Finding the best mattress for back pain takes a bit of research..
There are loads of guides online with diagrams of backs and videos of people showing off their bottoms so you can see how straight their spine is on a certain mattress.
I’ve tried to summarise all the waffle and pseudo science to establish the general consensus on what type of mattress is best for a bad back or for back pain. I’d like to emphasise that I’m not a chiropractor or a back specialist. Hopefully that means I’ll be able to keep it simple. Of course, personalised professional advice is always better than some guy on the internet. Please do your own research and speak to an expert as well as reading this guide.
Here are 6 things you should know about mattresses and looking after your back:
1. Mattresses should be supportive, not just hard or firm
There’s an old myth that firm or hard mattresses are what you need to look after your back. I’ve read claims that some Chiropractors still recommend firm mattresses to anyone with back pain. However, it’s no longer advised as being best for everyone. Indeed, the British Chiropractic Association and the National Bed Federation are amongst those that say that a supportive mattress the best mattress for back pain.
Remember those diagrams they always have in bed shops of people lying down with wonderfully straight spines? The general idea is that you need to find a mattress which supports you in a way that gives your spine the ‘correct alignment’. The British Chiropractic Association say this and it’s also on this Sleep Council guide.
It isn’t the case that a soft or firm mattress or very firm ‘orthopedic’ mattress will achieve this for everyone. The amount of pressure you put on the springs or foam varies according to your weight and build. Certainly, a firm mattress is right for many people with back pain. However, it isn’t as simple as saying that it will be the best mattress for back pain for everyone.
What do the mattress makers say?
Advice from manufacturers isn’t very consistent. However, The Queen’s mattress maker Hypnos suggests its firm mattresses ‘can help keep your spine in a comfortable and stable position’. The company also warns that ‘the common presumption is that the firmer the bed, the better it is for your back, but that is not always the case. Sometimes it’s just about getting the perfect mattress paired with the right pillow.‘
Meanwhile, another mattress manufacturer called REM-Fit suggests that the firmest of their three mattresses (REM-Fit 500) is their ‘recommended choice…if your preference is a supportive mattress or you suffer from a back complaint’. Again, please note that I’m not a back expert, I’m just quoting others.
What does the science say about the best mattress for back pain?
There has also been some relevant academic work in Spain exploring firmness levels and the best mattress for back pain. In 2003, Kovaks, Abraira et al carried out research with more than 300 adults. They were people who had ‘chronic non-specific low-back pain, but no referred pain, who complained of backache while lying in bed and on rising. Some people were given firm mattresses whilst others were given medium-firm mattresses. The allocation was done randomly rather than based on weight or build and people were assessed after 90 days’.
The study concluded that ‘patients with medium-firm mattresses had better outcomes for pain in bed…pain on rising… and disability…than did patients with firm mattresses.’ Furthermore, the patients with medium-firm mattresses also had ‘less daytime low-back pain…pain while lying in bed…and pain on rising…than did patients with firm mattresses.’
In summary, researchers decided that ‘A mattress of medium firmness improves pain and disability among patients with chronic non-specific low-back pain’.
Another study – from 1999 – by Dubb and Driver took a small group of nine people and looked at the best mattress for back pain. They aimed to find out whether ‘a hard, medium or soft mattress and base bed set affected the quality of sleep of patients with low back pain’. In that instance, they found that ‘backache was reduced and sleep quality improved on the first night on the hard mattress’. Overall, they concluded that the ‘well‐being of our patients therefore improved if they slept on a firmer mattress’. However, I would caution that this was a relatively small study.
2. Lighter people need softer mattresses, heavier people need firmer mattresses
There are two main things to consider when figuring out which mattress firmness you need:
- As a general rule a lighter person needs a softer mattress to be well supported. A heavier person needs a firmer mattress.
- People who sleep on their sides most of the time need slightly softer mattresses than people who sleep on their front or back. If a side sleeper uses a very firm mattress they may put a lot of pressure on their shoulders and hips.
Getting the right level of firmness for you is – perhaps obviously – very important. Academic researchers in Iran made this point in a study into ‘spine alignment in men during lateral sleep position’ (i.e. sleeping on your side). They said that ‘Observing the amount of required stiffness obtained for the sleep surface, can have a significant effect on keeping the spine healthy’. (Leilnahari, Fatouraee Khodaltfi et al, 2011).
Here are soft, medium and firm mattresses which made it into our ‘best of’ guides:
Soft mattresses in our top 5 soft mattresses guide include:
Silentnight Deluxe Box Top Mirapocket 2000 Limited Edition Mattress – £709
This mid-priced pocket sprung mattress is described as soft/medium. The 2000 number refers to the number of pocket springs, which is very decent for the price.
It uses a layer of super soft foam and comes with a 60 night comfort trial (terms and conditions).
See the full guide to 5 of the best soft mattresses.
Medium firmness mattresses in our top 10 mattresses guide include:
Nectar Sleep Mattress (£1199)
This memory foam mattress is more of a medium/firm firmness but it is commendable for its extra-long trial period. You get a whole 365 nights which allows you to try it during every season. Studies have shown that memory foam behaves a little differently depending on the temperature and can make you feel a little warmer than foam which bounces back quicker (Chiba, Yabi et al, 2018). Therefore, a trial period which includes summer and winter is better than one which just last for a month.
Nectar Sleep also offer an industry-leading ‘forever’ warranty, whereas most similar priced mattresses come with a 5-10 year warranty. Customers rate the brand as 4.2/5 on TrustPilot. That means it isn’t the highest scoring ‘bed in a box’ but is still ahead of many traditional big-name brands. It has won a number of awards from experts.
Simba Hybrid Original Mattress (£819)
The Simba Sleep is another medium/firm mattress, but it also uses a layer of mini springs and a layer of larger springs. That’s why it’s known as a hybrid mattress.
It originally came with springs which were miniscule in comparison to the large pocket springs you might be used to on a mattress. However, they redesigned their range and came up with a mattress with both larger and smaller springs (The Simba Hybrid Original) and a mattress which just has small springs (The Simba Hybrid Essential). In the case of the Simba Hybrid Essential, the idea is that the foam layers give you support whilst the mini springs add comfort.
The entire Simba range comes with a 200 night trial period. Over the years, it has been 100 nights and 365 nights but they seem to have settled somewher in the middle. I see 200 as being perfectly generous engouh as it allows you to try it out in summer and winter. The warranty length is 10 years. That is on a par with similarly priced foam mattresses but slightly more than you can expect to get with a pocket sprung mattress of this price. It’s a hugely popular mattress which has had lots of positive reviews and the brand scores 4.5/5 on TrustPilot.
Ergoflex 5G (£581)
The Ergoflex 5G memory foam mattress is worth a mention on this guide as it is recommended by The Back Doctor. The trial period is only 30 days. However, that does give you a few weeks to see if it’s right for you and you can return it for a refund. Some rival brands will only let you swap your mattress for another one. The warranty length is 10 years. That was unusually long a few years ago but has become relatively standard on foam mattresses around this price. Reviews on TrustPilot are outstanding at the time of writing. The score of 4.8/5 puts it right at the top, ahead of several more famous brands.
Happy Beds Majestic 1000 (£284)
This Happy Beds mattress is certainly a budget one, but the specification is better than you might expect. It uses pocket springs which provide a more stable sleeping surface than you get from old fashioned open coil springs. There’s evidence that stability is key to a good night’s sleep, so pocket springs are worth the money (see research by Shen, Chen et al in 2012 who found that ‘The percentage of deep sleep and sleep efficiency were low when subjects slept on mattresses with poor stability’.
On the downside, the spring count is a little on the low side. Regardless, it will still offer better support than many similarly priced sprung mattresses. It gets good reviews on Amazon (4.2/5).
Vispring Chiswick (£1499) – medium or firm
Simple but high-quality materials are the key with this mattress. It’s an entry level pocket spring mattress from a very posh mattress maker. It’s got 1200 pocket springs along with ‘hand side stitching’ which is a feature which adds stability at the edge of the bed. The Vispring brand has won multiple awards from Which? and others. However, it is most famous as being the inventor of the pocket spring.
The use of natural materials including wool and cotton should be seen as a positive. Both are naturally breathable and wool is hydrophilic which means it can absorb moisture without feeling damp. That means it will help keep you cool in bed.
The warranty length is extraordinary at 30 years. It’s also double-sided, which means you can flip it over to help it last longer. Most foam mattresses and some pocket spring mattresses are single sided. The only snag is that you have to spend another £250-£350 on a Vispring Mattress Pad if you’re using it on a base with slats.
See our top 10 mattresses guide for more medium firmness mattresses.
Firm mattresses in our top 5 firm mattresses guide include:
Silentnight Athens 1400 (£429)
Silentnight is the biggest name in UK mattress market and this model gets great customer reviews for the price. It’s a simple design with a good number of pocket springs on one layer and a ‘fibre layer’ on top. It is single sided unfortunately and the warranty is a little disappointing at five years. However, for this price it is very good value.
Hypnos Orthos Support 7 Pocket Sprung Mattress (£949)
Hypnos has built up a very credible reputation over the years. For many years it had the added prestige of being the Queen’s mattress maker (or at least the company with a Royal Warrant for supplying the Queen’s household). This is one of their more affordable mattresses, but it still comes with a 10-year guarantee.
As you’d expect, it uses pocket springs and natural materials which is one of the things that justifies the price. Hypnos has done a lot to become more environmentally friendly in the last few years. They were the UK’s first mattress brand with carbon neutral manufacturing, according to their blurb. They even use a special material for the giant bags that their mattresses arrive in, so you aren’t left with a huge amount of plastic to put into landfill. They won a big prize at the National Bed Federation Awards in 2022 for their industry leading sustainability efforts.
A big plus point with this mattress is that it is double sided which should help it last longer. A lot of pocket sprung mattresses around this price can’t be flipped over.
John Lewis & Partners Luxury Natural Collection British Wool 8750 (£1999)
This range of mattresses is made for John Lewis & Partners by a company called Harrison Spinks. They are based in Yorkshire and have won some notable awards, such as Manufacturer of the Year in 2018 at the National Bed Federation Awards.
The 8750 number refers to the number of springs, which is a huge number. A word of caution though – there is a limit to how many full size pocket springs you can fit onto one layer of a mattress. The only way to achieve huge numbers like this are to have multiple layers of mini springs. In this case, you get one layer of normal sized pocket springs and two layers of mini comfort springs.
This mattress is double sided. That’s a good thing as long as you will get around to turning it over routinely. The warranty length is seven years, which is a bit less than I’d expect for this price tag. However, it does now come with a 60 night comfort trial, so you can swap it if you don’t like it. It’s not quite as simple as some trial periods (e.g. you have to buy a mattress protector at the same time) but it’s still unusual to offer a trial period with a pocket sprung mattress.
See the full guide to 5 of the best firm mattresses.
How firm is a firm mattress?
There’s a slight complication when you’re searching for the best mattress for back pain.
The mattress industry has never quite agreed on what ‘soft’, ‘medium’ or ‘firm’ actually means. So, you can’t just say that a 12 stone person needs any ‘medium firmness’ mattress. However, it’s a good starting point to say that if you are an ‘average’ weight then you should start by looking at the ‘average’ firmness mattresses. In theory, a good mattress manufacturer will be able to tell you which of their beds is best for your build, but the 17 year old in the showroom may not actually know for sure.
John Lewis & Partners is one company which gives clear guidance on their own brand mattresses.
They suggest that:
- Soft John Lewis & Partners mattresses are for people who weigh up to 8 stone
- Medium firmness mattresses are for people who weigh 8 – 16 stone
- Firm mattresses are for people who weigh more than 16 stone
One final complication is that the way you sleep also affects the firmness of the mattress that you need. If you sleep on your side, you need to look for a slightly softer mattress than someone who sleeps on their back. Side sleepers don’t generally want a very firm mattress because they put extra pressure on their shoulders and hips.
3. Trying a mattress before you buy is wise
Trying a mattress before you buy is easier than it sounds in my experience. There are literally thousands of mattresses on the market, including many seemingly identical mattresses which go by several different names. So, you go into a huge bed showroom looking to try out a mattress you’ve read is decent, but there’s no sign of it. For example, the Which Best Buy award winning Sealy Teramo 1400 is also called the Sealy Nostromo 1400.
So, your options for buying the best mattress for back pain online are:
- take out a risk free trial of a mattress. Many of us would be too embarrassed and British to send a bed back that we’d been using. However, it’s becoming a common thing for foam mattress companies to offer. If you want to try before you buy, then Emma (£474), Nectar Sleep (£1199), Simba (£819), Tempur (£2000ish) and others offer a 100, 200 or 365 night trial.
- try out a few mattresses in a showroom. That will give you an idea of which level of firmness gives you the right level of support and comfort
- take a guess based on how heavy you are.
If you can, at least visit a showroom and see which firmness of mattresses tend to be best for you. Have a lie down and get someone to look at how straight your spine is. You’ll look like a real nerd, but it’s a useful exercise if you don’t mind momentary shopping embarrassment. Avoid dragging your teenage children along, they’ll be mortified.
4. An ‘orthopaedic mattress’ isn’t necessarily the best mattress for back pain
Mattress sellers like to impress people with scientific sounding names (much like shampoo sellers in my view…).
However, according to the Sleep Council:
“Any reference to beds being orthopaedic – or similar medical sounding terms – does not automatically mean that the bed has been professionally assessed or recommended. It is a term loosely used by manufacturers to refer to extra firm models in their range”. (N.b. the Sleep Council has since closed its website).
So, an orthopaedic mattress might be suitable if you are very heavy but for most people they won’t necessarily give you proper support along your spine in bed.
5. If you’re sharing a bed with someone much bigger or smaller than you…
…then you might consider a zip and link bed which is two single beds zipped together or a dual tension mattress which is a bed which is firmer on one side than the other.
For example, posh brand Flaxby sell a king size mattress which is soft tension on one side and medium on the other (£1399).
A cheaper option is to buy two Euro single mattresses/long single mattresses which are usually 90cm x 200cm. If you put them side by side, then they should fit neatly on a super king size base (180cm x 200cm). Double check the measurements first…
6. (Some) memory foam and latex mattresses are particularly good for bad backs
There’s some debate and disagreement online over whether memory foam, pocket sprung or latex makes the best mattress for back pain. Personally, I’d avoid cheap open coil mattresses as they are horrible and cheap, but I appreciate that budget is a factor.
One guide I found concluded that proper high quality latex mattresses are the best option for back pain (such as Dunlopillo, although they aren’t cheap), followed by memory foam mattresses (such as Nectar Sleep, Tempur or Ergoflex) and then pocket sprung mattresses come third (I’m paraphrasing). Meanwhile, another website concluded that memory foam is best for a bad back, closely followed by latex with sprung mattresses some way behind.
According to the charity Versus Arthritis, ‘many people find memory foam mattresses or toppers helpful’ although I appreciate that arthritis is a particular condition so the same advice won’t apply to everyone with a back problem.
Several other guides either sit on the fence or are written by manufacturers of one type of mattress, so you kind of conclude they might not be giving unbiased advice.
I’ve not found anything warning against pocket sprung mattresses for a bad back. I think it’s safe to assume that a high quality pocket sprung mattress will be better than a poor quality memory foam mattress.