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A firm mattress may help alleviate back pain by distributing the body’s weight more equally and supporting spinal alignment. This may then help improve sleep quality.

This article looks at how a firm mattress may help back pain, lists some mattresses a person can consider, and answers some frequently asked questions.

Below, we look at some of the best firm mattresses available for persons with back pain.

Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.

Medical News Today follows a strict product selection and vetting process. Learn more here.

Please note that unless otherwise stated, the prices below are all for queen-sized mattresses.

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Best for a variety of firm options: The WinkBed

  • List price: $1,149–2,049
  • Sizes: twin, twin XL, full, queen, king, California king

The table below compares each of the mattresses in this article for type, firmness, cooling features, price, and more.

Type SizesFirmness or ratingCoolingSleep trialWarrantyPrice
Laylafoam• twin
• twin XL
• full
• queen
• king
• California king
7 out of 10yes120 nightslifetime$749–1,249
WinkBedhybrid• twin
• twin XL
• full
• queen
• king
• California king
• Soft
• Firm
• Luxury Firm
• Plus
yes120 nightslifetime$1,149–2,049
Helixhybrid• twin
• twin XL
• full
• queen
• king
• California king
6–7 out of 10yes100 nights10–15 years$811.30–1,811.30
Saatvahybrid• twin
• twin XL
• full
• queen
• king
• split king
• California king
• split California king
Luxury Firm: 5–7 out of 10

Firm: 8 out of 10
no365 nightslifetime$995–2,710
Purplefoam• twin
• twin XL
• full
• queen
• king
• split king
• California king
medium firmno100 nights10 years$799–1,998
Nectarfoam• twin
• twin XL
• full
• queen
• king
• split king
• California king
6.5 out of 10no365 nightsforever$359–1,030
Sleep Numberfoam• twin
• twin XL
• full
• queen
• king
• split king
• California king
• FlexTop King
• California FlexTop king
not statedno100 nights15 years$699–1,999
Brooklyn Beddinghybrid• twin
• twin XL
• full
• queen
• king
• California king
• split California king
7 out of 10yes120 nights10 yearsbetween $1,099–2,399
Casperfoam• twin
• twin XL
• full
• queen
• king
• California king
medium firmyes100 nights10 years$895–1,695
Avocadohybrid• twin
• twin XL
• full
• queen
• king
• California king
7 out of 10no1 year25 years$1,399–2,599
DreamCloudhybrid• twin
• twin XL
• full
• queen
• king
• California king
• split king
6.5 out of 10no365 nightslifetime$1,973–4,546
Birchfoam• twin
• twin XL
• full
• queen
• king
• California king
medium firmyes100 nights25 years$1,811.30–3,623.80
Nolahfoam hybrid• twin
• twin XL
• full
• queen
• king
• California king
• Plush
• Luxury firm
• firm
yes120 nightslifetime$1,599–3,598
Brooklyn Bedding Plankhybrid• twin
• twin XL
• full
• queen
• king
• California king
• split California king
• short queen
• short king
• olympic queen
• RV king
• firm
• extra firm
yes120 nights10 years$924–1,732
Parachute Eco Comforthybrid• twin
• twin XL
• full
• queen
• king
• California king
firm and softno100 nights10 years$1,499–2,599

MNT chooses mattresses, sheets, pillows, and other bedding that meet the following criteria:

  • Certifications: MNT will choose products that have CertiPUR-US or other certifications. This means that the products are low in pollutants and free from heavy metals and volatile organic compounds.
  • Size: MNT chooses products that are available in various sizes.
  • Materials and fill: MNT selects products made from different materials and fills, such as memory foam and latex, to suit a range of sleep and lifestyles.
  • Budget: MNT features products to suit a wide range of budgets.
  • Firmness [only applicable to some products]: MNT selects mattresses that are available in a range of firmness options to suit most people’s sleeping styles.
  • Sleep trials: MNT chooses companies that offer a sleep trial.
  • Shipping: Where possible, MNT will include shipping information, such as where the company delivers to and whether shipping is free.
  • Warranties and return policies: MNT will include products that carry warranties and clear returns policies.
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The National Institute of Neurological Disorders and Stroke recommends sleeping on a firm surface to help prevent back pain.

However, people may interpret “firm” in different ways, and the best choice of a mattress will depend on a person’s weight and preferred sleeping position.

Learn more about firm mattresses.

An older review from 2015 investigated how mattress types affect sleep quality and pain reduction in people with or without back pain. Studies in the review grouped mattresses into the following categories:

  • soft
  • medium-firm
  • firm
  • self-adjusted

The review found that a medium-firm, self-adjusted mattress was the best option at promoting quality sleep, comfort, and spinal alignment.

A newer 2021 systematic review agrees with this, concluding that a medium-firm mattress can promote comfort, sleep quality, and spinal alignment.

Some mattress companies also sell pillows that may help alleviate back and neck pain, and people can adjust their heights to support their spine.

Learn more about the best cervical pillows here.

Also, if a person wants to keep their mattress but adjust its firmness, they might want to try a mattress topper. This may be available with memory foam, wool, or latex construction. However, latex mattresses will not be suitable for people with latex allergies.

Learn more about the best mattress toppers.

In addition, some may benefit from adjustable beds, as a change in positioning might provide better back support.

Learn more about adjustable beds.

A person should consider the following factors when shopping for a new mattress:

  • Firmness level: A 2015 study suggests that a medium-firm, self-adjusted
  • mattress may be the best option for promoting spinal alignment and improving sleep quality. However, the firmness a person is comfortable with will vary between individuals. Buyers should use sleep trials to test mattresses before committing to a purchase.
  • Temperature regulation: Some mattresses some with more cooling features than others. If a person lives in a warmer climate or tends to sleep hot, they may wish to prioritize getting a mattress that helps to keep them cool.
  • Materials: Mattresses come in various materials, including synthetic and natural foams and fabrics. Individuals who have allergies may wish to look at hypoallergenic mattresses, and others may wish to avoid synthetic foams that may release gases over time.
  • Environmental certifications: Some mattress brands make products that hold a wide range of environmental certifications that show the company has a minimal impact on the environment during manufacturing. Additionally, some certifications show that synthetic materials are safe.
  • Sleeping positions: A person should consider their preferred sleep style before buying a mattress as some are designed to suit specific positions.
  • Price: The prices of mattresses vary. A person should consider their budget and use sleep trials to test mattresses before making a purchase.

The United Kingdom’s National Health Service (NHS) recommends seeing a doctor about back pain if a person experiences any of the following:

  • back pain that does not improve with treatment
  • pain that is interfering with work, school, or sleep
  • pain from an injury that does not get better

A person should get emergency medical attention if they have weakness in the arms and legs or they lose control of their bowels or bladder.

Find out more about back pain here.

Below, we answer some of the most frequently asked questions about mattresses for back pain.

Which type of mattress is best for back pain?

Memory foam or latex mattresses may be best for back pain as they can conform to the shape of a person’s body and relieve pressure on the joints. However, foam mattresses can be too soft for people with back pain or heavier bodies and may not always align the spine properly. As such, a person may wish to try a firmer foam mattress for back pain.

What is the best mattress for back pain — firm or soft?

Research from 2015 and 2021 has shown that a medium-firm mattress may be best for back pain.

Is memory foam or spring better for back pain?

A memory foam mattress may be better for back pain as it can conform to a person’s body shape and relieve pressure points.

Spring mattresses cannot adapt to a person’s body and changing positions as accurately and may not provide adequate pressure point relief. Spring mattresses are better for keeping the spine in a neutral position.

Hybrid mattresses are best for back paint as they offer the pressure point relief of memory foam with the support of coils and springs.

Do mattress toppers cause back pain?

A 2020 study suggests that a mattress topper that is 1.2 in height may help align the spine and reduce body pressure. High rebound mattress toppers may help improve deep sleep.

How do I test a mattress if I’m buying it online?

A person buying a mattress online may consider checking that the company offers a home trial. This allows them to test the product for a few months, or sometimes even a year. If they are unsatisfied, they may return it within this time frame.

A person may also check if the mattress is soft or firm. Reading customer reviews may help them choose the right product.

Many firm mattresses are available for purchase that may suit people with back pain.

However, firmness level may also depend on a person’s body type and sleeping position.

Most mattress companies offer a trial period, during which a person can decide whether to keep or return the product. The cost of these mattresses can be high, and paying in installments is often an option.

If choosing more supportive bedding does not alleviate back pain, a person should see a doctor to discuss treatment options.