 10 a.m. to 6 p.m. ET

If you have questions about a purchase, consider scheduling a 30-minute virtual appointment with a sales representative. They can answer any questions you have about your sleeping preferences. You can also visit a retail location to try the mattress for yourself.

Avocado requires you to try the mattress for 30 days before returning it, and you only get one mattress return per household. All mattress tags must be intact to qualify for a return. If you purchase an Avocado product from a third-party retailer, you are not eligible for a trial period or returns.

Payment options

Avocado accepts Visa, Mastercard, Discover, American Express, Shop Pay, Amazon Pay, Google Pay, and PayPal. If you’d rather finance, you can do so through Shop Pay or Affirm.

Be sure to check your eligibility for discounts. Avocado offers a 5% discount to doctors and nurses, military members, law enforcement, firefighters, teachers, and emergency medical technicians.

Customer reviews

Avocado has low ratings across review sites, but there aren’t many reviews to back them up. On BBB, Avocado had an A+ grade and a 2.2 out of 5-star rating with 50 customer reviews. Trustpilot gave it a 2.1 out of 5-star rating with only 43 customer reviews.

Positive reviews praise Avocado mattresses for comfort. Negative reviews mostly cite bad experiences returning mattresses during the trial period.

Pros

• Plush foam disperses pressure points
• Coil layer conforms to the spine
• Limited lifetime warranty

Cons

• No in-home setup options
• Somewhat expensive

Cost: $2,849 for queen

Trial period: 101 nights

Warranty: Lifetime limited warranty

Mattress height: 12 inches

Delivery: Free shipping

Weight: 59 pounds for queen

The Puffy Lux Hybrid Mattress was awarded “Best Plush Mattress” in our best mattress roundup, offering six CertiPUR-US-certified memory foam layers with a plush, contouring feel. In this review, Puffy gets our “Best for Side Sleepers” pick because it also offers a supportive coil layer that reinforces the natural curves of your spine when you lay on your side. Coils are individually pocketed, which means that each one responds independently to conform to your body. Together, the plush and coil layers provide pressure relief and support where you need it.

Our Reviews Team also likes its medium-plush feel (5–7 out of 10) for those with back pain. Medium-firm is the general recommendation for spinal alignment, but side sleepers need a more forgiving surface at high-pressure areas like the shoulder and hips to prevent tossing and turning, which could cause back pain when you wake up.¹ And although the Puffy Lux Hybrid Mattress is made with multiple foam layers, your movements are boosted by the coil layer, so you won’t feel stuck getting out of bed.

Puffy is the only mattress on our list that does not offer an in-home setup option. But since it’s lighter than competitors’ mattresses, you may be able to set it up independently. Or you can recruit help from a family member or friend. When the mattress arrives, you’ll place it on your bed frame and remove the airtight packaging to let it expand.

Customer service

You can reach Puffy customer service the following ways:

• Phone (800-430-8380), available Monday through Friday, 5 a.m. to 8 p.m. PT and weekends from 8 a.m. to 5 p.m. PT
• Email (support@puffy.com)
• Complete a contact form on its website
• Live chat on the website, available Monday through Friday, 5 a.m. to 8 p.m. PT and weekends from 8 a.m. to 5 p.m. PT

It’s easy to contact Puffy representatives. You’re connected to an agent almost immediately when calling or chatting online. You can also visit a store to talk in person and try out different mattresses.

Puffy recommends testing your mattress for 30 nights, but it will accept returns after an initial two-week adjustment period. If you’re unhappy with your purchase, you can return it for a full refund before the 101-night trial expires. If you keep your mattress, it’s covered under a lifetime limited warranty as long as you’re the owner.

Payment options

Puffy accepts Visa, MasterCard, Discover, American Express, and PayPal. If you’re looking to finance, you can do so through Klarna.

Health care professionals, teachers, students, veterans, and active-duty military and their families are eligible for $825 off any Puffy mattress plus free additional bedding supplies worth $600.

Customer reviews

Puffy had mixed online reviews at the time of our research. On BBB, the company had a 2.79 out of 5-star rating with 63 customer reviews. Puffy wasn’t BBB-accredited and had a D- grade because it failed to respond to complaints. But it actively responded to customers on Trustpilot, where it had a 3.9 out of 5-star rating with 90 customer reviews.

Customers had different experiences with their mattresses. Some claimed the mattress didn’t provide enough support, while others were happy with their purchase. Many positive reviews reported good experiences interacting with customer service, while some negative reviews cited delayed delivery times by several weeks.

Pros

• Eco-friendly latex supports midsection
• Limited lifetime warranty
• One-year trial period
• Lifetime Renewal Exchange program

Cons

• Not good for latex allergies
• In-home delivery and setup starts at $250

Cost: $2,349 for queen

Trial period: 365 nights

Warranty: Lifetime limited warranty

Mattress height: 10.5 inches

Delivery: Free shipping, in-home setup starts at $250

Weight: 120 pounds for queen

The Nest Bedding Finch Natural Latex Mattress offers a customizable latex comfort layer, which comes in either medium (about 4–5 out of 10 on the firmness scale) or lux-firm (about 7 out of 10 on the firmness scale). If you’re a stomach or back sleeper, consider the firm mattress to prevent your midsection from sinking into it and causing discomfort in the low back and neck. If you’re a back sleeper who often finds mattresses too firm for your liking, you can try the medium, but note that it’s rated slightly softer than other mattresses with medium firmness.

Not sure which feel to choose? Nest Bedding offers a Lifetime Renewal Exchange program for this mattress, which allows you to exchange the comfort layer for a different firmness anytime during the one-year trial period. You can initiate the exchange by contacting customer support. Once you receive the new comfort layer, you’ll unzip your mattress, swap the old comfort layer for the new one, and recycle the old one. This program also lets you exchange a worn comfort layer of the same firmness at any time during your ownership, even after the trial period expires. Note that you can only do this once during your ownership.

Latex mattresses are heavier than foam and hybrid models because of the material’s density, so consider paying for in-home setup, which starts at $250. The exact cost depends on your location and the number of items in your order. You can’t choose this option during online checkout, so you must call customer service and arrange it separately.

Customer service

You can contact Nest Bedding in three ways. Note that when we called the customer service phone number, we were on hold until prompted to leave a voicemail.

• Phone (888-992-2001), available Monday through Friday from 8 a.m. to 7 p.m. PT and weekends from 7 a.m. to 6 p.m. PT
• Email (customerservice@nestbedding.com), available Monday through Friday from 7 a.m. to 5 p.m. PT and on weekends from 11 a.m. to 7 p.m. PT
• Live chat on the website, available Monday through Friday from 7 a.m. to 7 p.m. PT and weekends from 8 a.m. to 6 p.m. PT

If you live in Arizona, California, Illinois, Minnesota, Ohio, or Texas, you can visit a retail location to test different Nest Bedding mattresses.

Nest Bedding asks that you try your mattress for a full 30-day adjustment period before contacting customer support for a return or exchange. The company may accommodate you early if you’re returning your mattress due to discomfort, according to its trial period and warranty FAQ page.

Payment options

Nest Bedding accepts Visa, MasterCard, Discover, American Express, Shop Pay, PayPal, Google Pay, and Meta Pay. If you’d like to finance, you can do so through Shop Pay and Affirm. Nest also works with Katapult, which offers a lease-to-own payment program.

Customer reviews

Nest Bedding doesn’t have many reviews online. BBB gave the company an A+ grade at the time of our research, but it wasn’t accredited, and there were no customer reviews. Trustpilot only had three reviews and a 3.4 out of 5-star rating. One positive review reported a good overall experience with the purchase process and mattress. The other two reviews disliked the mattress and had difficulty claiming returns.

On Facebook, Nest Bedding has a significant following of 125,000 people. The company regularly posts on the page, but there is little engagement from followers to gauge customer satisfaction.

Pros

• Layers accommodate all sleeping positions
• Top-layer cooling cover
• Expands quickly for same-night use

Cons

• In-home setup costs an additional $279
• Somewhat expensive compared to competitors

Cost: $2,595 for queen

Trial period: 101 nights

Warranty: 25 years

Mattress height: 13 inches

Delivery: Free shipping, in-home setup costs $279

Weight: 101 pounds for queen

Combination sleepers enjoy more than one position. The GhostBed Flex Mattress is “Best for Combination Sleepers” because it offers forgiving CertiPUR-US-certified memory foam and resilient pocketed coils. Together, they adapt to any position you adopt throughout the night by contouring your body with adequate support (6–7 out of 10 feel) to relieve lower-back pressure.

GhostBed also offers unique Ghost Ice technology in its fabric, consisting of phase-changing materials (PCMs) that remove body heat, as supported by research.⁵ If you change position to regulate your temperature, the GhostBed Flex Mattress could help you settle comfortably without feeling overheated.

An adaptive, cooling mattress is also a great choice for couples with different sleeping preferences. A stomach-sleeping partner will feel supported under their midsection, while the side-sleeping partner will feel pressure relief at the shoulders and hips. The mattress supports you even when you change positions. Since GhostBed mattresses are built to disperse heat, your partner’s proximity won’t affect your temperature as you sleep.

If you’d like to fully customize your sleeping position, the GhostBed Flex Mattress is compatible with adjustable bases, which offer head and foot elevation. Couples with varying sleeping preferences can choose a split king adjustable frame, which allows independent adjustments on either side of the bed.

GhostBed offers white-glove delivery, but it costs an extra $279. Once it’s home, GhostBed asks you to break in your mattress for 30 days. After that, you can initiate a return within your 101-night trial period. The 25-year manufacturer’s warranty will cover all defects but will not cover normal wear or changes in feel over time.

Customer service

If you need to contact GhostBed customer service, reach out one of the following ways:

• ​​Phone (954-371-2004), available 8 a.m. to 10 p.m. ET daily
• Email (sleep@ghostbed.com)
• Live chat on the website, available 8 a.m. to 10 p.m. ET daily
• Contact form on the website

Payment options

GhostBed accepts Visa, MasterCard, Discover, American Express, Amazon Pay, Google Pay, and Meta Pay. You can also apply for financing through Affirm and Shop Pay.

This company also offers a 50% discount for military members, government employees, first responders, nurses, students, and teachers.

Customer reviews

GhostBed doesn’t have many third-party reviews. On BBB, the brand had no customer reviews and an F rating for not being active on the site. And on Trustpilot, GhostBed only had 99 customer reviews and 1.3 out of 5 stars. Positive reviews reported an easy returns process and comfortable products. Some negative reviews cited faulty products and difficulty claiming refunds or replacement under warranty.

The brand did have a presence on Facebook with more than 247,000 followers. People engaged with posts, commenting on and sharing product announcements and advertisements. But GhostBed had not been active in over a year at the time of this review.

Pros

• Adjustable firmness settings
• Memory foam offers pressure relief
• Mobile app tracks sleep quality

Cons

• Short 100-night trial period
• In-home setup costs $249
• Wireless remote sold separately for $49
• Most expensive mattress on our list

Cost: $3,999 for queen (may cost more in Alaska and Hawaii)

Trial period: 100 nights

Warranty: 15 years

Mattress height: 11 inches

Delivery: Free shipping, in-home setup available for $249

Weight: About 60 pounds for queen

Some people with back pain also have symptoms of sciatica, which is the irritation of the sciatic nerve. This nerve travels from your low back, through both buttocks, down the back of your thighs, and to the outside of your feet. When the sciatic nerve is irritated, it can cause uncomfortable sensations—like pain, numbness, tingling, burning, or weakness—to travel down this path. Sciatica can be provoked by multiple factors, like herniated discs or other obstructions. One of the most common causes is the spine’s position and subsequent pressure on the nerve.

Irritating body positions are highly individual, so your pain point may differ from someone with similar symptoms. You could also be more or less sensitive from one day to the next, which means people with sciatica may benefit from a mattress with a firmness level they can customize as needed. The Sleep Number m7 Smart Bed is “Best for Sciatica” because it offers adjustable firmness to fit your unique sleeping position preference, even if this changes day-to-day. Note that this mattress contains CertiPUR-US-certified memory foam, a forgiving surface that may influence how you select your firmness settings.

Sleep Number beds have air chambers that inflate or deflate depending on the setting, controlled by your SleepIQ app (available in the App Store and Google Play). The app also tracks sleep quality through mattress sensors, which can be useful for identifying factors that contribute to painful sleep. If you’d like to control your mattress using a wireless remote instead of the app, you can purchase one at checkout for $49.

Because Sleep Number mattresses have customizable firmness, they can accommodate all sleeping positions comfortably. They’re also compatible with adjustable bases, which is a good option if you feel relief when your legs or torso are elevated—although that position can be aggravating for some. If you have sciatica, consulting with a physical therapist is a good idea. They can provide insight into which positions and settings may be most comfortable for you.

Sleep Number requires smart bed customers to purchase in-home setup for $249. With this option, a Sleep Number professional will help you connect your mattress to your mobile app and show you how to access your sleep-tracking dashboards.

Customer service

If you need to contact customer service, you can do so via:

• Phone (888-411-2188), available Monday through Friday from 8 a.m. to 8 p.m. CT, Saturday from 8:30 a.m. to 5 p.m. CT and Sunday from 10 a.m. to 4:30 p.m. CT
• Live chat on the website, available 24/7

Live chat agents respond quickly during the day, but one of our Reviews Team members waited over 30 minutes to talk to an agent in the evening.

Sleep Number has only a 100-day trial and one of the shorter warranties compared to other mattresses on our list, so we highly recommend visiting a store, trying out items, and discussing your options with a representative before committing to your purchase.

Payment options

Sleep Number accepts Visa, Mastercard, Discover, and American Express. It also offers financing options with its Sleep Number Credit Card.

Customer reviews

On BBB, Sleep Number had an A+ grade and a 4.56 out of 5-star rating with more than 3,700 customer reviews. But on Trustpilot, the brand had 1.5 out of 5 stars and only 139 reviews.

Positive reviews reported great experiences interacting with the sales staff at retail stores and satisfaction with their smart bed purchase. Customers who left negative reviews reported faulty air chambers and difficulty claiming repairs and replacements under warranty.

Back pain and sleep quality are closely related. “Pain can interfere with sleep, but sleep deprivation can also intensify that pain, leading to a difficult cycle of sleep deprivation and escalating pain,” said Wu. “In the absence of adequate sleep, pain sensations become more intense. Getting as much healthy sleep as possible is essential to mitigating and hopefully fixing your back pain.”

One of the first questions I ask a physical therapy patient with back pain is about their sleep schedule. If the cycle Wu mentioned exists, I tell the patient to consider lifestyle changes prioritizing sleep hygiene for improved sleep quality. Although a better night’s sleep may not improve pain right away (especially if it’s chronic pain), it does improve a person’s ability to be active and mood, which helps break the cycle.⁶ Additional intervention requires a referral to a sleep specialist.

When shopping for a mattress to address your back pain, remember that your pain is highly individual and depends on multiple factors unique to your body and environment. Wu explained, “The best mattress for back pain can depend on personal comfort, the specific type of back pain, and individual sleep habits.” He also recommended consulting a doctor to rule out other medical conditions and determine the best treatment plan for your needs.

Your mattress isn’t always the culprit for discomfort, but finding a mattress that promotes a comfortable sleeping position could help, especially for those with chronic pain. “If someone has chronic back pain, they may want to consider changing their mattress if they are not getting enough relief from other first-line treatments, such as physical therapy or medication,” Wu said.

Aside from changing your sleeping surface, you may want to talk to a health care professional about your sleep hygiene or a routine and bedroom setup that promotes good sleep. Wu recommends doing the following:

• Get bright light first thing in the morning and avoid it close to bedtime. Get at least 10 minutes of light as soon as possible after waking up to reset your circadian rhythm for the day. Avoid light about 90 minutes before bed, though, to prevent it from keeping you awake.
• Avoid caffeine, large meals, intense exercise, and alcohol too late in the day. All four can keep you up or wake you up during the night.
• Have a relaxing bedtime routine. Make time for calming activities in the run-up to bedtime, like reading, journaling, or light stretching. Relaxation will help slow your brain down for sleep.
• Keep your bedroom dark, cool, and quiet. Set your thermostat to 65 to 68 degrees Fahrenheit, use blackout curtains, and consider wearing earplugs and an eye mask to stop anything from keeping you up or waking you during the night.
• Keep a consistent sleep schedule every day of the week.
• Try to avoid sleep aids if you can. Many prescription and over-the-counter sleep aids come with risks and dangerous side effects.

Wu also recommends gentle exercise, which research suggests is one of the best treatments for chronic low back pain.⁷ If you’re unsure which exercise is appropriate for your back pain, refer to a physical therapist who can help you develop a movement routine.

If you don’t want to commit to a new mattress, Dr. Wu suggests trying a mattress topper (ranging around $100–$500) that offers more support while sleeping. “And don’t forget your pillow, either. Opt for one that keeps your neck straight to avoid neck pain. Sleeping on either side with a pillow between the knees can help lower back pain. For upper back pain, sleeping on your back with a pillow under your knees can help,” he added.

If you have Medicare and are shopping for a new mattress because of back pain, you may want to consider checking with your doctor before you start your search. Although original Medicare doesn’t cover mattresses, Medicare Part B covers 80% of certain pressure-relieving beds as durable medical equipment if your doctor prescribes a special sleeping surface due to a medical condition.⁸ That includes mattresses and mattress overlays.

Based on our expert consultations and research, we determined the following factors to be important for our readers when shopping for a mattress:

• Overall cost, including discounts and financing options
• Firmness options
• Customer service responsiveness
• Delivery options
• Trial periods
• Warranty terms
• Unique features such as smart features or cooling technology
• Uses materials certified to meet third-party industrial standards

We had all of our selections medically reviewed by a medical expert in the field to ensure each brand and model is appropriate for NCOA readers’ needs.

Low back pain is a highly individual condition that may or may not benefit from a new mattress. If your doctor, sleep specialist, or physical therapist recommends replacing your existing mattress as part of your treatment plan, your best bet is to choose a medium-firm mattress with zoned support, like the Saatva Classic Mattress.^{1 2} Stomach sleepers may want to err on the firmer side, while side sleepers may lean toward the medium side.

These suggestions do not apply to everyone. For the best guidance, seek help from a health care professional who can assess your back pain and advise you on the best positioning and sleep hygiene practices to fit your needs.

Have questions about this review? Email us at reviewsteam@ncoa.org.

1. Bolton R, et al. Effects of Mattress Support on Sleeping Position and Low-Back Pain. Sleep and Science Practice. May 2022. Found on the internet at https://sleep.biomedcentral.com/articles/10.1186/s41606-022-00073-x
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