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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.

A quick look at the best firm mattresses for back pain

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.

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.

A 2015 review 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.

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

How we chose

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.

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.

Best for cooling: Layla Memory Foam Mattress

  • Price: between $749–1,249
  • Sizes: twin, twin XL, full, queen, king, California king

The foam in the Layla Memory Foam Mattress contains copper-infused gel that firms when there is increased pressure. This may help support pressure points and draw heat away from the body, making it a cooler alternative to other memory foam mattresses.

The makers claim that this provides gentle support around pressure points, which may be more suitable for side sleepers. However, a person can choose between a soft and a firm side by flipping the mattress.

Layla describes the firm side as a 7 out of 10 on its firmness scale, and says the firm side is best for back or stomach sleepers.

The mattress also features motion transfer control, which aims to prevent movement from traveling across the mattress, reducing the chances of disturbing a partner while shifting positions.

Layla states this mattress has CertiPUR-US certification, meaning its foam does not contain harmful chemicals.

It offers a 120-night sleep trial and lifetime warranty.

Positive reviews mention the affordable price and that the mattress helped reduce joint pain.

Negative reviews write that there is not enough edge support and the mattress and pillows have an unpleasant odor.

Pros

  • copper-infused memory foam may promote cooler sleep
  • more affordable than many brands
  • flippable
  • comes with two free pillows

Cons

  • some users report an unpleasant odor from the pillows
  • some reviewers write that there is not enough edge support

This mattress may be best suited to people who live in warmer climates or tend to sleep hot.

Best for a variety of firm options: The WinkBed

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

The WinkBed mattress is available in four firmness levels: Soft, Firm, Luxury Firm, and Plus.

According to the company, the Firm and Luxury firm options are suitable for side, back, and stomach sleepers. The luxury firm option offers a balance between body contouring and “pushback” support, while the firm option offers extra support without feeling hard.

The Soft option is for side sleepers, and the Plus option is designed for heavier people.

According to the company’s website, the mattress supports the back by:

  • Relieving muscle tension and pressure: A quilted top layer provides cushioning and support for the back, hips, and shoulders.
  • Aligning the lower back and hips: A supportive “lumbar layer” aims to prevent sagging and joint misalignment in the lower back and hips.
  • Providing adaptive back support: The mattress contains five sets of springs, and these are aligned to provide support for different areas of the spine.

The company offers a 120-night trial and lifetime warranty on this mattress.

Positive reviews write that this mattress is very comfortable and it has reduced lower back pain for some buyers.

More critical reviews mention that it is not comfortable enough and can cause pain in pressure points such as the hips.

Pros

  • offers two firm options
  • may limit motion transfer
  • fits different bed frames
  • long sleep trial

Cons

  • may off-gas
  • can be expensive
  • limited edge support
  • heavy to move around

This mattress may be best suited to people looking for more than one firm option in the same mattress model.

Best for heavier people: Helix Plus

  • Price: between $949–2,099
  • Sizes: twin, twin XL, full, queen, king, California king

The Helix Plus mattress is a hybrid, meaning that it combines coils with memory foam. The company has designed this mattress specifically for larger people and describes it as a 6–7 out of 10 on its firmness scale.

It is built with an extra layer of high-density foam, and reinforced coils may provide extra support for heavier people.

It also has three layers of foam that aim to support and cushion the body and prevent pressure on the joints. The mattress also features edge support.

The company uses Tencel fabric to make the mattress more breathable along with a GlacioTex Cooling Cover, which Helix claims draws heat away from the body.

The company offers a 100-night sleep trial and a 10–15 year warranty.

Positive reviews mention that this mattress offers very good support for heavier people and it keeps people with night sweats cool.

Negative reviews write that it does not provide enough back support and it caused hip pain in some users.

Pros

  • supports larger people
  • may provide a cooler sleep
  • may provide good pressure point relief

Cons

  • may off-gas
  • not a responsive mattress
  • can be expensive
  • no edge support

This mattress is best suited to people with higher body weights.

Best for a very firm mattress: Saatva Classic Mattress

  • Price: between $935–2,450
  • Sizes: twin, twin XL, full, queen, king, split king, California king, split California king

Saatva states that this mattress combines the durability of a coil mattress and the comfort and support of a memory foam mattress.

A person can choose between two firm options: Luxury Firm and Firm. Saatva places its Luxury Firm mattress at a 5–7 out of 10 on its firmness scale. Its Firm mattress is an 8 out of 10.

Saatva writes that the Luxury Firm mattress is suitable for all types of sleepers and can be a good choice for couples looking for a compromise on firmness.

The Firm option is designed for people who know they like a very firm mattress and is suitable for back and stomach sleepers and heavier people.

However, Saatva mattresses come with the following set features:

  • A luxury pillowtop: This reportedly has antimicrobial properties.
  • Edge support: This foam casing around the edges of the mattress helps prevent sagging.
  • Durable steel coil support: The base of the mattress has maximum-strength steel coils that also aim to prevent sagging.
  • Individually wrapped coils: These may contour the mattress to improve comfort and reduce motion transfer.
  • Spinal zone technology: There is a wire layer that aims to provide additional support in the center. Saatva writes that the memory foam layer may reduce stress and tension in the lower back.
  • Chiropractic approval: Saatva claims that the mattress holds the Congress of Chiropractic State Associations’ approval.

This mattress may be best suited to people looking for a very firm mattress.

Saatva offers a 365-night sleep trial and a lifetime warranty.

Positive reviews write that it balances a person’s temperature well during sleep and that customer service is very helpful.

Negative reviews mention it is very heavy to move and unsuitable for people with back pain in that respect.

Pros

  • two firm options
  • uses a range of organic materials
  • CertiPUR-US Certified
  • long sleep trial

Cons

  • expensive
  • limited motion control
  • some users found it very heavy to move

Best for people with allergies: Purple Original

  • Price: between $799–1,998
  • Sizes: twin, twin XL, full, queen, king, California king, split king

The Purple Original mattress aims to adapt to each person’s body shape and sleep position to ease pressure and support the back. The company describes it as a medium firm mattress.

Some of its main features include:

  • A soft-flex cover: This breathable cover aims to promote airflow, keeping the body cool during sleep.
  • A 2-inch (in) support layer: This GelFlex Grid can adapt beneath pressure points while providing support to the rest of the body.
  • Dual-layered comfort foam: A layer of soft, flexible memory foam rests above a firmer, more supportive base layer.

Purple writes this mattress is nontoxic, hypoallergenic, and Certified Clean Air Gold. This means the mattress emits very minimal amounts of volatile organic compounds (VOCs) into the air.

The company offers a 100-night sleep trial and a 10-year warranty.

Positive reviews write that it is comfortable and helps reduce back pain and muscle tension.

Negative reviews mention it made back pain worse and was not supportive enough for some.

Pros

  • supports pressure points
  • may help to keep sleepers cool
  • nontoxic and hypoallergenic
  • emits minimal VOCs

Cons

  • some people find the GelFlex Grid too soft
  • shorter warranty than other brands

This mattress may be suitable for people with allergies due to its hypoallergenic and nontoxic materials.

Best for smaller budgets: Nectar Memory Foam Mattress

  • Price: between $359–1,030
  • Sizes: twin, twin XL, full, queen, king, California king, split king

The Nectar mattress contains memory foam layers that the company claims help relieve shoulder, hip, and leg pressure points and improve spinal alignment. The company puts this mattress at a 6.5 out of 10 on its firmness scale.

It features a breathable cooling cover that wicks away excess body heat to keep people cool while they sleep. The layers include gel-infused memory foam to relieve pressure, a responsive, CertiPUR-US Certified foam layer to offer support and airflow, and a base foam layer for stability.

Nectar claims this mattress is very effective at reducing motion transfer, and, according to a company survey, 90% of users found this mattress to reduce overall aches, stiffness, and discomfort.

Nectar offers a 365-night sleep trial and a forever warranty.

Positive reviews mention that it helps people with back, hip, and knee pain.

More critical reviews write that it is too hot to sleep on and some found it too firm.

Pros

  • more affordable than many brands
  • carbon neutral construction
  • 365-night risk-free trial

Cons

  • not very responsive
  • may have an unpleasant smell

With the smallest mattress costing under $400, this mattress model may be suitable for people working with a smaller budget.

Best for customizable firmness: Sleep Number 360 c2 Smart Bed

  • Price: between $699–1,899
  • Sizes: twin, twin XL, full, queen, king, split king, FlexTop king, California king, FlexTop California king

This mattress from Sleep Number is customizable on both sides with a remote control.

The company claims that it can automatically adjust to a person’s movement.

Layers include a 2-in comfort layer. The company claims it stretches and conforms to a person’s position while they sleep to provide maximum support.

The mattress is 8 inches in height, and Sleep Number claims to use CertiPUR-US-certified foam.

A person can use the accompanying SleepIQ app to gain insight into their sleep. The app provides individual sleep scores.

Sleep Number offers a 100-night trial and a 15-year warranty.

Customers appreciate being able to adjust the mattress according to how they feel each night.

More critical reviews write that it was not comfortable and caused back pain. Others found that it exacerbated shoulder pain and adjusting the settings did not improve the comfort.

Pros

  • adjustable on both sides
  • comes with a sleep insight app
  • uses CertiPUR-US certified foam

Cons

  • some customers report it worsened pain
  • it is a relatively thin mattress compared to other brands

Best for athletes: Brooklyn Bedding Spartan

  • Price: between $1,099–2,399
  • Sizes: twin, twin XL, full, queen, king, California king, split California king

Brooklyn Bedding designed this mattress to help people recover after exercise.

It is a hybrid mattress featuring foam and coil layers. The coils offer zoned support and focus on pressure point relief and lumbar support.

Other layers include a 1.5 in CopperFlex foam, which has antimicrobial and cooling properties, and 2 inches of premium memory foam.

A person can also get additional pressure point relief from the 1 in gel memory foam layer.

It claims to help aid sleep recovery with Far Infrared Rays (FIR) technology, which reportedly restores energy and regulates temperature to improve sleep.

This technology is in the cover fabric. The company writes that it is activated by body heat, and the fabric produces energy waves that can improve blood flow, speed up muscle recovery, and lead to better quality sleep.

The company offers a 120-night sleep trial and a 10-year warranty.

Positive reviews write that this mattress can reduce back and joint pain.

Negative reviews mention that the firm option is softer than expected and it did not offer enough back support.

Pros

  • uses FIR technology to aid muscle recovery
  • zoned support coils
  • long sleep trial

Cons

  • some people found the mattress too soft
  • others report it did not provide enough back support

This mattress may be best suited to those who work out regularly as it claims to help aid muscle recovery.

Best for zoned support: Casper Original Mattress

  • Price: between $895–1,695
  • Sizes: twin, twin XL, full, queen, king, California king

Casper introduced the “bed in a box” mattress to the market. Its Original mattress features three zoned support areas, which aim to align the spine and relieve pressure.

These zones are softer under the shoulders and legs, and firmer beneath the hips, waist, and lower back.

There is also a cooling system called AirScape, which is a foam layer that features thousands of perforations to promote airflow through the mattress. These perforations also allow body heat to escape the mattress.

The company offers a 100-night sleep trial and a 10-year warranty.

Positive reviews write that this mattress helped to improve people’s sleep and it offers a good balance between comfort and support. Others write that it helped to reduce back pain.

Negative reviews mention increased neck pain and a lack of edge support. Some also wrote that they slept hot due to the foam.

Pros

  • easy to set up and move around
  • little motion transfer
  • zone support relieves pressure points
  • keeps the body cool during sleep

Cons

  • limited edge support
  • some reports of sagging in the middle
  • some users reported they slept hot on this mattress

This mattress is best suited to those who want specific supportive areas for their lower back.

Best for an environmentally friendly mattress brand: Avocado Vegan Mattress

  • Price: between $1,399–2,599
  • Sizes: twin, twin XL, full, queen, king, California king

This is a hybrid mattress that holds a wide range of environmental certifications. These include:

Avocado writes that it also does not contain toxic fire retardants, polyester, or foams made from polyurethane.

The mattress combines a 3-inch organic latex layer with coils and an organic cotton cover. The company writes that it has up to 1,414 pocketed support coils in five zones to provide targeted body support.

It describes its Standard Vegan Mattress as medium firm or a 7 out of 10 on its firmness scale. The company recommends this mattress for back and stomach sleepers, as well as larger or tall side sleepers.

The company offers a 1-year sleep trial and a 25-year warranty.

Positive reviews write that this mattress is very comfortable and suitable for side sleepers, and buyers appreciate that the brand aligns with their values in terms of environmental responsibility.

Negative reviews mention problems with delivery and customer service, and some people did not find the mattress firm enough.

Pros

  • long sleep trial
  • holds a wide range of environmental certifications
  • eco-friendly and vegan construction
  • uses natural materials
  • offers zoned support

Cons

  • delivery can take up to two months
  • more expensive than most brands
  • latex provides less motion transfer control
  • unsuitable for people with latex allergies

This mattress is best suited to people looking for an environmentally friendly mattress brand.

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$949–2,099
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$935–2,450
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$699–1,899
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

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 a memory foam, wool, or latex construction. However, latex mattresses will not be suitable for people with a latex allergy.

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-inflated 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 prioritise 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.

Below, we answer some of the top 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 keep the spine properly aligned. 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 keep the spine in a neutral position. Spring mattresses cannot adapt to a person’s body and changing positions as accurately, and may not provide adequate pressure point relief.

There are a lot of firm mattresses 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.