If you experience aches and pains first thing in the morning and think your old, unsupportive mattress is the culprit, you might be right.
When your mattress is saggy or uneven, your spine may not get the support it needs to remain in a neutral position while you sleep. That lack of support can mean lower back pain in the morning, or even longer if not treated.
If you’re searching for the right mattress for a better night’s sleep and to prevent a sore lower back in the morning, this list can help you narrow down your search.
Brand reputation: All the mattresses are manufactured by companies that meet our content integrity and vetting guidelines, meet safety regulations, have good customer reviews, and are also determined by their Better Business Bureau profile and lack of litigation issues.
Materials certifications: We prioritized picks with third-party material certifications, like CertiPUR-US and OEKO-TEX. CertiPUR-US ensures foam is made using low volatile organic compounds (VOCs) and without known ozone depleting chemicals, flame retardants, heavy metals, formaldehyde, and phthalates. OEKO-TEX tests for 100 chemicals thought to be harmful to human health, including pesticides and carcinogens. Our recommendations carry at least one of these certifications, and some include both or additional certifications.
Company policies: It’s generally understood that the best test of a mattress is sleeping on it for at least a few weeks. Our recommendations offer warranties and free in-home trials.
“You can blame your mattress for low back pain if you awaken with pain or have trouble getting comfortable because of pain,” says Monica Moreland, physical therapist and owner of Moreland Physical Therapy.
“Your best bet is looking for a mattress that combines softness and support so pressure points can be relieved and [the] spine can be neutrally aligned,” says Moreland.
“A mattress that doesn’t hold up our body will cause pain in the lower back,” explains Dr. Lynelle McSweeney, a chiropractor in Reno, Nevada. “We need support to keep our joints from going into a stress point, which puts pressure on nerves and strains the muscles.”
With that in mind, here are some characteristics to keep in mind as you decide on a mattress.
In general, hybrid or innerspring mattresses offer more support than all-foam options, which may be too soft.
“A good mattress is a medium-firm one that will allow for uniform pressure throughout the body and not cause excess pressure to bony prominences such as hips and shoulders,” says Moreland.
Soft or plush mattresses likely won’t provide enough support, but it’s also important to avoid mattresses that are too firm, and research agrees. A 2003 study suggests that medium-firm mattresses are better for reducing low back pain than firm mattresses.
The manufacturer’s firmness rating can help you zero in on a supportive option. These ratings are based on a scale of 1–10, with 1 being the softest and 10 being the firmest. Medium-firm mattresses, which have a rating of 7–8, are typically recommended for lower back pain.
Keep in mind that the best mattress will also depend on your preferred sleeping position, your body size and weight, and whether you share your bed with a partner or pet.
If you’re sleeping on your back, you may want a mattress that offers more support in the low back, hips, and shoulder area. Side sleepers may want slightly more plushness in the shoulder area. Stomach sleepers may want a firmer mattress overall to avoid their hips and pelvis from sinking.
Other things to consider
There is no one best mattress for everyone, but there are certain considerations when you’re dealing with lower back pain:
Adjustability: Adjustable mattresses that let you choose your firmness level from one night to the next can be a good option, but be prepared to pay a premium for this feature.
Zoned support: Some mattresses are designed with zoned support, offering stability and firmness in the lower back region.
Make a point of checking reviews so you can see what previous purchasers have to say about any mattresses you’re considering.
Comfort is highly individual, so take advantage of the free in-home trials that manufacturers offer when they’re available to find a mattress that balances enough support for your lower back with overall comfort. Check the return policy and warranty, too.
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How we sleep can be a direct contributor to lower back pain. “When we sleep, we can be in one position for a long period of time, 2–3 hours, before moving,” explains Moreland. “If this position is a compromised one, 2–3 hours could cause misalignment or pressure on a nerve.”
“Both of these positions keep the spine in a neutral position and are good for long time spans,” she says.
McSweeney agrees: “Sleeping on your back is generally considered best for the body, but supporting your body in your preferred sleep position can also work. Getting sleep is the most important thing for your health and well-being.”
The worst sleeping position for lower back pain? Stomach sleeping. According to Moreland, it’s more likely to cause back pain than other sleeping positions because of the stress put on the spine.
“The ‘dead body position,’ in which someone is on their stomach with arms overhead and one leg cocked up, is the worst,” she says. “Falling asleep like this could be detrimental to a healthy spine and worse for an aged one.”
To avoid low back pain, stomach sleepers can try using a pillow beneath the pelvis and lower abdomen. The extra support may relieve some of the pressure that can build in your low back when you sleep on your stomach.
If you’re a side sleeping, you can also try curling into the fetal position, with your knees tucked toward your chest and your back slightly curved forward, to help make space between vertebrae.
Remember to switch sides to avoid imbalances. Note that if you have an extension bias, or find that arching your back relieves your symptoms, then the fetal position won’t help with lower back pain.
If lower back pain is interfering with your ability to get a good night’s sleep and it persists, it’s time to see a doctor. The same is true if your lower back pain is making daily activities difficult or if the pain is severe.
If low back pain accompanies other symptoms, such as pain that extends into other body parts, tingling or numbness, or a fever, it’s important to see a doctor, as this can indicate nerve irritation or an infection.
If a brand-new mattress isn’t within your budget, there are other things you can try to help alleviate lower back pain.
Use a mattress topper
Mattress toppers are a budget-friendly way to offer specific benefits, including relief from low back pain. If you suspect your mattress is contributing to your lower back pain because it’s too firm, consider trying a plush mattress topper to help reduce common pressure points.
Put your mattress on the floor
Support is critical for proper spinal alignment. Try putting your mattress on the floor to see if a firmer mattress is a better fit for you. This is an easy way to check whether a firmer mattress will help alleviate your lower back pain.
Slide a piece of plywood under your mattress
If moving your mattress to the floor isn’t an option, try sliding a piece of sturdy plywood between your mattress and your box spring or bed frame. This will help minimize movement and increase support.
Try an adjustable bed base
An inclined sleeping position may offer more relief from lower back pain than a flat sleeping surface. Swapping your standard base for an adjustable version gives you the option of elevating your upper body to alleviate lower back pain.
If you can’t invest in an adjustable bed base, a wedge pillow or a body pillow may help you adjust your positioning.
Yes. A mattress that’s too soft, without enough spinal support, will cause pressure and pain in the lower back. But a mattress that’s too firm can also create lower back pain by not allowing enough “give” to pressure points, causing misalignment.
Can replacing your mattress improve lower back pain?
Yes. If your mattress isn’t offering enough support because it’s too soft or too old, swapping your mattress for a medium-firm option can help improve lower back pain.
You can also try moving the mattress to the floor, using plywood beneath the mattress, or adding a supportive mattress topper designed to alleviate back pain.
What style of mattress is best for lower back pain?
Medium-firm, adjustable mattresses are most effective for minimizing lower back pain. Look for hybrid or innerspring models with zoned support that offer more firmness in the lumbar region.
What style of mattress is worst for lower back pain?
Mattresses that are excessively soft or overly firm will worsen lower back pain. All-foam options that lack zoned support may not be a good choice either.
Many people experience lower back pain. A mattress that doesn’t offer enough support can make it worse, no matter how you sleep.
Consider looking for a mattress that offers medium-firm support with layers of foam or a hybrid system, and always opt for a company that has a generous in-home trial period.
Jessica Timmons has been working as a freelance writer since 2007, covering everything from pregnancy and parenting to cannabis, chiropractic, stand-up paddling, fitness, martial arts, home decor, and much more. Her work has appeared in mindbodygreen, Pregnancy & Newborn, Modern Parents Messy Kids, and Coffee + Crumbs. See what she’s up to now at jessicatimmons.com.
Last medically reviewed on September 11, 2023
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