The 10 Best Mattresses for Back Pain, According to the Sleep Doctor

Your choice of mattress matters more than you think.

People with acute and chronic back pain often experience worse quality sleep than those who report being pain free. That means if you suffer from back pain, then it’s a safe bet you likely also struggle with getting a good night’s sleep. Back pain robs you of your time to rest up and recharge, and it too often makes what should be the pleasant thought of turning in for the night a stressful one.

Often, your mattress is not addressing your sleep needs and supporting your spine’s natural curve the way it needs. In this case, it’s best to ditch the old bed and start from scratch. A new mattress can help you achieve better rest, and they come in many varieties. There are plenty of other variables aside from mattress type to consider before investing in one, such as your personal sleeping preferences and your particular kind of back pain. In fact, it’s easy to feel a little intimidated by all the choices you have to make when shopping for a mattress.

To help you on your mattress-buying journey, Dr. Michael Breus, Ph.D, the Sleep Doctor, partnered with the expert review team at Mattress Advisor to put together a list of the 10 best mattresses for people suffering from back pain.

Each product we feature has been independently selected and reviewed by our editorial team. If you make a purchase using the links included, we may earn commission.

Best Overall:

• Expert Pick: Saatva Classic
• Best Total Score: Casper
• Best Affordable Mattress: Nectar
• Best Memory Foam Mattress: Puffy
• Best for Side Sleepers: Helix Midnight Luxe

Honorable Mentions:

• Best for Hot Sleepers: Bear Hybrid
• Best Adjustable Bed: Saatva Solaire
• Best for Pressure Relief: Brooklyn Signature
• Best Firm Mattress: Cocoon by Sealy
• Best for Hip Pain: Nolah Original 10”

The team at Mattress Advisor performed hours of mattress testing at their lab in Raleigh, North Carolina to see which mattresses performed best in many different categories including: firmness, pressure relief, and spinal alignment — all vital for sleepers seeking relief from back pain. All mattresses tested by Mattress Advisor are rated on a scale of 1-10, with 10 being the perfect score, based on 14 different pieces of criteria related to the mattress materials, performance, and brand overall.

Ready to start shopping? Here are some of the most important factors to consider when selecting the right mattress for you.

The Right Level of Support for Back Pain Sufferers

For starters, no matter what type of back pain or soreness you suffer from, a mattress should keep your spine aligned throughout the night. Good posture is important even when you sleep, believe it or not, so the more support a mattress provides the better. But buyer beware: Just because a mattress is firm doesn’t mean it provides adequate support across your entire body. Likewise, while a softer mattress may feel nice and comfortable when you try it out in the store, it’s best to steer away from abundantly soft mattresses altogether due to their lack of support.

While every sleeper will need to evaluate their specific needs, the best solution might be to choose a medium-firm mattress. A study designed to explore the relationship between sleep surfaces and chronic back pain published in The Lancet medical journal found that 82 percent of patients who slept on medium-firm (vs. firm) mattresses saw improvements in their back pain.

The reality is, if you’re experiencing any mid or upper back pain, you need a mattress that can properly support your shoulders, while still being comfortable enough to sleep on.

“Support and comfort are two different aspects which a mattress can address,” explains Dr. Breus. “Support is the appropriate use of underlying materials that will allow for spinal alignment. Why do you need your spine aligned? When the spine is properly supported and aligned when the body sleeps, the muscles will relax and recover (this is known as stages 3 and 4 of deep sleep where the physical restoration occurs). Without this alignment, the muscles will continue to stay tense, in order to try and force the spine into alignment. Over a 6-8 hour period of time, these muscles will fatigue from the constant tension, not recover. In addition if pain is present, it will increase over time, and the brain does not go into deep sleep when a pain signal is coming in. And the tension itself can keep people in a lighter stage of sleep due to the body’s need to relax to recover. Finally, alignment allows for proper rehydration of the vertebral disks. A healthy spine is one where all the discs are fully hydrated, otherwise we see back pain.”  

Liken it to a sandwich. There’s a difference between comfort and support — comfort is the turkey, support is the lettuce, tomato, mayo, etc. Support is this notion of alignment and support that allows for a flattening of the spinal frame. Comfort is what allows you to adhere to that position. If it’s too firm, you’re restless, trying to get comfortable. If it’s too soft, you’ll have back pain.

Your Sleeping Position

While you’re on the hunt for the right mattress, there are steps you can take right now to help you with your back pain. For example, changing how you lie in bed – be it on your back, side, stomach, or a mix of all three – can make a big difference in how much you irritate existing back pain or create new pains altogether.

As Dr. Breus explains in his article about sleep positions, there is no “one size fits all” approach when it comes to picking the best sleep position. Each position has its own pros and cons, which can vary greatly from person to person. That said, the side sleeping position can reduce back pain more than other positions, provided you have a supportive mattress because it doesn’t put direct pressure on your spine.   If you’re looking to reduce back pain without completely changing your sleep preferences, there are still small tweaks you can make, and Cleveland Clinic and Mayo Clinic both offer tips on how to improve your posture regardless of how you sleep.

However it should be noted that if you have sleep apnea, and it is not being treated you will want to stay off your back, until you can get appropriate treatment.

Mattress Firmness

We can’t talk about sleeping and its relationship to back problems without discussing mattress firmness in greater detail. The two factors are closely link; whether you’re a back sleeper, a side sleeper, a stomach sleeper, or someone who mixes it up from one night to the next, how you sleep carries a lot of sway when it comes to figuring out the level of firmness you should look for in a mattress.

“First thing you need to establish is the right support system for you and your back,” says Dr. Breus. “Comfort is the next issue to address. Almost no mattress has you sleeping on the basic support layer ( no matter what it is made of), so the additional layers on the bed are used for your body’s comfort. These layers are usually made of cushioning materials like memory foam or latex to give that extra “bounce” and cradling sensation. The goal is to have a surface that conforms to the unique shape of your body, while keeping your spine aligned, based on your sleeping position.”

Here’s a quick breakdown of the Sleep Doctor’s recommendations for how firm your mattress should be based on your sleeping position.

Back Sleeping

It’s worth mentioning that sleeping on your back is your best bet for a pain-free day. When you sleep on your back, your head, neck, and spine rest in a neutral position. And, according to Cleveland Clinic, your weight gets evenly distributed across the widest surface of your body, which helps eliminate pressure points.

The Sleep Doctor recommends that back sleepers should aim to sleep for 7-9 hours on a firm to medium-firm mattress, like the Casper. Mattresses that are too soft won’t allow your body to align in a neutral position. Conversely, mattresses that are too hard won’t have any give for the natural curvature of your lower back.

Side Sleeping

Sleeping on your side has some noteworthy health benefits. It helps with digestion and can reduce back and neck pain. But if you’re sleeping on the wrong mattress, you may find yourself waking up with shoulder pain or aching in your hips. Side sleepers need a mattress that contours with the widest areas of their body, while delivering pressure point relief. A good example is the Puffy. A mattress with this range of firmness will alleviate pressure points in the shoulders and hips while also keeping those areas aligned with the rest of your body.

Stomach Sleeping

Basically, sleeping on your stomach isn’t recommended, so avoid it if you can. If you do sleep on your stomach and it’s the only way you can doze off, you probably have a hard time keeping your spine in a neutral position throughout the night, which is key for reducing or preventing back and neck pain. You’re also putting unhealthy pressure on your muscles and joints.

The wrong combination of pillow and mattress puts your neck in an unnatural position when sleeping on your stomach. Short of trying a new sleeping position altogether, the Sleep Doctor recommends pairing a thin pillow with a firm mattress like the Cocoon by Sealy. The thin pillow helps keep your neck lined up with the rest of your body, while a firm mattress provides the needed support for your lower back that you won’t get from a too-soft mattress.

Combination Sleepers

Maybe you’re the sleeper that does it all. You might fall asleep on your stomach, flop over on your back, and wake up in the morning on your side. If you do find yourself in the combination sleeper camp, then a versatile mattress is a must. You need firm support in the center of the mattress for times when you’re sleeping on your stomach, but you also need a little more give for your hips and shoulders for times when you sleep on your side.

The Sleep Doctor recommends a mattress that helps keep your spine aligned as much as possible regardless of sleep position. A mattress with one consistent level of firmness likely won’t do the trick, but the right memory foam mattress, like the Nectar, can lend the best overall support and help reduce pressure points as you switch things up throughout the night.

Mattress Type

Aside from figuring out how firm your mattress should be based on your sleeping position, you’ll also need to think about the construction of a mattress and the materials used to make it. You don’t need reminding that there is no shortage of mattress types on the market today. But even the same mattress type (say, two memory foam mattresses) will vary between brands. Some types and brands will be a better fit for you than others, all depending on your body shape, weight, and sleeping preferences. This means that, while you should definitely consider the same factors used by the Sleep Doctor when making his list to guide you, there are factors unique to you that you’ll need to think about as well.

Memory Foam Mattresses

An all-foam memory mattress doesn’t have coils, so it supports areas of the body where there could otherwise be pressure points. Since side sleepers tend to need more support for their shoulders and hips, which are concentrated impact areas, they should generally find a memory foam mattress more helpful in preventing or reducing back pain. One drawback, however, is that a memory foam mattress tends to trap heat.

Hybrid Mattresses

Hybrid mattresses are designed to offer the best of two mattress types: the additional airflow and support of a coil mattress with the contouring nature and pressure relief of a foam mattress.

While not always the case, hybrid mattresses tend to cost more than memory foam options since they do have coils built into them. The tradeoff is that a hybrid mattress combines the technology and structure of an innerspring mattress with the comfort of foam products to bring sleepers the best of both worlds. A good hybrid mattress also offers extra support for back sleepers and stomach sleepers.

Innerspring Mattresses

The innerspring mattress has come a long way since the 1930s. Once the most prominent mattress around, the innerspring design still holds its own against relative mattress newcomers.

Innerspring mattresses are composed of metal coils, and more modern designs boast hybrid features such as one or more layers of foam on top of individually pocketed springs. These hybrid innerspring mattresses can often provide the contouring and pressure point reduction of foam options.

Latex Mattresses

The latex material provides moderate contouring, so it cushions your body without letting your neck, back, shoulders, or hips sink too far down and out of alignment. Like the innerspring mattress, the latex mattress doesn’t trap a ton of heat because it allows for strong airflow underneath you. Latex is also naturally resistant to the build-up of bacteria and other microbes.

Most rubber latex mattresses on the market today use all-natural latex from trees, though you will find some models that use synthetic or blended latex.

The 10 Best Mattresses for Back Pain, According to Experts

If everything you just read feels like a lot of information, that’s because it is – but don’t feel overwhelmed. You essentially just took a crash course in the relationship between back pain and sleep quality, which means you’ve equipped yourself with the knowledge necessary to make the most informed mattress purchase possible. And even then, the Sleep Doctor has done the heavy mattress lifting for you. Now you’re ready to take a closer look at his list of 10 best mattresses for back pain.

1. Expert Pick: Saatva Classic

The experts at Mattress Advisor rate the Saatva Classic their top pick for people struggling with lower and upper back pain.

There were quite a few contenders for top spot on this list, but ultimately it’s what Saatva calls the Lumbar Zone technology that earns their Classic model the distinction. Active wire support reinforces the middle of the Saatva Classic mattress to prevent your lower back from sinking. This promotes great neutral spinal alignment.

A Saatva Classic mattress contains 884 individually wrapped coils designed to contour to your body while minimizing motion transfer. The dual-coil system not only makes the mattress very responsive, but it also helps promote healthy airflow.

The Saatva Classic is available in three firmness levels: plush soft, luxury firm, and firm. For dealing with lower back pain, the Sleep Doctor advises you take a look at the luxury firm or firm models, though the plush-soft model is a good choice for side sleepers looking to relieve shoulder and hip pressure. Simply put, this mattress was designed to help you reduce back and joint pain in a way other mattresses like it aren’t. But if you’re not convinced, fear not; you can always try the Saatva Classic with a 120-day trial period.

• Mattress Type: Luxury Hybrid
• Customer Rating: 8 out of 5
• Firmness: Plush, Luxury Firm, and Firm
• Warranty: 15-Year Limited

Saatva Classic Mattress, $1,299 for a Queen, saatva.com (Click to see exclusive offer)

2. Best Total Score: Casper

Made out of premium foam that cushions your body and relieves pressure in areas like your hips, shoulders, and core, the Casper Original earned an impressive 9.1 out of 10 from Mattress Advisor. This mattress is also the perfect go-to for every type of sleeper (back, side, stomach, or combo) who want both support and cooling, with its perforated breathable surface that moves hot air and body heat away. It’s also very responsive, adjusting quickly to your body. Even if you don’t suffer from back pain, this may be the best mattress for combination sleepers on the list.

The mattress features Casper’s Zoned Support technology that helps the mattress contour to your body, and it’s this unique design that the Sleep Doctor says is especially helpful for people with upper back pain. The Zoned Support layer is made up of three ergonomic zones to keep your spine aligned during the night. The mattress even has a durable base that prevents sinking.

• Mattress Type: Memory Foam
• Customer Rating: 5 out of 5
• Firmness: Medium-Firm
• Trial: 100-Night Sleep Trial
• Warranty: 10-Year Limited

Casper Original Mattress, $1,095 for a Queen, casper.com (Click to see exclusive offer)

3. Best Affordable Mattress: Nectar

For great back support that doesn’t break the bank, the Sleep Doctor singles out the Nectar as proof you don’t have to sacrifice quality for affordability. Its adaptive memory foam layers (incredibly, there are five of them) are designed to relieve common pressure points beneath your shoulders, hips, and legs while minimizing heat capture and motion transfer. So, no matter your preferred sleeping position, the Nectar mattress has your back. It even provides good support for edge-of-the-bed sleepers to help prevent them from rolling off.

You might think a budget-friendly mattress might have a catch, but Nectar is more than happy to let you put its product to the ultimate test with an amazing 365-trial period and a lifetime warranty. Additionally, reviews for the Nectar mattress are overwhelmingly positive – and fewer than 3% of customers end up returning their mattress, despite the year-long trial period.

• Mattress Type: Memory Foam
• Customer Rating: 8 out of 5
• Firmness: Medium-Firm
• Trial: 365-Night Sleep Trial
• Warranty: Lifetime Warranty

Nectar Mattress, $949 for a Queen, nectarsleep.com (Click to see exclusive offer)

4. Best Memory Foam Mattress: Puffy

Memory foam mattresses tend to have more sinkage and less responsiveness than other mattresses, but the experts designed Puffy with every intention to break the mold – and they succeeded.

It features three foam layers that help to keep your spine aligned, eliminate pressure points, and provide a good night’s sleep without a lot of tossing and turning. First, the foam layer makes the mattress resistant to contractions and expansions caused by temperature fluctuations. Then, the gel-infused foam layer draws heat away from your body, so you won’t burn up during the night. Finally, the firm core support layers adapt to your movements, keeping you comfortable as you shift during the night.

While it’s a notably great mattress for side sleepers looking for pain relief, the Puffy mattress is an absolute great choice for all kinds of sleepers. Not only does it help side sleepers keep their spines straight and relieve pressure from their hips and shoulders, it gives stomach sleepers and back sleepers the firmness needed to maintain spinal alignment.

There’s also one very nice perk about a Puffy mattress that’ll help you sleep a little more peacefully: a lifetime warranty. As long as you own the mattress, your purchase is completely covered.

• Mattress Type: Memory Foam
• Customer Rating: 6 out of 5
• Firmness: Medium-Firm
• Trial: 101-Night Sleep Trial
• Warranty: Lifetime

Puffy Mattress, $1,150 for a Queen, puffy.com (Click to see exclusive offer)

5. Best for Side Sleepers: Helix Midnight Luxe

Side sleepers who opt for the Helix Midnight Luxe will not be sorry about their purchase. The hybrid mattress has zoned-lumbar support thanks to its pocket coil core layer, which ensures consistent spinal alignment and even weight distribution. And not only does the mattress provide softer support for your shoulders in its upper region, it delivers firmer support around your hips to stop your lower back from sinking too far into the mattress.

Another layer in the mattress that provides cushioning and helps eliminate pressure points is its gel-infused memory foam layer. Meanwhile, a dense layer of foam that serves as the bottom layer makes the mattress highly durable, so it’ll provide great support for years to come. As far as the Sleep Doctor is concerned, the Helix Luxe Midnight checks the boxes on every design must-have a side sleeper needs for back pain relief.

Outside of the pain relief it can provide, the Helix Luxe Midnight is also a great mattress for hot sleepers. It uses an innovative built-in cooling cover to absorb heat and regulate your body temperature. And if you sleep with a partner, you can both move freely without disturbing one another, thanks to the Helix Luxe Midnight’s ability to minimize motion transfer.

• Mattress Type: Hybrid
• Customer Rating: 5 out of 5
• Firmness: Medium
• Trial: 100-Night Sleep Trial
• Warranty: 15-Year Limited Warranty

Helix Midnight Luxe Mattress, $1,599 for a Queen, helixsleep.com (Click to see exclusive offer)

6. Best for Hot Sleepers: Bear Hybrid

Feeling overheated while you sleep can be just as disruptive as back pain, so it’s important that you find a mattress that solves both problems if you’re a hot sleeper. The Bear Hybrid is a hybrid foam mattress with encased coil springs. It features cooling gel foam and a quilted cover infused with FDA-approved Celliant fiber technology that moves body heat away from you as you sleep.

As far as back pain relief, the Bear Hybrid goes above and beyond what you would expect from a mattress designed mainly with hot sleepers in mind. The Sleep Doctor was impressed by the Bear Hybrid’s ability to keep the spine straight throughout the night. It preserves spinal alignment and ensures a healthy posture, so sleepers wake up feeling more refreshed and less achy. The Bear Hybrid also includes proprietary foam that’s designed to relieve pressure by contouring to your body. ll in all, this mattress is a great choice if you live an active lifestyle – and if you’re a hot sleeper with back pain.

• Mattress Type: Memory Foam
• Customer Rating: 7 out of 5
• Firmness: Medium-Firm
• Trial: 100-Night Sleep Trial
• Warranty: 20-Year Limited Warranty

Bear Hybrid Mattress, $1,390 for a Queen, bearmattress.com (Click to see exclusive offer)

7. Best Adjustable Bed: Saatva Solaire

A mattress that can accommodate any sleeping position under the moon, the Saatva Solaire unapologetically jumps over its peers and straight to the top of the Sleep Doctor’s list as his recommendation for best adjustable mattress.

What makes the Saatva Solaire so great for back relief is its supportive latex design that relieves pressure for your back. In fact, the design of the Saatva Solaire is so beneficial to those suffering from back pain, it’s even been approved by the Congress of Chiropractic State Associations.

And with the Saatva Solaire providing the support your back needs, all that’s left for you to do is to choose one of its 50 different firmness settings on your remote and say goodnight. Each side of the mattress comes with its own remote, by the way, so you and your partner can each tailor your firmness based on your own unique back relief needs.

If you’re a back sleeper or stomach sleeper, the Sleep Doctor recommends setting the Saatva Solaire to a higher firmness setting, which will help ensure consistent spine alignment and proper support throughout the night. Or, if you’re a side sleeper, the Sleep Doctor recommends a softer firmness level for greater pressure relief and cradling of your shoulders and hips.

• Mattress Type: Adjustable Airbed
• Customer Rating: 9 out of 5
• Firmness: 50 custom firmness levels
• Trial: 120-Night Sleep Trial
• Warranty: 25-Year Limited Warranty

Saatva Solaire Mattress, $2,795 for a Queen, saatva.com (Click to see exclusive offer)

8. Best for Pressure Relief: Brooklyn Signature

The hybrid Brooklyn Signature mattress was built – and then reinforced – for incredible support. And though it is available in three levels of firmness – soft, medium, and firm – the Sleep Doctor singled out the firm option as the best for anyone who is seeking pressure point relief. However, this mattress has so many layers of support, people with even aches from pressure points like the hips and shoulders should still find relief with the medium firm option.

The pocketed coils of the Brooklyn Signature provide incredible lumbar support, and its foam layers contour to your body and promote a healthy posture. Beneath a quilted top layer designed to resist body impressions, a 2-inch layer of specially blended foam holds the contouring properties of memory foam and the responsiveness of latex. But the support doesn’t stop there; incredibly, there is another 2-inch layer of highly firm proprietary foam that provides even deeper compression and support. This layer sits on top of a 6-inch base of up to 961 individually encased coils which are reinforced by a high-density foam.

That’s impressive, and it’s this uniquely layered design that makes the Brooklyn Signature a firm choice for pressure point and pain relief.

• Mattress Type: Hybrid
• Customer Rating: 7 out of 5
• Firmness: Plus, Medium, Firm
• Trial: 120-Night Sleep Trial
• Warranty: 10-Year Limited Warranty

Brooklyn Signature Mattress, $999 for a Queen, brooklynbedding.com (Click to see exclusive offer)

9. Best Firm Mattress: Cocoon by Sealy

This foam mattress actually comes in two firmness levels – medium soft and extra firm – and while both have their benefits depending on who will be sleeping on them, it’s the extra firm Cocoon mattress that the Sleep Doctor singled out as his top firm mattress pick for back pain sufferers.

The extra firm version of the Cocoon works best for back and stomach sleepers. There are three premium foam layers in the mattress, each one engineered from heavy, robust foam for increased durability and resiliency. The foam does a great job of adapting to your body size, shape, and sleep position while staying responsive enough to adjust with your body if you tend to move around during the night.

The Cocoon also keeps the body evenly supported and your spine aligned, which is perfect for side sleepers. Additionally, it does a surprisingly good job of keeping you cool at night, and it offers great edge support you wouldn’t expect to find in a foam mattress.

• Mattress Type: Memory Foam
• Customer Rating: 6 out of 5
• Firmness: Medium Soft and Extra Firm
• Trial: 100-Night Sleep Trial
• Warranty: 10-Year Limited Warranty

Cocoon by Sealy Mattress, $930 for a Queen, cocoonbysealy.com (Click to see exclusive offer)

10. Best for Hip Pain: Nolah Original 10″

What makes the Nolah Original 10” mattress the top pick for hip pain in the Sleep Doctor’s book is its patent-pending memory foam called AirFoam. This foam doesn’t trap heat like other foam materials, and it has the buoyancy and responsiveness of latex. And this special foam layer is one of three foam layers in the mattress, all of which work to reduce pain on pressure points in the hips and shoulders..

Nolah tested the design of this mattress rigorously and found that it relieves pressure in the hips and back 4x times better than traditional memory foam mattresses. The mattress was also found to be 300% more durable than high-end memory foam mattresses, thanks in part to its 7” high-density base foam.

However, Nolah didn’t just rely on its proprietary foam for pressure relief and support. The company’s Original 10” mattress contains shock-absorbing air pockets that minimize pressure points, especially important for keeping your neck aligned and preventing strain. In conjunction with the AirFoam, this feature makes the mattress a great investment for side sleepers and anyone dealing with back or joint pain.

• Mattress Type: Memory Foam
• Customer Rating: 8 out of 5
• Firmness: Medium-Firm
• Trial: 120-Night Sleep Trial
• Warranty: 15-Year Limited Warranty

Nolah Original 10″ Mattress, $1,019 for a Queen, nolahmattress.com

Some Parting Words Regarding Back Pain

You don’t have to let the stress of shopping for a mattress keep you up at night – and you shouldn’t have to deal with pain when you wake up in the morning. Use the Sleep Doctor’s list to find the right mattress that will keep your back pain in check, so you can take back control of your sleep.

Sources for this Article

Breus, Michael. 2019. “Low Back Pain and Sleep.” The Sleep Doctor (blog), December 14, 2019. https://thesleepdoctor.com/2019/12/14/low-back-pain-sleep/?cn-reloaded=1

Cleveland Clinic. 2019. “Is Your Sleep Position Causing You Back Pain?” Health Essentials (blog), August 29, 2019. https://health.clevelandclinic.org/sleep-position-causing-back-pain/

Mayo Clinic, 2020. “Slide show: Sleeping positions that reduce back pain” https://www.mayoclinic.org/diseases-conditions/back-pain/multimedia/sleeping-positions/sls-20076452?s=2

Casper Editorial Team, 2020. “How To Sleep With Back Pain: 5 Tips for Relief.” Casper (blog), March 4, 2020. https://casper.com/blog/how-to-sleep-with-back-pain/

The Lancet, 2003. “Effect of firmness of mattress on chronic non-specific low-back pain.” The Lancet (Vol. 362, Issue 93396), November 15, 2003 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)14792-7/fulltext#secd8814777e1475

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