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Shopping for the best mattress for lower back pain can be overwhelming. Soft or firm? Springs or foam? Here are our picks to help you narrow it down.

If you experience aches and pains first thing in the morning and suspect your old, unsupportive mattress is the culprit, you might be right.

When your mattress is saggy, uneven, or even too hard, your spine may not get the support it needs to remain in a neutral position while you sleep. A lack of support can mean lower back pain in the morning, or even longer if not treated.

If you’re searching for a mattress to help prevent a sore lower back, this list can help you narrow down your search and give you tips and guidelines for what to look out for while you shop around.

Why you can trust us

A 2015 study suggests that medium-firm, self-adjustable mattresses effectively promote comfort, so we looked for the best when creating our list.

In addition to screening each product through our intensive vetting process, we considered federal flammability regulations and material certifications like CertiPUR-US and OEKO-TEX. We also identified the industry standard for best practices to make sure the mattresses we chose are, at baseline, safe and good quality.

We considered the brands’ reputation, making sure there are no ongoing, debilitating lawsuits. We made sure the customer reviews for each mattress were generally high. We also confirmed that our picks had at least a few weeks for at-home trials and warranties so you have the option to send the mattress back if it’s not working out.

Here are more details about how we score mattresses.

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DreamCloud Hybridhybridmedium firm$1,332lifetime
Helix Midnight Luxehybrid medium firm$2,373.8015 years
Helix Plushybrid medium firm $1,498.8015 years
Puffy Cloud Mattressfoammedium firm $2,399lifetime
Saatva Solairehybridadjustable$4,495lifetime
Saatva Loom & Leafmemory foamrelaxed firm, firm$2,395lifetime
Birch Luxe Naturalhybridmedium firm$3,24825 years
Casper The Onefoammedium firm$1,29510 years
Nolah Natural 11-Inchhybridluxury firm$2,099lifetime
Molecule 1memory foammedium to medium firm$899lifetime

“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,” she says.

“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.

Firmness options

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,” Moreland says.

Soft or plush mattresses likely won’t provide enough support, but it’s also important to avoid mattresses that are too firm. The manufacturer’s firmness rating can help you zero in on a supportive option. Medium-firm mattresses, which have a rating of 7–8, are typically recommended for lower back pain.

Sleeping positions

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 be the only ones who could benefit from a fairly firm mattress to avoid their hips and pelvis from sinking.

Other things to consider

  • 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.

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.”

Moreland advises two sleeping positions. If you’re a side sleeper, use a pillow between your knees or a body pillow between your arms and legs. If you’re a back sleeper, lay with a pillow beneath your knees for a slight bend.

“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.”

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.

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 healthcare professional. 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.

Use pillows

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.

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.

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.

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.