Say Goodnight To Back Pain: Tips To Buy The Perfect Mattress

Authored by: Dr. Thomas Schuler

An extremely common question that I am asked in my clinic is, “What is the best mattress that I should buy?”.  Given this is such a common question, one would think that an answer, driven by data, would be readily available. Unfortunately this is an extremely difficult question to answer because of the nature of human variability. Just as there are people that enjoy sleeping on their back, stomach, or side, we also have to contend with variations in their anatomy.  After reviewing many of the studies that have attempted to answer this, it is clear that none of them definitively solve the question.  This causes us to rely on our own experience and those of thousands of patients that we treat over our career.


The optimal mattress allows our bodies to relax while providing appropriate support to our lower back.  It should aim to decrease tension in areas that are injured and reduce the risk of developing new injuries. Support for the lower back means the mattress will contour to the normal upward curve of the back when one is lying flat. Cervical {neck} support is also critical because of the natural forward curvature in the neck. Support for the neck is easily found by using a soft pillow that molds to the shape of the head and doesn’t contort the neck. Meeting these requirements may seem simple enough but not all mattresses withstand the test of time. A mattress may initially seem more comfortable than the rest, but the question is whether the support, or lack thereof, feels as good after a complete night of sleep. Extremely soft beds can actually become more uncomfortable after prolonged use. The same can be said for extremely firm mattresses.


One of the positions that seem to be the worst for people’s back is anything that sags.  A sagging mattress causes the normally lordotic, or forward-shaped, lumbar spine to flex, which compresses the discs in the front.  Degenerative discs are an extremely common source of chronic back pain, therefore anything which causes abnormal force or stress on the discs will predispose us to more pain and injury down the line. My recommendation after reviewing the data and my own experience is that we should purchase a firm mattress pad that has a softer cushioning top. The firmness provides adequate support for our legs, pelvis, and spine, while the flexibility of the top pad enables the pressure to be diffused across the different contours.

  • Place a pillow under your knee
    • This will take tension from the back and allow the natural forward-flexed curve of the back to exist in a relaxed state while your sleep.
  • Sleep with a soft pillow under your head
    • Any large or firm pillow tends to force our heads into a flex position which can aggravate neck pain. A soft pillow can be contoured to fit into the optimal alignment for your neck and respective anatomy.

Getting a good night’s sleep is critical for our mental function, but also for our well being and pain control.  We cannot be healthy and function optimally without getting adequate sleep as that is the time that our body heals and recharges.  Having adequate time and being in the best environment are key, not only to being rested, but to our overall well being and how we optimize our performance each day.  If you have an old or uncomfortable mattress, it is time to invest in your health and buy the right mattress to help you sleep and enjoy life more fully.

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