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 Contrary to popular belief, your aching back doesn’t need a firm-as-a-plank mattress. In fact, there is no specific mattress that’s best for back pain. Instead, people with back pain should look for mattresses that feel medium-firm—however you define that—because those beds have the best chance of reducing both soreness and stiffness. For this guide, we dove into our latest mattress picks,
all of which we selected after months of research and testing, and chose six in a range of prices and features that we think are likely to hit the sweet spot for most back-pain sufferers. For more suggestions, check out our Notable contenders section. You can also read about other medium-firm picks in our guides to the
best foam mattresses, the best hybrid mattresses, the best innerspring mattresses, and the best
cheap mattresses. Saatva ClassicA plush innerspring with bounceThe Saatva, which pairs a classic innerspring bounce with a cushy but understated Euro top, may appeal to those who want to nestle in without feeling engulfed. But it doesn’t offer the best motion isolation. Buying Options*At the time of publishing, the price was $1,200. Back-pain sufferers who prefer a bed with some cushiness but no extra fluff are likely to appreciate the Saatva Classic. The Luxury Firm model is a plush, medium-firm mattress with just a bit of cuddle. Pocketed coils, quilted polyfoam, and a touch of memory foam conform to your curves and support your spine. The support coils at the base aren’t pocketed, though, which means motion isolation is limited; as a result, this mattress is perhaps best for people who have the whole bed to themselves. (If your back pain makes climbing into bed difficult, opt for the 11½-inch-thick version over the 14½-inch-thick one.) To avoid body impressions, rotate this mattress at least every six months, especially if you weigh more than 200 pounds. Saatva offers a 365-day trial period, during which you can return the Classic for a full refund minus a $100 transportation fee. Our pickThe Leesa Sapira Hybrid might appeal to back-pain sufferers who prefer a loose, pressure-relieving cuddle over an all-out, body-conforming hug. Dense (4 pounds per cubic foot) memory foam and more than 1,000 individually pocketed coils conform to your curves to help support your achy back and relieve pressure points. It should hold up over the long term for people of most weights, including those who weigh more than 200 pounds. Since the Leesa Sapira Hybrid is neither too hard nor too soft, the mattress is likely to support just about any sleeping position. And because it’s neither overly bouncy nor too “sticky,” it should satisfy backache sufferers who want a memory-foam cradle with enough resilience to make shifting positions easy. Use the store locator to find partner retailers near you so that you can try the Leesa Sapira Hybrid before you buy it. Leesa allows for a 100-night trial, and returns give you a full refund. Our pickZenhavenA durable foam and latex mattressThe all-latex Zenhaven is $1,000 more than similar online options, but it should prove more durable and breathable (and thus feel cooler) than many foam mattresses. Good latex mattresses are expensive, but this one provides solid value. Buying Options*At the time of publishing, the price was $2,200. If durability is your top priority, the all-latex Zenhaven from Saatva is a logical choice, including for people who weigh more than 200 pounds. Latex, a foam engineered from the milky sap of a rubber tree, won’t break down as easily as memory foam or polyurethane foam; it’s also intrinsically springy, which is helpful for back-pain sufferers who find it hard to move around on pillowy or sinky surfaces. The Zenhaven is flippable, too, allowing you to choose between two firmness options: The Gentle Firm side, designed for back- and stomach-sleepers, is almost firm, while the Luxury Plush side is a supple medium-firm. But it’s heavy, so you need either a platform frame or a box spring. You can try the Zenhaven for 365 nights and return it if you don’t like it (you pay a $100 fee). Our pick
Novaform ComfortGrandeBest foam mattress under $1,000This Costco favorite is made from layers of foam that are as dense (and probably as durable) as the foam in mattresses that cost twice as much. Testers loved its cuddly yet supportive feel, though some found it too firm. Buying Options*At the time of publishing, the price was $580. If you’re looking for a budget-friendly memory-foam mattress, the Novaform ComfortGrande may be worth a try. It doesn’t feel quite as sturdy as our higher-end foam pick, the Tempur-Adapt (Medium Hybrid), but we found it surprisingly supportive for the price. It has a cuddly memory-foam sink, but that sink is not as slow or conforming as what you can find on the Tempur-Adapt. With a memory-foam density between 3 and 3.5 pounds per cubic foot (the company wouldn’t provide exact numbers), the Novaform ComfortGrande should prove durable in the long term for people under 200 pounds; to prevent body impressions, it’s best to rotate the mattress at least every six months and vary where you sleep on it. Thanks to Costco’s generous return policy, you can return the ComfortGrande for a full refund whenever you’d like, for any reason. Our pickCharles P. Rogers Estate SEFlippable durability in a boxThis flippable, two-piece mattress is made of high-quality, durable materials—including latex and extra-sturdy coils—that are rare even in pricier mattresses. But it’s heavy, and you’ll likely have to pay extra if you want help setting it up. Buying Options*At the time of publishing, the price was $1,900. The house-made coils and latex foam in the two-piece Charles P. Rogers Estate SE provide durable, sturdy support for back-pain sufferers (and anyone else). Thanks to its latex-and-cotton-quilted topper, it offers cushioning for sore joints and muscles, too. Each side of the mattress has a different firmness level: Place the coil unit right-side up for a medium-firm feel with a bit more give; turn it over for a slightly firmer sleeping surface. Either way, the latex adds a subtle springiness to that conventional coil bounce, making it easier for achy sleepers to move around in bed. The quality materials should prove durable, even for those who weigh more than 200 pounds. One possible downside: The Estate SE is heavy and thus requires either a platform frame or a box spring. The company offers a 100-night trial, within which time you can return the mattress for a full refund (minus the $200 white-glove delivery fee, if you chose that in lieu of free FedEx shipping). Our pickTempur-Adapt (Medium Hybrid)Super comfortable but priceyWith luxurious, slow-sinking foam and sturdy edge support, the Tempur-Adapt feels leagues ahead of most foam mattresses we tried. But it also costs two to four times as much. Buying Options*At the time of publishing, the price was $2,200. The Tempur-Adapt (Medium Hybrid) mattress is on the firm side of medium-firm, but it’s also extremely curve-conforming—meaning your finicky spine is likely to feel well supported while your pressure points are gently cushioned. Its foam density is 4.5 pounds per cubic foot, so the Tempur-Adapt should hold up for the long term, even for those who weigh more than 200 pounds. But that foam is quite huggy, so back-pain sufferers who frequently shift positions may have a hard time moving around on it. You can try the mattress in the many showrooms and department stores that carry it. The Tempur-Pedic site also offers a 90-night tryout, with a full refund (less shipping) if you don’t like it after sleeping on it for at least 30 days. However, if you purchase from a third-party retailer, you’re subject to that seller’s return policy instead. Everything we recommendOur pickSaatva ClassicA plush innerspring with bounceThe Saatva, which pairs a classic innerspring bounce with a cushy but understated Euro top, may appeal to those who want to nestle in without feeling engulfed. But it doesn’t offer the best motion isolation. Buying Options*At the time of publishing, the price was $1,200. Our pickOur pickZenhavenA durable foam and latex mattressThe all-latex Zenhaven is $1,000 more than similar online options, but it should prove more durable and breathable (and thus feel cooler) than many foam mattresses. Good latex mattresses are expensive, but this one provides solid value. Buying Options*At the time of publishing, the price was $2,200. Our pickNovaform ComfortGrandeBest foam mattress under $1,000This Costco favorite is made from layers of foam that are as dense (and probably as durable) as the foam in mattresses that cost twice as much. Testers loved its cuddly yet supportive feel, though some found it too firm. Buying Options*At the time of publishing, the price was $580. Our pickCharles P. Rogers Estate SEFlippable durability in a boxThis flippable, two-piece mattress is made of high-quality, durable materials—including latex and extra-sturdy coils—that are rare even in pricier mattresses. But it’s heavy, and you’ll likely have to pay extra if you want help setting it up. Buying Options*At the time of publishing, the price was $1,900. Our pickTempur-Adapt (Medium Hybrid)Super comfortable but priceyWith luxurious, slow-sinking foam and sturdy edge support, the Tempur-Adapt feels leagues ahead of most foam mattresses we tried. But it also costs two to four times as much. Buying Options*At the time of publishing, the price was $2,200.
In the past, if you had back pain, many doctors and well-meaning friends probably directed you toward a firm mattress. As it turns out, that advice was wrong. What you really need, according to the most recent research, is a mattress that feels medium-firm to you. The key word here is you. Firmness levels are highly subjective. Owner reviews reveal that the same mattress can feel too soft for some people and too hard for others. Apart from personal preference, such discrepancies exist because a person’s weight and shape can influence the feel of a mattress. On a soft mattress, for example, my 128-pound body might feel like it’s floating. But for my 230-pound brother, that same mattress could feel overly firm, given that he would drop immediately to its bottom support layer. Here’s the rule: When back-pain sufferers lie on a mattress they determine to be medium-firm, that mattress is the best backache-relieving mattress for them—regardless of how the company labels it or whether the mattress has “support zones,” reinforced layers, or any other bells and whistles that cater to a spine-focused buyer. Mattresses labeled medium-firm are a good place to start because they’re likely to support your spine’s natural curves whether you sleep on your back, stomach, or side. Ahmed Radwan, PhD, DPT, co-author of a Sleep Health: Journal of the National Sleep Foundation review paper about mattress design and sleep quality, explained to us in an interview that although people might prefer to fall asleep in a particular position, they can shift a lot during the night. Thus, “the successful mattress is the one that accommodates many positions and helps you wake up with less pain and tenderness.” The “medium” part of “medium-firm” not only relieves pressure points (which vary depending on your sleep position, as illustrated below) but also cushions the heavier parts of your body in a supportive way without letting them sink too far into the mattress. When you’re sleeping on your back, your shoulders and hips can settle into a medium-firm mattress just enough that your lumbar (lower-back) region is supported and remains concave. When you’re on your stomach, your belly is both cushioned and held up, rather than caved in and forcing your lower spine into the shape of a hammock. When you’re on your side, the mattress offers enough cushion to support your shoulders, hips, and knees, but not so much that your spine flexes or twists. The “firm” part of medium-firm helps keep the spine aligned. If you were to take a picture of yourself in each of these three sleep positions (a good thing to do when you’re shopping in person, as we suggest in our guide about how to choose a mattress), your body should be roughly straight, in neutral alignment. This means back- and stomach-sleepers should be able to draw a line from the neck to the lumbar (lower spine) region to the knees, while side-sleepers should be able to draw a line along the midpoints of the ears, shoulders, and hips. (See the illustration of ideal spine support below.) If the mattresses you’re interested in are available in a store, and you can shop in person (we have guidance for what to do if you can’t), bring your favorite pillow and try the mattress out before you buy. (Our bed-pillow guide can help you find the best one for your preferred sleep position.) Spend at least 15 minutes lying on the beds and zero in on your spine: Does it feel relaxed, rather than flexed or strained? At the same time, does your body feel cushioned, as opposed to pressed against the surface of the mattress? If you already have a medium-firm mattress but are still experiencing back pain, your mattress could be too old. “Whenever patients tell me that their back pain is the worst first thing in the morning, one of the things I always ask is, ‘How old is your mattress?’ They often say, ‘I don’t know, maybe 20?’ or some big number. But we know that mattresses usually don’t last more than 10 years, depending on their materials,” said Marlís González-Fernández, MD, PhD, associate professor of physical medicine and rehabilitation at the Johns Hopkins University School of Medicine. Research bears out those claims. A study published in 2008 asked 33 women and 29 men to record back and shoulder pain for 28 days, first in their own beds (which were, on average, nine and a half years old) and then in new beds of similar quality. The researchers found that the new mattresses reduced back pain by 62.8% and stiffness by 58.4%. “Over time, the mattress can soften and sag,” said Bert Jacobson, EdD, the study’s lead author and a professor of health and human performance at Oklahoma State University. “It becomes less good at aligning your spine.” Even if you start out with a medium-firm mattress, you might not actually be sleeping on one 10 years later. Of course, we can’t know exactly what medium-firm feels like to you, so in this guide we’ve highlighted the models that we expect will feel medium-firm to most people. Whatever you decide, make sure to take advantage of trial periods and return policies. Ideally, you should test out a mattress for at least 60 days, said González-Fernández: “Trying a mattress for a long time is important and can help make sure that a mattress works for a particular person.” If you can’t shop in personIt’s really hard to tell whether a specific mattress is right for you without lying on it first. Firmness, pressure relief, and support are all highly subjective factors, which is why we’ve always advised trying out a mattress in person prior to purchasing. But we also know that can be easier said than done. So in lieu of our usual try-before-you-buy advice, we recommend that you look for a generous return policy on any mattress you’re thinking of buying sight unseen. With respect to trial periods and return policies, here are your best options of all the mattresses in this guide:
A plush innerspring: Saatva Classic (Luxury Firm)
Our pickSaatva ClassicA plush innerspring with bounceThe Saatva, which pairs a classic innerspring bounce with a cushy but understated Euro top, may appeal to those who want to nestle in without feeling engulfed. But it doesn’t offer the best motion isolation. Buying Options*At the time of publishing, the price was $1,200. Who it’s for: The Saatva Classic in Luxury Firm caters to back-pain sufferers who prefer a traditional innerspring mattress with a just-cushy-enough top. It’s likely to feel comfortable regardless of your preferred sleep position. How it feels: We’ve been long-term testing our Saatva Classic for more than a year, and it has softened slightly from a stiff medium-firm to a plusher medium-firm. Why it’s great: The Saatva Classic is one of the least expensive innerspring mattresses we’ve tested, yet it feels sturdy and supportive. A layer of memory foam and a polyfoam and cotton-quilted Euro top (a pillowy layer of cushion sewn underneath the mattress cover) create a down-pillow-like surface that cushioned my sore shoulder muscles without being suffocatingly fluffy. In the top, more than 800 individually pocketed 14.5-gauge coils and a touch of memory foam conform to your curves, while sturdier coils at the base prevent your spine from caving in. “It’s almost like you feel lifted,” said one Wirecutter staffer who tried it. People who have owned the Saatva for a few months to a couple of years tend to be quite vocal about how comfortable they find it (though comfort is highly subjective, of course). Flaws but not dealbreakers: The 416 support coils in the bottom half of the Saatva Classic are sturdy, but they number only about half those in the pricier WinkBed (Luxury Firm), another innerspring we’ve liked in the past. They’re not individually wrapped, either, which can lead to motion transfer. For that reason, we think the Saatva works best if you sleep alone or don’t wake easily when your partner rolls over. (If you need more motion isolation, consider the Charles P. Rogers Estate SE. The Estate SE is a good option if you prefer a firmer feel, though it cushions with intrinsically less-fluffy latex compared with the Saatva.) The Saatva Classic in Luxury Firm is likely to work well for back-pain sufferers who sleep in all positions, but some side-sleepers have told us it feels too firm (the mattress also comes in Plush Soft and Firm models, though we haven’t tested those versions yet). Body impressions are a risk with the Saatva Classic (as they are with all thick Euro-top mattresses); rotate your mattress religiously at least every six months and sleep in the middle whenever you can. You can try the Luxury Firm for 365 nights and return it for a full refund, but if you do return it, you have to pay a $100 transportation fee. (Read more about the Saatva Classic in our innerspring-mattress guide.) A mix of foam and bounce: Leesa Sapira HybridOur pickWho it’s for: The Leesa Sapira Hybrid is likely to appeal to back-pain sufferers, regardless of preferred sleep position, who want a foamy feel with a pinch of springiness. The foam’s density suggests it will hold up well for people who weigh more than 200 pounds. How it feels: The bounce from the coils seems to mellow out the feel, making this hybrid just a touch softer than a typical medium-firm. Why it’s great: The foam-innerspring feel of the Leesa Sapira Hybrid is more balanced than that of the Tempur-Adapt, our other hybrid pick in this guide, whose memory foam takes over the entire experience of the mattress. In the Leesa Sapira Hybrid, the 4-pounds-per-cubic-foot memory-foam layer and 1,000-plus individually pocketed coils support your spine and conform to (and cushion) your curves. It’s “sturdy but not rigid,” said one of our back-and-side-sleeping testers. You can sit on the edges without sliding off, too. Unlike the Saatva Classic, Leesa mattresses are available at partner retailers, so you may be able to try the Leesa Sapira Hybrid in person before you buy it. Within the 100-night trial period, you can return it for a full refund if you don’t like it, though you’re required to sleep on it for at least 30 days first. Flaws but not dealbreakers: In our tests, this mattress produced slightly more motion transfer than the Tempur-Adapt but less than the Saatva Classic. This means you may feel your sleep partner’s movements in the night. Some of our testers (who had spent years sleeping on innerspring mattresses) described their experience on the Leesa Sapira Hybrid as “feeling stuck”; if that sensation sounds off-putting to you, we recommend trying the Saatva Classic or the Charles P. Rogers Estate SE instead. Several readers have also commented that the Leesa Sapira Hybrid felt too stiff for side-sleeping; this is not a super-soft mattress, but it represents a good compromise for people who require sturdy spinal support. (Read more about the Leesa Sapira Hybrid in our hybrid-mattress guide.) Best latex-foam mattress: ZenhavenOur pickZenhavenA durable foam and latex mattressThe all-latex Zenhaven is $1,000 more than similar online options, but it should prove more durable and breathable (and thus feel cooler) than many foam mattresses. Good latex mattresses are expensive, but this one provides solid value. Buying Options*At the time of publishing, the price was $2,200. Who it’s for: The flippable, all-latex Zenhaven mattress is likely to suit back-pain sufferers who want curve-conforming cushioning without the slow sink of memory foam. It should work best for people who sleep on their back or stomach, as well as those who change positions often (aka rotators). It should be durable for people of all weights, too, including those who weigh more than 200 pounds. How it feels: The Zenhaven has two sides. The Luxury Plush side is on the softer end of the medium-firm spectrum, while the Gentle Firm side provides a slightly firmer sensation (about 20% firmer, according to the company, which sounds about right to us). Why it’s great: Latex (which is made from the milky sap of a rubber tree) is inherently durable and supportive. It also has an elastic resilience, which makes it easier for back-pain sufferers to move around. When we first tested the Zenhaven in 2019, it was made from Talalay latex, known to be a supple, consistent, breathable foam. By contrast, many cheaper latex mattresses (including the Sleep On Latex Pure Green, a former pick) are made from Dunlop latex, which tends to be firmer and more bouncy. In 2021, Saatva switched to using Dunlop latex. When compared side by side, the 2019 version (made with Talalay latex) was almost identical to the 2021 version (made with Dunlop). The company told us that to create a similar feel to the original Talalay Zenhaven, it used softer variations of the Dunlop foam and blended a range of layers. The 2019 Zenhaven did seem a bit more pillowy in comparison with its newer counterpart. But it isn’t clear whether that’s the difference in latex materials or the fact that it had been broken in over our previous testing. If you’re considering the Zenhaven, try it before buying it, if possible; you’ll find it at the Saatva Company’s showrooms in New York City, San Francisco, and Washington, DC. Flippable mattresses give you a choice of firmness levels, and couples can alternate. And if you’re not picky about the feel, you can still flip the mattress periodically to increase its longevity. Back-pain sufferers—who, of course, should not be lifting a 125-pound queen mattress—will probably be relieved to know that if they change their mind about the side they want to sleep on, the company will send movers for a “one-time courtesy flip.” Flaws but not dealbreakers: Although the Zenhaven is more pliable than cheaper latex offerings, latex isn’t an inherently cuddly material. The Saatva Classic and the Charles P. Rogers Estate SE both offer more of a pillowy feel without making it difficult for back-pain sufferers to move around at night. Like the Saatva Classic, the Zenhaven is available to try only at Saatva’s showrooms in New York City, San Francisco, and Washington DC. Because of the mattress’s weight, you need either a platform (not slatted) frame or a box spring. The company offers a 365-day trial period, within which time you can return the Zenhaven if you don’t like it, but you need to pay a $100 transportation fee. (Read more about the Zenhaven in our foam-mattress guide.) Best memory-foam mattress under $1,000: Novaform ComfortGrandeOur pickNovaform ComfortGrandeBest foam mattress under $1,000This Costco favorite is made from layers of foam that are as dense (and probably as durable) as the foam in mattresses that cost twice as much. Testers loved its cuddly yet supportive feel, though some found it too firm. Buying Options*At the time of publishing, the price was $580. Who it’s for: The Novaform ComfortGrande is an appealing option for back-pain sufferers who like a good deal (who doesn’t?) and a loose memory-foam hug. This mattress should work well for side-sleepers who prefer a firmer mattress, as well as back- and stomach-sleepers who want a cuddly surface. How it feels: The Novaform ComfortGrande is available in one firmness level, medium-firm, which is an accurate description, according to our testers. Why it’s great: The Costco-exclusive Novaform ComfortGrande costs a relatively affordable $600 online and $500 in-store (a 5% fee applies to non-Costco members). Yet it offers sturdy support that even my firm-mattress-loving husband, who experiences periodic back spasms, could vouch for. The density of the memory foam, which cradles loosely and feels cushy, is somewhere in the range of 3 to 3.5 pounds per cubic foot (the company wouldn’t reveal the exact specifications), and the polyfoam’s density is a sturdy 1.8 to 2 pounds per cubic foot. These values, while suggesting good durability for people who weigh less than 200 pounds, make the Novaform more likely to sag for people who weigh more. (If that’s you, choosing a denser option—such as the Tempur-Adapt, which has a more-pronounced memory-foam sink, or the springier Zenhaven—can lower your chances of making body impressions.) Thanks to Costco’s generous return policy, you can return the Novaform ComfortGrande for any reason, at any time, for a full refund and free mattress pickup. Flaws but not dealbreakers: The memory-foam density in the ComfortGrande is less than 4 pounds per cubic foot, which is what experts consider suitable for people over 200 pounds. Although we didn’t see any complaints about body impressions among the 30 good-quality (evenhanded, detailed) online reviews we collected for this mattress, it’s unclear how long most of those owners had the Novaform ComfortGrande before writing their review (and we don’t know how much they weigh, either). We did notice repeated complaints about floppy corners, though we did not experience that problem in our own testing. (Read more about the Novaform ComfortGrande in our foam-mattress guide.) An ultra-durable, flippable innerspring mattress: Charles P. Rogers Estate SEOur pickCharles P. Rogers Estate SEFlippable durability in a boxThis flippable, two-piece mattress is made of high-quality, durable materials—including latex and extra-sturdy coils—that are rare even in pricier mattresses. But it’s heavy, and you’ll likely have to pay extra if you want help setting it up. Buying Options*At the time of publishing, the price was $1,900. Who it’s for: The Charles P. Rogers Estate SE is likely to satisfy back-pain sufferers who prefer extra-sturdy coil support with a plush—but not billowy—sleeping surface. The firmer side of this two-piece, flippable mattress works well for those who tend to drift off on their back or stomach; the softer side accommodates those who also roll onto their side on occasion. We expect it to be durable for most people, including those who weigh more than 200 pounds. How it feels: This two-sided mattress feels medium-firm on one side and slightly firmer on the other. Why it’s great: The Charles P. Rogers Estate SE delivers on the sturdy support that back-pain sufferers typically seek out, without feeling like a kitchen countertop. The key: 1,221 pocketed, house-made coils in the base, reinforced with two layers of rugged Dunlop latex, as well as a 2-inch layer of softer Talalay latex and two layers of fiber padding zipped together into a quilted cotton cover. You can use the bottom portion right-side up for a medium-firm feel or turn it upside down for a slightly firmer surface. (This flippability factor is helpful for those who aren’t sure of their firmness preferences or who want to prolong the life of their mattress, assuming they’re not particular about the feel.) The Estate SE gets its strong edge support from stronger (thicker) coils around the perimeter, as opposed to a foam encasement or coils that either have more turns or are more tightly packed (which is often the case in other innerspring mattresses). The slight springiness of Talalay latex also makes shifting positions easy. Latex is intrinsically more durable than memory foam or regular polyurethane foam, so we expect this bed to hold up well (for people of any weight) through its 20-year warranty. This mattress offers a 100-day trial, so you can return it for a full refund (minus the $200 white-glove service fee, if you selected that instead of free FedEx delivery). Flaws but not dealbreakers: There are only three showrooms (in New York, New Jersey, and Pennsylvania) where you can try the Charles P. Rogers Estate SE before you purchase it. FedEx will ship the mattress for free, but each box weighs roughly 45 to 150 pounds (depending on mattress size), so you may need help setting up the bed. If you live within 100 miles of Charles P. Rogers’s East Rutherford, New Jersey, factory, the company will deliver your mattress unboxed, generally for no extra charge. Because of the mattress’s weight, it needs either a platform (not slatted) frame or a box spring. White-glove delivery costs $200. (Read more about the Charles P. Rogers Estate SE in our innerspring-mattress guide.) A substantive, body-conforming hybrid: Tempur-Adapt (Medium Hybrid)Our pickTempur-Adapt (Medium Hybrid)Super comfortable but priceyWith luxurious, slow-sinking foam and sturdy edge support, the Tempur-Adapt feels leagues ahead of most foam mattresses we tried. But it also costs two to four times as much. Buying Options*At the time of publishing, the price was $2,200. Who it’s for: The Tempur-Adapt (Medium Hybrid) may appeal to back-pain sufferers who like a supportive mattress with the slow, hugging sensation of memory foam. It should work well regardless of your preferred sleep position, and we expect it to hold up over the long term for people of all weights, including those who weigh more than 200 pounds. How it feels: The coil-on-foam construction makes this mattress feel medium-firm to almost firm. But because the foam is so contouring, it’s not stiff. Why it’s great: The Tempur-Adapt (Medium Hybrid) offers arguably more pressure relief than the other mattresses in this guide. Tempur-Pedic’s unique memory-foam layer (4.5 pounds per cubic foot) is also the densest—and probably the most durable—of all the mattresses we recommend for back pain. That layer, topped with a proprietary, polyfoam-like material (2.5 pounds per cubic foot, which is a good density for polyfoam), creates the overall sensation of a gradual, measured cushioning (as opposed to instantaneous). The material’s density makes the mattress less prone to body impressions and sagging, too. More than 1,100 pocketed coils contribute additional support and conformity, though only a bit of resilience. For those who are able to shop in person, we also like that this mattress is available to try in Tempur-Pedic showrooms and many department and furniture stores nationwide. Flaws but not dealbreakers: Our testers either loved or hated this mattress. Some found the slow sink to be wonderfully “transportive,” while others described it in more terrifying terms (“like quicksand”). If you have aches and pains, the pronounced memory-foam sink of the Tempur-Adapt may make shifting positions difficult; instead, consider the Leesa Sapira Hybrid, which is made with almost-as-dense memory foam but has a more dominant innerspring feel. You can return the Medium Hybrid within the 90-day tryout period for a refund, but if you do so, you have to pay the shipping costs, which can be well over $100. That’s why we recommend browsing in-store whenever possible. But be aware that if you buy the mattress from a department store rather than from the company’s site or showroom, you’re subject to that seller’s return policy, which may or may not be as generous as Tempur-Pedic’s. (Read more about the Tempur-Adapt in our hybrid-mattress guide.) Other good mattresses for back painAlthough we liked the following mattresses, they fell short of our main picks for various reasons. Still, one of these may be right for you. (All prices are for queen-size mattresses and are subject to change.) The $500 IKEA Hesstun (Medium Firm) may suit back-pain sufferers in search of a wallet-friendly innerspring model. We found that it’s actually a bit firmer than its medium-firm designation. (We haven’t tested the Plush and Firm versions yet.) The almost-13-inch Hesstun has just under 600 mini pocket springs near the surface (and the same amount near the base), which makes the mattress feel quite supportive and not at all cheap. A puffy Euro top adds softness, though some testers found it off-puttingly “stuffed" (as in, with feathers) rather than conforming. The Hesstun’s polyfoam densities (1.7 and 1.8 pounds per cubic foot) are typical for mattresses in the $500 to $1,200 price range—and in most cases, the steel coils help protect against sagging. As a result, the Hesstun should hold up adequately for the long term, particularly if you weigh less than 200 pounds. Because the Hesstun has fewer total coils than its competitors, people who weigh more are likelier to see body impressions or dips in the mattress over time. (Whatever your weight, it’s especially essential to rotate the Hesstun at least every six months and vary where you sleep on it when possible.) If you don’t like the Hesstun, you can exchange it for another mattress within 90 days or return it for a refund within 180 days, but you’ll likely have to haul it back to your local IKEA store yourself. (Read more about the IKEA Hesstun in our innerspring-mattress guide.) Back-pain sufferers open to new mattress sensations might consider the 11-inch-thick Purple Hybrid ($1,700) or the 12- or 13-inch-thick Purple Hybrid Premier ($2,300 to $3,000). Essentially upgraded versions of the original Purple mattress, these beds consist of various thicknesses of the Purple Grid (2 inches in the Hybrid; 3 or 4 inches in the Hybrid Premier) on top of 540 13½-gauge pocketed coils in a queen. The thicker the Purple Grid—a proprietary highly stretchy, resilient gel foam—the jigglier it seems. However, underneath that cushioning is a sturdy, supportive feel. When we included the original Purple in our 2018 group test, participants found the composition off-putting. Since then, two staffers have been sleeping on a Purple mattress and say they like it. One staffer, who opted for the 4-inch Hybrid Premier, said that although he’s not sure that the mattress helped his back issues, it at least it didn’t hurt. “It’s comfortable, in a way that spring mattresses haven’t been,” he said. You can try it yourself and find out if it’s right for you at select partner retailers nationwide. (Read more about the Purple mattresses in our review of the brand.) Care and maintenance
Mattresses can collect a lot of unwanted nastiness, including dust mites, dead skin, and liquids (everything from water droplets to sweat and pee). Your mattress is susceptible to stains and odors that may drive you to trash it before its expected shelf life is up. According to our guide on how to clean your mattress, a mattress encasement will keep the worst of the unpleasantness out, and it will make routine cleaning as simple as throwing the encasement in the wash once or twice a year. We recommend the Protect-A-Bed AllerZip Smooth Mattress Encasement, which has super-strong seams and a zipper that won’t easily open. A mattress encasement can also make it easier to inspect your mattress for bed bugs. (If this is a problem you’re dealing with, or something you’re worried about, check out our advice on how to get rid of bed bugs.) If you don’t have a mattress encasement, vacuum your mattress once a month using a full-size vacuum cleaner with powerful suction, to draw out trapped dust and grime from every crevice. For bigger accidents and spills on a bare mattress, spray equal parts warm water and white vinegar onto the stain and dab it until the stain disappears. Then, sprinkle baking soda onto the affected area to absorb the wetness, wait a few hours until it’s dry, and vacuum it up. Dry your mattress completely before dressing and sleeping on it again—dampness invites mildew, and no amount of vacuuming can fix that problem. Kelli Pate contributed to this guide. This guide was edited by Courtney Schley and Kalee Thompson. Frequently asked questionsWhat is the best type of mattress for back pain?When it comes to back pain, mattress type (innerspring, foam, hybrid) is less important than mattress firmness. Likewise, the number of foam layers or support coils won’t matter as much as how the mattress feels. And if you have back pain, studies show that a mattress that feels medium-firm is the best type of mattress for you. According to one expert we spoke with, that’s because a bed labeled “medium-firm” is likely to support your spine’s natural curves whether you’re a side-sleeper, a back-sleeper, or a stomach-sleeper. Whether you’re trying a mattress in a store or testing one you purchased online, ask yourself these questions to get a better idea of how comfortable it really is. What is the best type of mattress for side-sleepers with back pain?Most side-sleepers do well with a medium-soft to medium mattress, which should provide enough cushiness to relieve pressure on their hips and shoulders but enough support to keep their spinal alignment in check. People with back pain, however, ideally need a mattress that feels medium-firm, which is likelier to ease their aches and pains than a softer bed. We do suggest some slightly firmer mattresses for side-sleepers who require more support, and we think one of them will hit the sweet spot for back-pain sufferers who regularly sleep in that position. If you’re a side-sleeper with back pain, start by considering the Saatva Classic or Leesa Sapira Hybrid. These mattresses are still medium-firm, but we’ve found that they’re relatively plusher than the others, especially after a break-in period. If you’re not sure about your firmness preferences, the flippable Zenhaven gives you two options to choose from, with one side slightly more pliable than the other. Finally, although the Tempur-Adapt Medium Hybrid feels firm, it also has a uniquely contouring memory-foam sink, and it should adequately cushion shoulders and hips for side-sleepers, too. Keep in mind that firmness level is subjective, so we strongly suggest trying the mattress before you buy, if you can, or paying close attention to the trial window so you can return the mattress if it doesn’t feel right. Bonus tip: Side-sleepers who struggle specifically with lower-back pain may benefit from sleeping with a pillow between their knees, which can help keep their hips, pelvis, and spine properly aligned. (Get more pillow advice and recommendations in our guides to the best bed pillows and the best pillows for side-sleepers.) Are memory-foam mattresses good for back pain?Memory foam, which was developed for use in airplane cushions under a NASA contract in the 1970s, tends to mold to the body, allowing it to cushion pressure points, align the spine, and distribute weight more evenly on a mattress. But if the memory foam lets your body sink too far into the mattress, it could throw your spine out of alignment and possibly worsen your back pain. If you want the benefits of memory foam without the potential downsides, the Saatva Classic (Luxury Firm) combines an innerspring’s bounce with a quilted Euro top—and throws in just the right amount of memory foam to create a mattress that cushions but isn’t too cuddly. And if you share a bed with someone and want more motion isolation, the medium-firm Leesa Sapira Hybrid is a foam-forward hybrid that may appeal to back-pain sufferers who like a little more cuddle without the assertive, sink-right-in sensation of an all-foam mattress. Sources
About your guideJoanne Chen is a former senior staff writer reporting on sleep and other lifestyle topics. Previously, she covered health and wellness as a magazine editor. After an assignment forced her to sleep eight hours a day for a month, she realized that she is, in fact, a smarter, nicer person when she isn’t sleep-deprived. Further reading
Is it better to sleep on a soft or firm mattress for back pain?A softer mattress is usually recommended for those who are experiencing back pain on a standard mattress, or those who have pre-existing back problems. They're also recommended for lighter individuals as a harder mattress can end up not compressing for them at all.
What firmness is best for back pain?When in Doubt, Go 'Medium-Firm' Research is limited, but in one study, researchers assigned new mattresses to more than 300 people with low back pain. They used either "medium-firm" or "firm" mattresses for 90 days. Those in the medium group reported the least amount of discomfort.
Which type mattress is best for back pain?Memory foam mattresses can alleviate back pain by cushioning the spine and promoting even alignment, but you may find the foam layers too soft and prone to deep sinkage — especially if you weigh 130 pounds or more.
Whats better for back pain a firm or a medium firm mattress?While there is not much clinical data about mattresses, one study found that medium-firm mattresses usually provide more back pain relief than firm mattresses.
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What type of mattress is best for back pain firm or soft
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