Part of finding the best mattresses for older adults is taking into account some of the physical changes that occur as we age and how they impact sleep. Back pain is an extremely common one. It affects 45% of people 65+, according to the Centers for Disease Control and Prevention.¹ “Anyone with back pain will tell you that sleeping is a challenge,” said Jeremy Smith, MD, chief of spine surgery at Hoag Orthopedic Institute in Irvine, California. Along with proper medical treatment, finding the best mattress for spinal stenosis may help.

“Spinal stenosis occurs when the area inside the spinal column shrinks through age, wear and tear, or osteoarthritis,” said Dr. Smith. That can put pressure on nerves in the spine and cause: 

• Pain, most commonly in the neck or lower back 
• Numbness or weakness
• Tingling feeling in your legs, arms, or hands 

These symptoms can make finding a comfortable sleeping position difficult. Much like the best mattresses for back pain, the best mattress for spinal stenosis is medium-firm with good support for the neck and lower back and keeps the spine in a neutral position. Our overall winner, the Saatva Classic, has all those features. Read on to find out more—and see which other mattresses made our roundup.

Our Top Pick

Saatva Classic Luxury Firm: Best Overall for Spinal Stenosis

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• Cradles and supports pressure points to help ease pain
• Great pressure relief for the back and side

• Reinforced support for lower back 
• Solid edge support for easier movement

Helix Midnight Luxe: Best for Lower Back Pain

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• Earned top back pressure and pain relief testing scores
• Reinforced support for the low back 

• Plush feel but still firm enough to support movement

Nectar Premier Memory Foam: Best for Side Sleepers

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• Can help relieve pressure on shoulders, hips, and neck
• High pain relief score

• Good firmness for side sleepers

Best mattresses for spinal stenosis in 2025

• Saatva Classic Luxury Firm: Best Overall
• Helix Midnight Luxe: Best for Spinal Stenosis and Lower Back Pain
• Nectar Premier Memory Foam: Best for Side Sleepers with Spinal Stenosis
• The WinkBed Plus: Best for Arthritis and Spinal Stenosis
• Bear Original: Best Cooling Mattress for Spinal Stenosis
• Nolah Evolution Luxury Firm: Best for Couples with Spinal Stenosis
• Titan Plus: Best for Higher-Weight Sleepers with Spinal Stenosis
• Birch Natural: Most Accessible Mattress for Spinal Stenosis

Comparing the best mattresses for spinal stenosis in 2025

What we look for in a mattress for spinal stenosis

We looked for the following features when choosing the best mattresses for spinal stenosis:

Firmness

A medium-firm mattress (between a 5–7/10) offers the best balance between spinal alignment and pressure relief. Medium-firm mattresses were also found to promote comfort, sleep quality, and spinal alignment, according to one review.²

Spinal alignment

Spinal stenosis most often affects the lower back. So a mattress that can support the spine in those areas and keep it in a neutral position may help ease back strain. 

Zoned support

Some mattresses have extra foam or reinforced springs in the area below the low back. This is called zoned support. It makes the mattress firmer to support the bottom of the spine and slightly softer at the hips and shoulders. That can help reduce pressure on the spinal nerves and possibly bring some relief. 

High pain relief score

Unique to NCOA, a high pain relief score indicates that a mattress has a good balance of pressure relief, edge support, and bounce. This usually means a mattress is both firm and comfortable to move on. That’s a great combo for people who may find changing positions or getting in and out of bed difficult due to spinal stenosis pain.

Good pressure relief

Sleeping on your back or side can help lessen the pain of spinal stenosis symptoms. So we looked for mattresses that earned high scores for pressure relief in those two sleeping positions, especially beneath the shoulders, back, hips, and neck (areas where pressure commonly builds up for back and side sleepers).

Saatva Classic Luxury Firm: Best Mattress Overall

We chose the Saatva Classic Luxury Firm as our Best Mattress for Spinal Stenosis Overall because it has excellent support for back and side sleepers. It earned the best pain relief score of any mattress we tested. Its zoned support under the low back can help keep your spine aligned.

Saatva Classic Luxury Firm

Best Mattress Overall

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• Cradles and supports pressure points to help ease pain
• Great pressure relief for the back and side

• Reinforced support for lower back 
• Solid edge support for easier movement

Saatva Classic features

• Our pain relief score: 4.87/5
• Accessibility score: 4.55/5
• Mattress type: Hybrid
• Brand’s firmness rating: 6/10

Why we chose the Saatva Classic Luxury Firm as the Best Overall for Spinal Stenosis

We chose the Saatva Classic Luxury Firm as our Best Mattress for Spinal Stenosis overall because it had the highest pain relief score (4.87/5) of any mattress we tested. That means it has the right mix of pressure relief, firmness, and more to help ease back pain. It also earned near-perfect scores for relieving pressure on the back. 

We tested the Luxury Firm, Saatva’s medium-firm option, and found it had great support for back and side sleepers. Those two positions tend to bring the most relief to people with spinal stenosis. The Saatva Classic’s ability to relieve pressure on the neck and low back is paired with great edge support. Often, people with a painful condition like spinal stenosis can’t get comfortable and may wake at night when switching positions due to their symptoms. The Saatva Classic earned solid edge support and accessibility scores (4.33/5 and 4.55/5, respectively), meaning the Classic is easier to move on. Its great all-around performance plus one of the longest free trial periods in the industry (365 nights) and free white-glove delivery (free delivery, set up, and disposal of old mattress), makes the Saatva Classic a great mattress for spinal stenosis.

For more information on Saatva’s lineup see our in-depth Saatva mattress review.

Saatva Classic Luxury Firm pros and cons

Our testing experience with the Saatva Classic Luxury Firm

The Saatva Classic Luxury Firm is a medium-firm innerspring mattress with two layers of springs. The base layer is sturdy tempered gauge steel surrounded by dense foam rails for stability. On top of that are nearly 900 individually wrapped coils that respond to your body’s movements to support you where you need it. This layer has extra support in the lower back region. A half-inch thick layer of gel-infused memory foam on top adds still more low back support and helps keep the spine neutral. 

Our older adult testers felt the double layer of coils provided the right mix of support and comfort to cradle joints and ease pressure and pain on their back and side. “I can’t believe how comfortable it is,” said Ruth, 70, an average-weight tester with sleep apnea and arthritis who usually sleeps on her stomach. “I am typically not a side sleeper and I could see myself sleeping like this on this mattress. I can feel it supporting my legs and contouring my body.” The extra support in the lower third of the mattress was noticeable. “I feel that the mattress supports my middle,” said Ruth. “My spine feels straight and my back feels relaxed. I feel very comfortable in this position and my shoulder and neck feel good, with no pressure.”

Back sleeping also earned strong reviews. “I really feel great lying on my back on this mattress, it is unbelievable. It’s very comfortable,” said Ruth. “My shoulders and my arms are even with my hips. I can feel the contour on my lower back and there isn't a hollow spot. It’s contouring very nicely and supporting my back.” 

Testers also liked that they didn’t have to struggle to move on the mattress. “I feel like the mattress helps move my body,” said Ruth. “It moves with me. When I rolled back over, the bed felt supportive and I didn't feel like I would fall.”

The Classic excels at edge support. It is so stable that it only sank two inches under weight in our tests, which was one of the best scores we recorded. The less an edge dips under pressure, the more stable you’ll feel sitting on the edge. Our testers could lie right at the edge without feeling like they would fall off. “Even with laying and readjusting, I feel supported on the edge,” said Ruth. “If I lay on my mattress at home in this position, I would be on the floor!”

Our testers did feel the Classic could do a better job at regulating temperature. They gave it only average marks and commented that “It doesn’t feel as cold as other mattresses I’ve tested.” They rated the Saatva Rx as better for staying cool (another mattress from Saatva that earned high scores in testing). Our heat gun test confirmed this, showing that the Rx increased in temperature only around 6 degrees F, while the Classic saw a more than 10-degree jump. 

One area testers felt the Saatva could improve upon was motion isolation, which is not unusual for innerspring mattresses. Poor motion isolation means you’re more likely to be woken up by your partner’s movement in bed. Testers said, “I felt bounced, with a little bit of a ripple effect. I definitely think this motion would wake me up to the point where I’d be annoyed.” 

Who is the Saatva Classic Luxury Firm right for?

We think the Saatva Classic is a good fit for people with chronic back pain who sleep in any position, since it offers great support and responsiveness. We think it’s especially well-suited to anyone with mobility issues because it has such a high accessibility score and very stable edges. It stays relatively cool, but if you sleep hot you might want something that stays cooler. And if you are a light sleeper with a partner, a memory foam mattress will muffle motion better.

The Saatva Classic customer experience

• Trial period: 365 nights
• Shipping: Free
• In-home setup and mattress removal: Free
• Warranty: One-year limited

Customer service

You can contact Saatva customer service by:

• Phone: 860-452-3977, available 24/7
• Email: info@saatvamattress.com
• Live chat: Available via the chat icon on the website, 24/7
• Calling or visiting a viewing room

Payment options 

• Ways to pay:
  • Visa
  • Mastercard
  • Discover
  • American Express
  • Google Pay
  • PayPal
• Discounts? Yes, find more information here
• Financing: Yes, Affirm

Helix Midnight Luxe: Best for Spinal Stenosis and Lower Back Pain

We chose the Helix Midnight Luxe as our Best Mattress for Spinal Stenosis and Lower Back Pain because it was one of the top mattresses we tested for easing low-back pain and pressure, especially with the optional ErgoAlign layer ($259). That extra zoned support in the lower-third of the mattress helps provide support and comfort to people with chronic back pain. 

Helix Midnight Luxe

Best for Lower Back Pain

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• Earned top back pressure and pain relief testing scores
• Reinforced support for the low back 

• Luxury, plush feel but still firm enough to support movement

Helix Midnight Luxe features

• Our pain relief score: 4.21/5
• Accessibility score: 4.06/5
• Mattress type: Hybrid
• Brand’s firmness rating: 6/10

Why we chose the Helix Midnight Luxe as the Best for Spinal Stenosis and Lower Back Pain

We chose the Helix Midnight Luxe as the best mattress for spinal stenosis and low-back pain because of its ability to relieve back pain and pressure. The Midnight Luxe’s great back pain and pressure relief has earned it top marks in our best mattresses for back pain roundup and our best mattresses for a herniated disc review.

The Midnight Luxe has a layer of steel springs sandwiched between memory foam layers. Each layer has a unique purpose: pressure relief, cooling, contouring, and stability. The ErgoAlign foam layer is optional but provides extra low-back support. Together, the foam and coils give the Midnight Luxe a balance of support and bounce. That combination keeps you on top of the mattress, not sunk into it, which can help keep your spine aligned. It also distributes weight evenly to avoid pressure buildup. This may help people with chronic back pain move more easily on the mattress. 

Helix Midnight Luxe pros and cons

Our testing experience with the Helix Midnight Luxe

The Helix Midnight Luxe is a hybrid mattress made with springs and memory foam. There is a dense foam base for stability. On top of that are 1,000 individually wrapped steel springs, reinforced around the edge of the mattress and under the lower-back region. More layers of memory foam provide pressure relief and contour to the body for a more comfortable experience.

Our older adult testers immediately loved how comfortable the Helix Midnight Luxe felt. “This bed has some nice texture to it,” said Chris, 66, a higher-weight back sleeper with spinal stenosis. “The top feels nice and soft, but the layer below still feels firm.” 

When Chris laid on his back, he said the Helix Midnight Luxe supported his body and kept his spine neutral. “My butt and hips feel aligned and I don’t feel any extra pressure on my lower back or hips,” Chris said. “My body feels equally supported all over.” 

When we measured this using a pressure mat with sensors to detect pressure buildup, the Helix Midnight Luxe earned the highest back pressure relief score possible, a perfect 5/5. You can read more about why we named the Helix Midnight Luxe one of the best mattresses for back sleepers in our roundup.

Great back support also factored into the Midnight Luxe’s well-above-average pain relief score (4.21/5). We calculated that score based on pressure relief, edge support, and bounce, three things the Midnight Luxe does exceptionally well. “Going closer to the edge I still feel supported,” said Chris while assessing how stable the edges felt. “I don't feel at all like I'm going to slip off.” He rated the mattress firmness as slightly higher (8) than the brand claimed (6), and commented that the extra firmness makes it easy to move on.

Our testers also rated the Helix Midnight Luxe as above average for cooling, and our tests backed that up. When we measured using a heat gun, there was an 8-degree F difference in temperature before and after a tester used the mattress. The average increase of all the mattresses we tested was 8.5 degrees F.

Although the Midnight Luxe performed well in other areas, it scored just average in motion isolation. Our testers could feel each other’s movements when sharing this mattress and thought that movement might disturb lighter sleepers. “It made my body move and bounced me slightly,” said one tester. “I’m a heavy sleeper, so that probably wouldn’t wake me up, but my husband’s a light sleeper, so I think it would definitely wake him up.” 

While Helix offers white-glove delivery (delivery and setup of new mattress and removal of old mattress), prices start at $119. It can be a good option because the Midnight Luxe weighs roughly 100 pounds. It’s about the weight of 12 gallons of water. That can be a lot for people even if they don’t deal with chronic pain or mobility issues. 

Who is the Helix Midnight Luxe right for? 

Because of its great back support and comfort, the Helix Midnight Luxe is a good choice for people who are experiencing chronic pain, especially back pain and spinal stenosis. It offers good support for all sleeping positions and may help if you have issues with mobility. It has decent airflow. But it wasn’t the greatest at limiting how much you can feel a partner’s movements. So if you’re easily awakened by that, you may want to keep looking.

The Helix customer experience

• Trial period: 100 nights
• Shipping: Free shipping
• In-home setup and mattress removal: $159
• Warranty: Limited lifetime

Customer service

You can contact Helix customer service by:

• Phone: 831-777-5976, Monday through Friday from 11 a.m. to 6 p.m. ET
• Email: help@helixsleep.com
• Live chat: Available via the chat icon on the website, Monday through Sunday from 10 a.m. to 10 p.m. ET
• Website: Submit a contact form
• Calling or visiting a viewing room

Payment options 

• Ways to pay:
  • Visa
  • Mastercard
  • American Express
  • Discover
  • Paypal
  • Google Pay
  • Shop Pay
  • Amazon Pay
• Discounts? Yes, find more information here
• Financing: Yes, Affirm

Nectar Premier Memory Foam: Best for Side Sleepers with Spinal Stenosis

We chose The Nectar Premier Memory Foam as the Best Mattress for Side Sleepers with Spinal Stenosis because it was great at relieving pressure and pain in the side sleeping position. It is also compatible with an adjustable base, which can help people with spinal stenosis get the comfort and support they need.

Nectar Premier Memory Foam

Best for Side Sleepers

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• Helps relieve pressure on shoulders, hips, and neck
• High pain relief score

• Good firmness level for side sleepers

Nectar Premier Memory Foam features

• Our pain relief score: 4.02/5
• Accessibility score: 4.06/5
• Mattress type: Memory foam
• Brand’s firmness rating: 6.5/10

Why we chose the Nectar Premier Memory Foam as the Best Mattress for Side Sleepers with Spinal Stenosis

It’s no secret that the Nectar Premier Memory Foam mattress has exceptional support for side sleepers. It was our overall top pick in the best mattresses for side sleepers roundup. Our pressure map test showed that it relieved pressure very well underneath the neck, shoulders, hips, and knees, receiving a perfect 5/5 score. Our testers also said it felt supportive in all sleeping positions.

Memory foam mattresses contour to support the spine in any position, and work with adjustable beds. Both these qualities give people with spinal stenosis more options to find a position that takes pressure off their joints and feels comfortable, said Dr. Smith, the spine surgeon in California. What is somewhat surprising about the Nectar Premiere Memory Foam mattress is that its bounce (rated a 4/5) is comparable to a spring or hybrid mattress. That makes it easier to move on than a lot of memory foam mattresses, which tend to swallow up a sleeper. People with spinal stenosis may have mobility issues due to their back pain; a mattress that is easier to move around on can help them sleep uninterrupted even if they switch positions. 

Nectar Premier Memory Foam pros and cons

Our testing experience with the Nectar Premier Hybrid

The Nectar Premier is a memory foam mattress with four layers: an upper cotton cooling cover, two layers of pressure-relieving foam, and a dense foam foundation. Like most memory foam mattresses, it feels soft and plush. This can be a bonus for someone who has spinal stenosis or other forms of chronic back pain and wants to feel cushioned. To some of our older adult testers, this mattress felt softer than it is. Nectar’s brand rating of 6.5/10 falls into the category of medium-firm that offers the best support for people with spinal stenosis, but our testers said this mattress felt more like a 4/10. 

“My lower back feels contoured and there isn't any pressure,” said Sheila, 70, an average-weight combination sleeper who tested this mattress. “But I would like a little more firmness in my mattress,” she said. Liking a plush mattress is a matter of personal preference. If you prefer one that feels firmer, Nectar makes a Premier Hybrid mattress that our testers also rated highly.

The Nectar Premier Memory Foam mattress performed really well at relieving pressure beneath the shoulders, neck, hips, and knees in the side sleeping position. Someone with spinal stenosis may be bothered by pressure near their neck or low back. Memory foam can help ease that pressure for side sleepers by contouring to the body while supporting those contact points. Our testers found this to be the case. “I feel really aligned,” said Sheila, while lying on her side. “I feel no pressure at all on the hips and shoulders.” Our pressure mat test confirmed that, showing only areas of slight pressure buildup (the yellow, orange, and green parts on the image on the screen). 

Testers were also impressed with how responsive this mattress was. They rated the bounce as a 4/5, as high as many mattresses with springs. “Pushing down on this mattress, it bounces back quickly,” said Sheila. “The mattress doesn't feel too firm or soft when pushing down on it.” That ability to spring back can help with mobility issues and make changing positions easier. It was also a factor in the Nectar earning high pain relief scores.

At the same time, memory foam is great at stifling motion. That quality can be useful if you sleep with a partner because their movements are less likely to disturb you. People with spinal stenosis may have difficulty getting comfortable and be easily disturbed by jostling on the other side of the bed. Testers rated the motion isolation abilities of the Nectar premier Memory Foam mattress as 4/5. “I can feel the initial bounce, but that's it,” said one. “The energy of the bounce is absorbed by the bed's foam. I don't think it would wake me up. It was very light. It feels like a classic memory foam.” Our seismograph measurements (below) show how little the bed moves when someone is getting in and out of it.

There are a few areas where the Nectar Premier Memory Foam mattress could have performed better. Its edge support was only slightly above average (3/5). Our testers said that they felt secure but would have liked more stability. “The edges sink, but not too much. I don’t feel like I’m sliding off, but it doesn’t feel secure,” one tester said. “I feel fine sitting, but because the edges are a little soft, it doesn’t help me stand up.”

This also wasn’t the coolest mattress we tested. Memory foam tends to trap heat because it is so dense, and our heat gun tests showed around a 10-degree F increase in temperature. But testers had their own opinions. “The top feels dense and like it'll actually trap and increase heat,” said one. “But lying down, I'm surprised by how well it keeps me cool. So at first glance, it doesn't seem great for cooling but I was pleasantly surprised.” If you prefer a mattress with better airflow, the Nectar Premier Hybrid mattress scored a 4/5 and was described by our testers as "one of the best mattresses I’ve tested for cooling.” For more information, see our Nectar mattress review.

Who is the Nectar Premier Memory Foam right for? 

Due to its superior pain and pressure relief, the Nectar Premier Memory Foam is a great choice for anyone who sleeps on their side or back or who has chronic pain or mobility issues. If you don’t sleep alone and want to minimize the movement you feel from your partner, this mattress has good motion isolation. If you want a cool mattress, the Nectar Premier Hybrid is a better choice with similar features.

The Nectar customer experience

• Trial period: 365 nights
• Shipping: Free
• In-home setup and mattress removal: $199
• Warranty: Lifetime

Customer service

You can contact Nectar customer service by:

• Phone: 888-863-2827, seven days per week from 8 a.m. to 4 p.m. PT
• Email: suppport@nectarsleep.com
• Live chat: Available via the chat icon on the website, 24/7
• Calling or visiting a viewing room

Payment options 

• Ways to pay:
  • Visa
  • Mastercard
  • Discover
  • American Express
  • Amazon Pay
  • PayPal
• Discounts? Yes, military, first responders, and health care professionals
• Financing: Yes, Affirm and Splitit

The WinkBed Plus: Best for Arthritis and Spinal Stenosis

We chose The WinkBed Plus as the Best for Arthritis and Spinal Stenosis because of its high pain relief score, and strong, even spinal support. With foam to cradle achy joints and springs to relieve pressure and aid mobility, this medium-firm mattress is a good choice for anyone who deals with chronic back and joint pain. It also stays comfortably cool, which may feel soothing. 

The WinkBed Plus

Best for Arthritis

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• Great at easing joint and back pain and pressure
• Made of breathable materials that stay cool

• Responsive support makes moving on it easier

WinkBed Plus features

• Our pain relief score: 4.78/5
• Accessibility score: 4.51/5
• Mattress type: Hybrid
• Brand’s firmness rating: 8.5/10

Why we chose the WinkBed Plus as the Best for Arthritis and Spinal Stenosis

We chose the WinkBed Plus as the Best Mattress for Arthritis and Spinal Stenosis because it had one of the highest pain relief scores of all the mattresses we tested. This mattress also gets good airflow, which helps it stay cool to the touch. A cool mattress can feel soothing when you have inflammatory pain like arthritis. 

The WinkBed Plus has the stability and support to keep the spine in a neutral position and avoid putting pressure on joints. Both arthritis and spinal stenosis are conditions that can cause achy joints, particularly near the neck, shoulders, and lower-back/hip region. The WinkBed Plus combines springs and foam to not only cushion and support those areas, but also help make moving on this mattress easier. Painful conditions can sometimes limit mobility, so a mattress that is responsive and has good bounce may help. 

WinkBed Plus pros and cons

Our testing experience with the WinkBed Plus

The WinkBed Plus is a medium-firm hybrid mattress made of several layers of foam over a bed of individually wrapped steel coils. The innerspring layer has zones of targeted support to offer greater pressure relief to specific areas, including the lower back. This is a plus for people with spinal stenosis, who often experience lower back pain and can use extra support. 

Our older adult testers said it is easier to move around on the WinkBed Plus than other beds they’ve tested. “I was able to easily roll from one position to another,” said one tester, Sheila, a 70-year-old average-weight combination sleeper. “I didn’t struggle at all to change positions and I didn’t have to use my arms to assist me. This bed feels very supportive.” 

Testers also said the WinkBed Plus offers consistent pressure relief in all sleeping positions. They rated it 5/5 for relieving pressure while lying on their backs and sides, and 4.5/5 for stomach sleeping. 

Those high marks contributed to the WinkBed’s high pain relief score (4.78/5). Testers also said the mattress felt slightly softer than the brand claims. They rated it a 6/10 firmness, but the brand says it’s 8.5/10. 

A combination sleeper who switches positions, Sheila felt the WinkBed had plenty of support when she was on her side and back. Those two positions tend to provide the most pain relief and comfort for people with spinal stenosis. When lying on her back, she said, “My body feels evenly supported. Even the curve of my spine and my lower back feel supported,” she said. “Honestly with this mattress it feels good without a pillow. My body feels very nice and even.”

Testers were impressed by the Luxury Firm’s cooling abilities. “It feels cooler to the touch than most,” said one tester. “There isn't much quilting or heavy fabric on the top that feels like it could trap heat. Also the top layer seems kind of airy, like there's a little bubble or air pocket which could help breathability and air flow. Overall, this one feels really nice for cooling.”

Testers appreciated that the bed was noticeably cool, and our temperature test confirmed that, earning the bed a cooling score of 4/5. A cool-feeling mattress can feel good on sore joints and stiff muscles, which can accompany conditions like spinal stenosis and arthritis. 

While the WinkBed Plus excelled in many areas, it wasn’t great at motion isolation. If you are a light sleeper who may be disturbed by a partner’s movements, the WinkBed Plus may not be a great choice. “There was no absorption of the movement,” said one tester. “I was definitely bounced. It's a bouncy bed, I think it would wake me up.” Testers rated the motion isolation as 2/5. 

Who is WinkBed Plus right for? 

The WinkBed Plus has a good balance of pressure relief and bounce, making it an option for those with pain and mobility concerns. The Plus’s above-average cooling features make it great for hot sleepers. It may also be a good choice for higher-weight sleepers, those with back pain, or who sleep on their back. It’s not a great choice if you are easily disturbed by a partner’s movement.

WinkBed customer experience

• Trial period: 120 nights
• Shipping: Free
• In-home setup and mattress removal: No
• Warranty: Limited lifetime

Customer service

You can contact WinkBed customer service by:

• Phone: 855-946-5233, Monday through Friday from 8 a.m. to 7 p.m. ET
• Email: info@winkbeds.com
• Live chat: Available via the chat icon on the website, same hours as phone
• Calling or visiting a viewing room

Payment options 

• Ways to pay:
  • Visa
  • Mastercard
  • Discover
  • American Express
  • Google Pay
  • Shop Pay
  • Apple Pay
• Discounts? Yes, military and first responders
• Financing: Yes, Bread

Bear Original: Best Cooling Mattress for Spinal Stenosis

We chose the Bear Original as our Best Cooling Mattress for Spinal Stenosis because it had the smallest temperature change in our heat gun tests, just over 3 degrees F. That earned the Bear Original the only 5/5 perfect cooling score out of all the mattresses we tested. This memory foam mattress also earned high marks for side pressure relief. And it was above-average for pain relief. 

Bear Original

Best Cooling

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• Exceptional cooling
• Lowest-priced mattress in this review

• 120-day trial period and limited lifetime warranty
• Offers white-glove delivery for an extra fee

Bear Original features

• Our pain relief score: 3.37/5
• Accessibility score: 3.51/5
• Mattress type: Hybrid
• Brand’s firmness rating: 7/10

Why we chose the Bear Original as the Best Cooling Mattress for Spinal Stenosis

We chose the Bear Original as the Best Cooling Mattress for Spinal Stenosis because it was able to limit heat buildup better than any mattress we tested. This is especially surprising for a memory foam mattress, as most tend to trap heat. “Temperature regulation can be important for people with spinal stenosis, especially if pain disrupts sleep,” said Anthony Giuffrida, MD, a spinal stenosis expert in Fort Lauderdale, Florida. A cool mattress may feel better to lie on when symptoms flare. 

Memory foam mattresses are also good for contouring and pressure relief, said Dr. Giuffrida, and this one got high marks for the side-sleeping position. The way foam contours to the body can help keep the spine aligned. It can also support places where pressure is likely to build, such as under the shoulders, neck, and hips. And they’re compatible with adjustable beds, which can help people with chronic pain find the most comfortable sleeping position. See our review of the best adjustable beds and best mattresses for adjustable beds for more information.

The Bear Original’s three layers of foam were also good at minimizing motion transfer, earning a score of 4/5. People with spinal stenosis often have trouble sleeping due to pain, and may be more sensitive to subtle movements from a partner or pet. This mattress prevents that from happening. It also had slightly above average scores for pain relief, edge support (earning another perfect for lying edge support), and accessibility. These are all important for people with spinal stenosis, who may have mobility issues due to painful symptoms. 

Bear Original Hybrid pros and cons

Our testing experience with Bear Original

Memory foam is notorious for trapping heat. But the Bear Original was the top performer in our heat gun tests, earning the only perfect score. The mattress is made with a special kind of open-cell foam, which is more breathable than other dense memory foams. The top of its three layers is cooling gel foam, to draw body heat away. The quilted cover is breathable, and one of our older adult testers described it as “cool and light.” 

In our tests using a heat gun to measure the surface temperature of the mattress before and after a tester used it, the Bear Original was only 3 degrees F warmer after use. The average mattress we tested heated up by 8.5 degrees F. People with spinal stenosis or other chronic pain may feel more comfortable on a cool mattress, as overheating can wake them and pain or other symptoms can make it difficult to fall back asleep.

Memory foam mattresses are often known for their soft, plush feel, but testers rated this one a 9/10, much firmer than the brand’s claim of 7/10. “I feel more ‘on’ than ‘in’ the mattress,” said Chris, 66, a higher-weight back sleeper with back pain and spinal stenosis. “It feels forgiving while being firm.” The Bear Original is at the upper end of the best firmness range for people with back pain or spinal stenosis, but our testers felt the support was good in most sleeping positions. 

When lying on his back, Chris said, “I don't feel any extra pressure on my lower back or hips. It's firm, but I'm not feeling any pressure buildup in any specific area.” When lying on his side, he said, “My hips and spine feel pretty much aligned. And my body feels equally supported—no body part feels more elevated than the other. There is no pressure in my shoulder or my neck. It's definitely holding me up and it has the support.”

Although the mattress had very little bounce, which usually helps with switching positions, Chris said he found it easy enough to move around on. “Going to the side is fine, not hard to move into that position at all,” he said. Our testers also had no concerns about the mattress’s stability, although the Bear Original had only average scores for both seated and lying edge support. “I don't feel like I'm going to roll off,” Chris said, when testing the edges’ stability. “I feel really stable. It's comfortable and firm. The top layer feels like it's giving me some comfort and then the bottom layer is firmer. It's a nice combination. I feel equally supported throughout my whole body.” 

When he sat on the edge of the mattress, Chris said, “I don't feel like I’m going to slide off. It feels pretty stable. I don't need to use my hands for support or balance or anything. The edge feels stable and solid for sure.” But, he added, “There's no bounce helping me get back up. When I sit down on one side I feel a little off-balance for a split second, but then the foam equalizes and supports equally on both sides of my body. I could see someone with balance issues falling easily.”

Because of its lack of bounce, the Bear Original may be a good choice for anyone who can be easily disturbed by a partner’s movements. Its layers of foam kept motion transfer to a minimum, earning a score of 4/5. “I did not feel like I was bounced, I maybe felt some back-and-forth motion,” one tester said. People with spinal stenosis who sleep with a partner may prefer a mattress with good motion isolation so they aren’t disturbed during the night. 

While a lack of bounce helps isolate motion, it may also make it harder for people with mobility issues to change positions. A little bit of bounce can help assist people when they move so they don’t have to exert as much energy. It’s also worth noting that, because it’s on the firmer side, some sleepers (especially lighter weight) may feel this mattress is too firm. 

Who is Bear Original right for?

The Bear Original outperformed all the other mattresses we tested for cooling and has the lowest price tag of any mattress we tested. That means it could be a good choice for anyone who sleeps hot or who is on a budget. If you are a light sleeper, you may like the Bear Original's ability to dampen motion. But someone with balance or mobility issues might struggle to get in and out of the bed because this mattress is not the most responsive. If you prefer a less-firm mattress with more bounce, the Bear Elite Hybrid may be a good choice.

Bear customer experience

• Trial period: 120 nights
• Shipping: Free
• In-home setup and mattress removal: $100–$200
• Warranty: Limited lifetime

Customer service

You can contact Bear customer service by:

• Phone: 844-311-0035, available Monday through Friday from 10 a.m. to 6 p.m. ET
• Email: support@bearmattress.com
• Live chat: Available via the chat icon on the website, available Monday through Friday from 10 a.m. to 6 p.m. ET
• Calling or visiting a viewing room

Payment options 

• Ways to pay:
  • Visa
  • Mastercard
  • American Express
  • Discover
  • Paypal
  • Shop Pay
  • Venmo
• Discounts? Yes, find more information here
• Financing: Yes, Affirm and ShopPay

Nolah Evolution Luxury Firm: Best for Couples with Spinal Stenosis

We chose the Nolah Evolution Luxury Firm as our Best Mattress for Couples with Spinal Stenosis because of its targeted support for the low back, high pain and pressure relief scores, and ability to minimize motion as well as top memory foam mattresses in our tests. That means a partner’s movements are less likely to wake you at night. 

Nolah Evolution Luxury Firm

Best for Couples

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• Limits motion transfer between partners
• Top marks for back pain and pressure relief

• Sleeps cool

Nolah Evolution Luxury Firm features

• Our pain relief score: 4.31/5
• Accessibility score: 3.96/5
• Mattress type: Hybrid
• Brand’s firmness rating: 6/10

Why we chose the Nolah Evolution Luxury Firm as the Best for Couples with Spinal Stenosis

The Nolah Evolution Luxury Firm mattress is a hybrid mattress that, unlike most hybrid mattresses, isolates motion extremely well. That can be great for couples who have spinal stenosis and who may be more sensitive to motion due to pain or other symptoms. The Nolah Evolution Luxury Firm’s individually wrapped coils limit motion transfer as well as some of the better memory foam mattresses we tested. Memory foam is usually the go-to for exceptional motion isolation.

Because people with spinal stenosis often have trouble getting comfortable or falling back asleep due to their symptoms, a mattress that limits motion transfer could potentially limit their sleep disturbances. 

This hybrid mattress was also far more responsive than most memory foam mattresses, with a test score of 4/5. Its individually wrapped springs move with the person on top of the mattress. That can help people who have pain or mobility issues get in and out of bed or switch positions, an area where memory foam usually falls short. 

The Nolah Evolution Luxury Firm also earned top scores for pain relief and easing pressure on the back.

Nolah Evolution pros and cons

Our testing experience with the Nolah Evolution Luxury Firm

The Nolah Evolution Luxury Firm is made to be as plush as a luxury hotel mattress—and as durable as one. It has individually wrapped 8-inch steel springs with larger coils around the edge for more stability, topped by layers of pressure-relieving foam. The areas beneath the shoulders, knees, and hips have extra support to keep stress off joints and spine. This may help ease pain for anyone with spinal stenosis who tends to feel pain in the lower back and neck.

This hybrid mattress is the medium-firm option from the brand, and our older adult testers described it as softer than the brand rating, but still supportive in all the right places. They called it “soft and springy,” but not unstable. “I don't feel any pressure around my body,” said one tester, Sheila, a 70-year-old average-weight combination sleeper. When lying on her back, Sheila said, “This mattress is conforming to my body nicely. My spine feels aligned and I feel really great.” Testers gave this mattress high marks for support in every position, including 4.5/5 when lying on their back. 

Testers appreciated the quality construction and materials used for the Nolah Evolution. Sheila said “It feels soft and silky and is one of the best textures I have felt from all the mattress options.” Several layers of dense memory foam give the mattress a plush feel and cushion the sleeper, but the support of the springs was still noticeable. “When I place my hand on the mattress, it bounces back instantly,” she said. “The topper is soft and springy. It's really difficult to push past the topper and get to the second layer of memory foam.” 

Several layers of foam and individually wrapped springs help dampen the motion of the coils, so as responsive as the Nolah Evolution Luxury Firm is, it won’t transfer movement from one partner to the other. The Nolah had one of the top scores for a hybrid mattress for motion isolation, on par with many memory foam mattresses. Testers said they barely felt the bounce of a partner moving. “I didn't really feel the movement in my upper half at all,” said one tester. “I don't think this would wake me.”

Couples tend to generate more heat than single sleepers, and a hot mattress can be uncomfortable when you have any kind of pain. The Nolah only had average cooling capabilities. The Nolah Evolution also could have had stronger support at its edges. “I do feel like my left side of my body is tilting slightly,” said Sheila when lying near the edge. “I don't feel like I would roll off, but I don't feel fully supported either.”

Who is Nolah Evolution Luxury Firm right for? 

For couples where one or both partners have back or other pain, the Nolah Evolution Luxury Firm was great at minimizing motion but still helping with mobility issues. Testers found it relieved pressure in most positions, and the combination of zoned support and memory foam helped ease back pain. It was only average for cooling and could have better edge support.

Nolah customer experience

• Trial period: 120 nights
• Shipping: Free white-glove delivery
• Warranty: Limited lifetime
• Financing: Yes, through Affirm

Customer service

You can contact Nolah customer service by:

• Phone: Call 866-403-6615, available Monday through Friday from 8 a.m. to 5 p.m. CT
• Email: support@nolahmattress.com
• Chat: Live chat via the bottom right corner of the website, available Monday through Friday from 8 a.m. to 5 p.m. CT

Payment options 

• Ways to pay:
  • MasterCard
  • Visa
  • American Express
  • Discover
  • Shop Pay
  • PayPal
• Discounts? The brand currently offers $50 off for military members and their families, as well as health care workers. This discount can’t be combined with other promotional codes.
• Financing: Available through Affirm.

Titan Plus: Best for Higher-Weight Sleepers with Spinal Stenosis

We chose the Titan Plus as the Best for Higher-Weight Sleepers with Spinal Stenosis because it scored in the top third of every category we tested, including back support and pain relief. The Titan Plus is designed for higher-weight sleepers and has the highest weight limit of any mattress on this list at 1,000 pounds. It is also a great value, as one of the more affordable mattresses on this list.

Titan Plus

Best for Higher-Weight Sleepers

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• Helps keep spine neutral and neck supported
• Built specifically for higher-weight people

• Individually wrapped coils for great pressure relief

Titan Plus features

• Our pain relief score: 4.36/5
• Accessibility score: 4.30/5
• Mattress type: Hybrid
• Brand’s firmness rating: 9/10

Why we chose the Titan Plus as the Best for Higher Weight Sleepers with Spinal Stenosis

We chose the Titan Plus as the Best for Higher-Weight Sleepers with Spinal Stenosis because it is made to evenly distribute weight and can support up to 1,000 pounds (the highest weight limit on this list). It has a layer of 900 individually wrapped 8-inch steel coils for support sandwiched between dense memory foam. This creates stability that helps maintain a neutral spine and keeps pressure from building up under joints where people with spinal stenosis often feel pain. The Titan Plus earned perfect scores in several testing categories, including edge support, responsiveness, and a 4.5/5 in overall pressure relief.

Testers praised this hybrid mattress for easing pressure when lying on your side, a position that can lead to neck pain and stiffness. That’s a frequent problem for anyone with spinal stenosis. For more information on sleeping with neck pain, see our review of the best mattresses for neck pain.

The Titan Plus also had the strongest/most stable edges of any mattress we tested. Edge support is important for everyone, but especially for older adults and higher-weight people. The stronger the edge support, the less likely you are to slip or fall while sitting on the bed’s edge. This mattress displayed both good bounce and good motion isolation in our tests, earning a 4/5 for both. That means it’s responsive enough to help those with mobility issues but also won’t transfer movement to wake a partner. 

Titan Plus pros and cons

Our testing experience with the Titan Plus

The Titan Plus is a firm hybrid mattress with a base layer of foam, a layer of individually wrapped 8-inch steel coils, another layer of foam to provide contouring and pressure relief, and a quilted top with gel foam for comfort. It is designed to support people with a higher weight, but our testers found it had great support and comfort in general no matter their weight. The Titan is firmer (9/10) than what is usually recommended for people with back pain (medium-firm or 5–7/10) but felt slightly softer to our older adult testers. Still, one said, “You do need to like a firm mattress.”

Testers were impressed with the Titan Plus’ ability to ease pressure, especially when lying on their side. One tester, Patti, a 74-year-old lighter-weight combination sleeper, was surprised how comfortable the mattress was when lying on her side. “I don’t feel any sinkage, and no pressure or pain forming,” she said. “My spine is aligned. I can tell it’s firm. It’s not cushioning or contouring, but not painful. I think it’d be good for back and neck problems.” 

When lying on her back, Patti found the same firm support. “It's a firm surface with no indentations or sinkage,” she said. “It would be great for people with back pain because of the excellent spinal alignment. The space at my lower back is being filled in with no gapping. I feel very flat, and my spine is in a straight line.” Lynn is a lower-weight person, so it’s possible someone with a higher weight would feel differently. 

Our testers also found that the Titan Plus had some of the most stable edges of any mattress we tested. Testers gave it a perfect score for edge support. This can help with durability, but also makes it easier to get in and out of the bed, something that could be a concern for people with chronic back pain like spinal stenosis. “The edge is just as supportive as the middle,” Patti noted. 

People with a higher weight may appreciate that the Titan has good bounce, another area where it earned a perfect score. Springs can assist with mobility and switching positions. Patti found that it was not hard to move on such a firm mattress. “It was very easy to roll from one position to the next,” she said. “There was no sinkage that could inhibit movement. All positions were equally easy to do.” 

Although Patti found the Titan Plus very comfortable, other lighter-weight sleepers may find it too firm, since it is the firmest mattress on this list at 9/10. 

It’s also worth noting that Titan doesn’t offer white-glove delivery, meaning you’ll need to move and set up the mattress yourself or enlist outside help. If you’re interested in brands with white-glove delivery, we recommend Saatva, which offers it free.

Who is Titan Plus right for? 

With high scores across the board for pressure and pain relief, the Titan Plus may be a great fit for higher-weight sleepers with joint or back pain, as it’s very firm and supportive. It also offers solid edge support, making it easier to get out of bed. It was above average for cooling and had high marks for motion isolation, so it could be a good choice for couples, especially if one is a light sleeper or has back pain.

Titan Plus customer experience

• Trial period: 120 nights
• Shipping: Free
• Warranty: Lifetime limited

Customer service

Titan is a Brooklyn Bedding company, and its hours tend to be inconsistent, according to our mystery shopping. Its website states you can reach customer service by:

• Phone: Call 623-624-1222, available seven days a week from 11 a.m. to 8 p.m. ET Monday to Friday and 11:30 a.m. to 8 p.m. Saturday and Sunday 
• Chat: Live chat via the bottom right corner of the Titan website, available Monday through Friday from 9 a.m. to 8 p.m. ET and Saturday through Sunday from 11:30 a.m. to 7 p.m. ET
• Website: Submit a contact form

Payment options 

• Ways to pay:
  • American Express
  • Discover
  • Mastercard
  • Visa
  • Google Pay
  • PayPal
  • Shop Pay
• Discounts? Yes, the company currently offers 5% off for military members, first responders, medical providers, students, and teachers. The discount code can’t be combined with other promotional codes.
• Financing: Yes, Affirm or Shop Pay

Birch Natural: Most Accessible Mattress for Spinal Stenosis

We chose the Birch Natural as our Most Accessible Mattress for Spinal Stenosis because it had the highest test scores in areas that help with mobility, such as edge support and responsiveness. Moving can be difficult when you have pain from spinal stenosis. This mattress also has great back support scores and is made with natural and organic materials, which is a plus for anyone with sensitivities to synthetic chemicals.

Birch Natural

Most Accessible

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• One of the easiest mattresses to get in and out of
• Strong, stable edges

• Natural and organic construction materials

Birch Natural features

• Our pain relief score: 4.55/5
• Accessibility score: 4.51/5
• Mattress type: Hybrid
• Brand’s firmness rating: 6.5/10

Why we chose Birch Natural as the Most Accessible Mattress for Spinal Stenosis

The Birch Natural has the right mix of exceptional edge support, bounce, and firmness to provide a stable surface that makes it easier to get in and out of bed. Strong, stable edges make it easier to change positions while lying in bed, something people with spinal stenosis may do a lot in trying to find a comfortable sleeping position. Edge support also makes it easier to go from sitting to standing with less effort. 

This mattress got equally high marks for its superior responsiveness, which also helps with mobility. It is a hybrid so some of the bounce comes from steel coils, but the Birch is the only mattress on this list that includes latex foams. “Latex is naturally cooling, supportive, and resilient, so it is often ideal for people with spinal stenosis,” said Dr. Giuffrida, the spinal stenosis expert in Florida.

The Birch Natural had one of the highest pain relief scores of any mattress we tested, and great support for the lower back. Spinal stenosis often causes lower back pain, so a mattress that supports that area can be helpful. This mattress is also made with natural and organic materials, which can be good for anyone who is sensitive to synthetic chemicals. 

Birch Natural pros and cons

Our testing experience with the Birch Natural

The Birch Natural is a hybrid mattress made with layers of wool and latex foam over a base layer of individually wrapped steel. The materials are all breathable and the top cover is made from organic cotton. Our testers noted that the material “feels cool, and it doesn't feel rough. It’s soft and has a nice texture.” 

With its spring and latex layers, this mattress had exceptional bounce. We measured bounce by dropping a weight from a standard height and measuring the rebound height. The Birch Natural measured 22.5 inches, achieving a perfect 5/5 score. Bounce is important because it can make it easier to move around and get in and out of a mattress. People with chronic pain like spinal stenosis tend to do well with more bounce. Our testers felt this mattress was very responsive to pressure. “It’s pretty firm, but it does come right back into shape,” said Chris, 66, a higher-weight sleeper with back pain and spinal stenosis. That translated to better mobility. “Going to the side is really easy, and rolling over to my stomach is really easy,” he said. “It's easy to move around, I hardly need any effort.”

Whether sitting or lying on the edge of the Birch Natural, testers were impressed by the extremely stable edge support. “I don’t feel any need for extra support,” Chris said, while sitting on the edge. “The edges bounce back quickly when I go from sitting to standing. It’s really firm on the edge.” Lying as close as possible to the edge without slipping off the bed had the same result. “I think this is very supportive and I feel very stable in this position,” Chris said. “I sleep on the edge a lot, so this mattress is definitely better than mine. It’s very comfortable. When I’m lying on the edge I don’t feel like I’m going to roll off at all.”

Our testers rated Birch Natural’s edge support as a perfect 5/5, and when one of our average-weight testers sat on the edge, it only sank by about two inches. That’s better than the average amount of edge sinkage (3.1 inches) of every mattress we tested. 

Testers also rated the Birch Natural highly (4/5) for its ability to relieve pressure on the back. When lying on their backs, testers found the bed comfortable and supportive. “I feel really aligned. My butt’s in line with my shoulders,” Chris said. “I feel maybe a tiny bit of pressure on my lower back, but nothing on my hips at all. My body feels equally supported all over.” 

While the Birch Natural earned high marks in pain relief and accessibility, it was below-average in motion isolation. That means movement on this mattress is more likely to disturb you if you’re sleeping. Our testers assessed motion isolation, and they weren’t impressed. “It feels a little thin. I can feel every single movement and nothing feels dampened,” said one tester. “It feels like I’m getting bounced a little. It feels really springy and like none of the movement is dampened.” When we tested motion isolation using a seismograph, we saw what the testers felt: There were several spikes as the motion rippled across the mattress.

Who is Birch Natural right for? 

If you want a stable mattress with good back support that is easy to move on, the Birch Natural could be a good choice. Its use of natural and organic materials makes it an option for anyone with allergies or sensitivities to synthetic materials or chemicals. If you sleep with a partner and are easily disturbed by their movement, you may want a mattress with better motion isolation, like the Nolah Evolution.

Birch customer experience

• Trial period: 100 nights
• Shipping: Free
• Warranty: Limited lifetime
• Financing: Yes, through Affirm and Katapult

Customer service

You can contact Birch customer service by:

• Phone: 917-540-5525, Monday through Friday from 11 a.m. to 6 p.m. ET
• Email: info@birchliving.com
• Live chat: Available via the chat icon on the website, every day from 10 a.m. to 10 p.m. ET
• Website: Submit a contact form 
• Calling or visiting a viewing room

Payment options 

• Ways to pay:
  • Visa
  • Mastercard
  • American Express
  • Discover
  • Paypal
  • Google Pay
  • Amazon Pay
  • Shop Pay
• Discounts? Yes, find more information here
• Financing: Yes, Affirm

Our process testing the best mattresses for spinal stenosis 

Our team has spent thousands of hours researching and testing mattresses so you can feel confident in our reviews. We work with experts in sleep, physical therapy, and occupational therapy to know what features are most important when searching for the best mattresses for spinal stenosis.

For this review, we personally tested 30 mattresses identified through our research to offer spinal stenosis pain relief and ease pressure on the back. Each mattress was put through rigorous testing by older adults with pain, to ensure we have real-world data about how they perform.

We considered these important factors when testing the best mattresses for spinal stenosis:

Firmness levels

A medium-firm mattress (5–7/10) tends to offer the best balance between spinal alignment and pressure relief. Past testing has shown that firmer mattresses sometimes feel softer to people with a higher weight. 

Pressure relief

People with spinal stenosis often need extra support under the low back and neck. Our pressure relief score reflects our testers’ experiences on the mattress and the results shown on our pressure map. The pressure map uses sensors to show how much pressure the body feels when lying on the mattress. Blue and green show great pressure relief. Yellow, orange, and red show places where pressure builds up. 

Experts agree that sleeping on your back or side is generally the best position for lessening the pain of spinal stenosis symptoms. For that reason, we looked for mattresses that earned high scores for pressure relief in those two sleeping positions, especially beneath the shoulders, back, hips, and neck (areas where pressure commonly builds up).

Zoned support 

Some mattresses have extra foam or reinforced springs in the area below the low back. This is called zoned support. It makes the mattress firmer to support the bottom of the spine and slightly softer at the hips and shoulders. That can reduce pressure on the spinal nerves and possibly bring some relief. We referred to our pressure map tests and asked testers how supported they felt in key areas (neck, shoulders, back, and hips) to determine how well the zoned support was working in mattresses that had it. For more information on zoned support, see our review of the best mattresses for hip pain.

Spinal alignment

Spinal stenosis most often affects the lower back. So a mattress that can support the spine in those areas and keep it in a neutral position may help ease back strain. We looked for mattresses that are supportive throughout the spine while offering enough cushioning to relieve pressure on the joints. We asked testers how they felt lying on their side and had them lie on each mattress to understand the level of support the mattress provided to people of varying weights. When a mattress has to hold more weight overall, distributing that weight evenly is key to keeping the spine in a neutral position, whatever position you sleep in.

Pain relief

Unique to NCOA, a high pain relief score indicates that a mattress has a good balance of pressure relief, edge support, and bounce. This usually means a mattress is both firm and comfortable to move on, a great combination for people who may find changing positions or getting in and out of bed difficult due to spinal stenosis or other forms of chronic back pain.

Understanding spinal stenosis and sleep

“Sleep difficulty from back pain often is the last straw for many patients who think the pain will resolve on its own in a few weeks," said Dr. Smith, the chief of spine surgery in California. “That’s when they go to a doctor’s office seeking relief.”

When you have spinal stenosis, it can feel like a vicious cycle. You can’t sleep because of the pain in your back or neck, but lack of sleep can make symptoms worse. “Poor sleep can [increase] pain perception, reduce pain tolerance, increase body inflammation, and increase fatigue,” said Dr. Giuffrida. “It can in turn worsen daytime function. Conversely, increased pain from stenosis can disrupt sleep due to discomfort, leg cramps, or numbness.”

Spinal stenosis is one of the top causes of back pain in people over age 50. “Age is the strongest risk factor, as degenerative changes like disc bulging, arthritis, and ligament-thickening accumulate over time,” said Dr. Giuffrida. It occurs when the spinal canal narrows, which can compress the spinal nerves. That can result in pain, numbness, tingling, and/or weakness in the lower back and neck that can spread to the arms or legs.

“People with spinal stenosis often face several sleep challenges that can significantly impact rest and recovery,” said Dr. Giuffrida. When spinal stenosis occurs in the low back, it might cause leg pain and numbness at night. It can make it difficult to find a comfortable position. “Lying flat can worsen symptoms due to lumbar extension, leading to increased pain,” he continued.

Cervical stenosis may contribute to neck pain, tingling in the arms or hands, and difficulty finding enough head and neck support during sleep. It’s common to be woken up by nerve irritation and discomfort as people change positions during the night.

There is no real cure for spinal stenosis, but the symptoms can be managed with medical care and lifestyle changes. One of those is choosing a mattress and/or accessories that can support you properly if you have spinal stenosis. “Sleep position and quality of sleep are important elements in managing spinal stenosis,” said Dr. Smith. Medium-firm mattresses offer the best support for back pain patients. 

Sleep positions and spinal stenosis

Like most people with back pain, people with spinal stenosis can struggle with sleep. “Finding the right sleep position is key to managing spinal stenosis symptoms,” said Dr. Smith. “I tell my back pain patients to experiment until you find a position that provides some relief of your pain. Some adjust their bodies with pillows, some like to lie flat on their back.” Read on for expert advice about sleep position and spinal stenosis. 

Best sleeping positions for minimizing back pain

“The best position for minimizing pain is side sleeping with the knees slightly bent and a pillow placed between them, which helps open the spinal canal and relieve pressure,” said Dr. Giuffrida. “Sleeping on the back with a pillow under the knees can also be beneficial, as it reduces lumbar nerve compression by maintaining a gentle bend in the spine. In contrast, stomach sleeping is typically the worst position. It hyperextends the lumbar spine and can [increase] nerve impingement and pain.”

How to select a mattress based on your primary sleep position

While it’s no substitute for medical care, a mattress with the right support and other features can help people with spinal stenosis sleep more comfortably. 

Spinal stenosis most commonly affects the neck and lower back. Where you need the most support can also depend on the position you tend to sleep in: 

• Back sleepers: You want zoned support around the low back area to reduce nerve pressure. 
• Side sleepers: Look for support beneath your hips, shoulders, and neck. The goal is to keep your spine straight.

Using pillows and accessories to enhance comfort

“Pillows and other accessories can significantly enhance comfort for individuals with spinal stenosis,” said Dr. Giuffrida. “Knee pillows are especially helpful for side sleepers, as they promote proper spinal alignment. Back sleepers may benefit from wedge pillows that elevate the legs, reducing pressure on the lower back. Lumbar rolls can provide targeted support for the natural curve of the spine, helping to maintain a more comfortable posture during sleep.” For more information, see our review of the best pillows for back sleepers.

You could also consider a mattress topper. “Mattress toppers made from memory foam or latex can adjust the firmness and contouring of a bed without the need to replace the entire mattress, offering improved pressure relief and support,” Dr. Giuffrida said.

Position-specific pressure point concerns

When sleeping on your back, most of the pressure buildup is going to be below your lower back where your spine curves. Depending on how spinal stenosis affects you, you may also feel pain beneath your neck. 

Side sleepers, on the other hand, may experience the most pressure at joints, particularly the hips, knees, shoulders, and neck. That’s because all your body weight is concentrated on those areas. It may help to find a mattress that relieves pressure in those areas.

Additional spinal stenosis management strategies

While spinal stenosis is a degenerative disease, there are several lifestyle and therapeutic strategies that can help manage spinal stenosis symptoms, said Dr. Giuffrida. You’ll want to talk to your doctor before starting any new therapies to make sure they’re right (and safe) for you. But many patients can manage the condition with conservative treatment, said Dr. Smith. 

• Regular stretching can improve spinal stability. Gentle flexion-based movements like knees-to-chest stretches may relieve pressure on spinal nerves. Stretching the hamstrings and hip flexors can also promote better posture and reduce strain. 
• Exercise focused on core strengthening, such as planks and pelvic tilts, can also help, said Dr. Giuffrida. “Physical therapy is an effective first line conservative therapy for any spinal stenosis patient. The right exercise can have a profound impact on your symptoms.”
• Complementary pain relief methods such as heat therapy before bed, use of a TENS unit, acupuncture, and massage therapy may offer additional relief. Over-the-counter or prescribed pain medications can also be part of a comprehensive symptom management plan.
• Medications can be used to reduce the pain and swelling as well as perhaps some specific injections at the site of the stenosis, said Dr. Smith. 

How much do the best mattresses for spinal stenosis cost?

The choices for our best mattresses for spinal stenosis cost between $855–$2,398 for a queen-sized mattress. 

Along with size, other things that contribute to the cost of a mattress include the materials used in its construction, certifications, and added features such as a cooling layer or pillow top, as well as extras offered by the brand. Extras can include free shipping, white-glove delivery (where a mattress is delivered directly to your bedroom), or a lifetime warranty. 

How to save money on mattresses

A mattress may ultimately be worth it in per-use cost, but it can seem like a lot to spend all at once. If you’re looking for ways to save, consider the following:

• Look for sales, especially around holidays like Labor Day and Memorial Day. 
• Many manufacturers offer coupons, sale codes, and discounts on their websites. 
• Lots of mattress manufacturers offer discounts for current or former members of the military, students, teachers, older adults, and other groups. 
• If you have a medical need for a mattress and your health care provider writes a note of medical necessity, you may be able to use FSA or HSA funds to make your purchase. 
• Retail stores often have floor models or returns at a big discount.
• Most mattress manufacturers offer some kind of financing plan, which can be a better bargain than paying for a mattress with a credit card. 

It’s a good idea to research mattresses before you buy, so you can find the best mattress for the best price. Knowing what features you need and which you can live without can save you some money, too. 

Frequently asked questions

Are natural/organic mattresses better for people with spinal stenosis?

Natural or organic materials are unlikely to help ease pain or other symptoms related to spinal stenosis, but they may benefit those with allergies or sensitivities to synthetic chemicals.

Can a mattress really help with spinal stenosis?

When used with proper medical treatment for spinal stenosis, the right mattress may help ease some of the symptoms of this condition and help people who have one to sleep better. 

What firmness is best for spinal stenosis?

A medium-firm mattress (5–7/10) tends to offer the best balance between spinal alignment and pressure relief for people with spinal stenosis. Your mileage may vary depending on your exact symptoms, body weight, and other factors. 

How long should I trial a mattress to know if it works for my spinal stenosis?

For any new mattress, it may take between 30–90 nights of sleeping on it to know if it is easing your spinal stenosis symptoms. Your body will need time to adjust and adapt to new support patterns. Most mattress companies offer at least a 100-night sleep trial and free returns.

Questions? Email us at reviewsteam@ncoa.org