With most of us spending nearly a third of our lives in bed, it's no surprise that you might start side-eying your mattress when your back hurts. What may surprise you, though, is that the best mattress for back pain isn't the firmest bed you can stand, but typically a medium to medium-firm model that keeps your spine in a neutral position while relieving pressure points.
For years, the advice was simple: the firmer the mattress, the better your back.1 More recent research suggests otherwise. A randomized controlled trial found that medium-firm mattresses reduced lower-back pain more effectively than firm ones,2 while a systematic review on sleep ergonomics shows that maintaining a neutral spinal posture while sleeping minimizes strain on the lower back.3 In other words, both support and pressure relief are important to keep your spine aligned.
When shopping for the best mattresses for back pain, you want a balance between support and pressure relief that aligns with your weight and sleeping position. Proper support is particularly important for back and stomach sleepers, while side sleepers usually need extra pressure relief, since more weight is concentrated on their arm and hip. You'll want to look for mattresses made with durable materials to avoid having to replace them every few years. Research shows that replacing an older or sagging mattress can significantly improve both back pain and sleep quality, so your worn-out mattress is likely contributing to your back pain.4
We've tested over 50 mattresses, and below are our recommendations for the best mattresses for back pain. Our recommendations are primarily based on our data-driven testing and research into how mattresses affect back pain, but we also consider price and product availability. For more guidance, check out our 'What To Look For' guide below and learn how to use our tools to find a mattress for back pain. If you're interested in seeing other options, check out our recommendations for the best mattresses for cooling, the best memory foam mattresses, and the best latex mattresses.
We've recently started testing mattresses. We purchase each unit independently from major retailers, just like you, to keep our reviews free of manufacturer influence. Each mattress undergoes the same tests to measure objective data on characteristics like firmness, cooling, and motion isolation, so you can easily compare results. Since we buy all our mattresses, we can tear them down layer by layer and isolate the mechanical properties of every component: quilted tops, foams, coils, and any special materials.
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Best Mattress For Back Pain
Firmness LevelMedium (44 Pa/mm)Support7.3Pressure Relief7.9Longevity6.8Side Sleeping7.8Back Sleeping7.5See all our test resultsStomach Sleeping7.3The best mattress for back pain that we've tested is the Novaform Serafina Pearl. This all-foam, memory foam mattress's 'Plush' variant has a Medium feel and offers a balance of pressure relief and support for people with back pain. The soft memory foam and polyfoam upper comfort layers allow you to sink in quite deeply, while a firmer support layer helps the mattress provide satisfactory support for most people. The comfort layers provide enough cushioning for pressure relief, but you'll sink in evenly, which helps keep your spine aligned and prevents back pain caused by your mattress. This makes it well-suited for a range of back sleepers, but it's also a good option for side sleepers in the average and heavier weight categories.
This mattress is also a good choice if you're concerned about long-term back support. It's entirely made of dense, good-quality foam, which will help it resist signs of wear like sagging for longer and maintain the support your back needs over time. Its all-foam design makes it a great choice for couples, since it does a fantastic job of isolating motion, reducing the likelihood that you'll be disturbed by your partner's movements. That said, it's not a bouncy mattress, which can make it harder to change sleeping positions. Also, while it's cooling enough for most people, if sleeping hot is often a problem for you, you may want a mattress that dissipates heat a bit more efficiently.
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Best Mattress For Side Sleepers With Back Pain
Firmness LevelMedium (44 Pa/mm)Support7.2Pressure Relief8.3Longevity6.8Side Sleeping8.2Back Sleeping7.4See all our test resultsStomach Sleeping7.2If you're a side sleeper with back pain, consider the Helix Midnight Luxe 2025. This hybrid mattress has a Medium feel but offers better pressure relief than the Novaform Serafina Pearl, which is especially important for side sleepers with back pain, since more weight is concentrated in the smaller areas of your hips, arms, and shoulders. While it's not as supportive for average-weight and heavier individuals, it still offers decent support across a range of weight categories, helping keep your spine aligned while side sleeping. The durable comfort layers will resist permanent impressions and sagging longer than lower-quality foams, helping the mattress maintain its support performance over time.
The mattress's quilted layer and memory foam comfort layer give it an enveloping but responsive feel, so you'll feel like you're sleeping 'in' the mattress but won't feel stuck in place. Its bouncy feel also makes it easy to shift to a more comfortable sleeping position if your back is bothering you.
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Best Mattress For Stomach Sleepers With Back Pain
Firmness LevelMedium (46 Pa/mm)Support7.6Pressure Relief7.9Longevity6.3Side Sleeping7.9Back Sleeping7.7See all our test resultsStomach Sleeping7.6If you're a stomach sleeper with back pain, we recommend the Tuft and Needle Mint. Support is particularly important for stomach sleepers with back pain, since you need extra support for proper spinal alignment if you sleep on your stomach. If you're not properly supported, your hips can sink in, causing your back to arch and contributing to back pain. While a firm mattress might offer enough support, finding one with Medium or Medium-Firm support recommended for back pain is more challenging. This mattress has the same Medium firmness level as the previous picks, but offers better support regardless of your weight. Its plush comfort layers allow you to sink in evenly, helping to keep your spine in a neutral position without sacrificing pressure relief.
The sleeping surface doesn't contour around you very closely and has a responsive feel, so it's not a hugging or enveloping mattress, and you won't feel stuck in place. That said, its lack of bounce can make changing sleeping positions feel a bit more difficult. That said, it offers fantastic motion isolation, making it a great option if you sleep with a partner who tosses and turns. About half of the foam in the mattress is dense enough to be considered good quality, so while the upper comfort and support layers will resist sagging, the layers in between could compromise the support and pressure relief you need to avoid back pain over time.
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Most Durable Mattress For Back Pain
Firmness LevelMedium (47 Pa/mm)Support7.0Pressure Relief7.2Longevity7.6Side Sleeping7.2Back Sleeping7.1See all our test resultsStomach Sleeping7.0If you want to avoid a sagging mattress making your back pain worse after a few years, you'll want a more durable option, like the Big Fig Mattress. While all the mattresses we recommend above are at least moderately durable, this one stands out. This hybrid mattress features four foam layers made from good or high-quality foam, making it one of the most durable mattresses we've tested. This will help it resist showing signs of wear longer than mattresses made with lower-quality materials, so you can sleep easily knowing it won't be the cause of your back pain for a long time. Otherwise, it has a Medium feel and is designed for heavier individuals, with Big Fig claiming a 1110-lb weight rating.
This mattress isn't as versatile as previous picks, and despite its marketing, it's not quite supportive enough for heavier (or average-weight) back and stomach sleepers with back pain. It's supportive enough for heavier and average-weight side sleepers, and offers better support for lighter people, making it a good option for back/stomach sleepers in that weight category. Otherwise, its bouncy, responsive feel makes it easier to switch to a more comfortable sleeping position, and its great motion dissipation makes it well-suited for sleeping with a partner. However, its cooling performance is just decent, so it's not a good option for hot sleepers.
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Best Cheap Mattress For Back Pain
Firmness LevelMedium (42 Pa/mm)Support7.5Pressure Relief7.3Longevity6.7Side Sleeping7.4Back Sleeping7.4See all our test resultsStomach Sleeping7.5If you need a budget mattress for back pain, consider the Casper Cooling Select. This cheap, Medium all-foam model includes a zoned transition layer with a firmer feel in the lumbar area, which helps prevent your hips from sinking in overly far and keeps your spine in the neutral position you want to reduce back pain caused by your mattress. Its satisfactory support for most people makes it a good option for back sleepers, and while lighter people may need more pressure relief for side sleeping, it's also well-suited to average-weight and heavier side sleepers.
This mattress isn't very enveloping, but it has a responsive, somewhat bouncy feel, so you won't feel stuck in place. Its excellent motion dissipation means you won't feel your partner's movements all over the mattress. Despite the lower price, it's reasonably durable, and even includes a layer of high-quality memory foam. The good- and high-quality foam layers will help it resist sagging and forming permanent indentations, which can compromise a mattress's support performance and ultimately worsen back pain. However, while its cooling performance is very good, if you often sleep hot, it may not be cooling enough.
Notable Mentions
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Saatva Latex Hybrid:
The Saatva Latex Hybrid is a high-end Firm mattress. While Medium and Medium-Firm mattresses are generally recommended for back pain over Firm ones, you might prefer it to the Novaform Serafina Pearl for its durability. While its firm feel means it won't offer enough pressure relief for some, it's a strong option for heavier back, stomach, and side sleepers, who will compress the mattress more.
See our review -
Bear Elite Hybrid:
The Bear Elite Hybrid is a high-end Medium-Firm mattress. Like the Novaform Serafina Pearl, it's a good option for back sleepers with back pain in a range of weight categories, and its more responsive sleeping surface is less likely to make you feel stuck in place. However, its layers of low-quality foam make it much less durable, so it's likely to sag and become less supportive sooner.
See our review -
Allswell Hybrid:
The Allswell Hybrid is an inexpensive Medium-Firm mattress with better support for lighter people than the Casper Cooling Select, making it a great option for stomach sleepers in that weight category, since it'll do a better job of keeping your spine aligned. It's also more cooling, but uses lower-quality foam, so you can't count on it to maintain its support performance for as long.
See our review
What To Look For In A Mattress For Back Pain
Focus on a few measurable factors that affect spinal alignment, pressure relief, and long-term support. Firmness is a helpful consideration, but alone, it's not a reliable indicator.
Firmness
Use firmness as a guide, not a rule. For most people with back pain, Medium to Medium-Firm mattresses (42–58 Pa/mm normalized stiffness) provide the best balance of support and pressure relief, but factors like body weight and composition can shift the scales. Generally, the more you weigh, the firmer your mattress needs to be. You can check out all of our reviews of Medium and Medium-Firm mattresses.
Spinal Alignment
Regardless of the mattress's overall firmness level, the most important factor is whether it keeps your spine in a neutral position.
We measure this in our Support test, which evaluates how evenly you sink into the mattress at different weight thresholds. Mattresses with a lower indent difference for people in your weight category will do a better job of preventing your hips from sinking in too far. Look for a mattress with a Support score of 7.5 or higher for your weight category, which indicates consistent support between your upper body and pelvis, and reduced risk of misalignment.
Pressure Relief
A mattress must also reduce pressure at the shoulders, hips, and lower back to prevent discomfort and shifting during sleep.
We recommend a Pressure Relief score of 7.5 or higher for your weight category, especially for side sleepers who place more weight on smaller contact areas.
Sleep Position Performance
Depending on your sleeping position, you'll need a different balance of support and pressure relief. We have weight-specific scores so you can see how each mattress performs for your body type and sleeping position.
Aim for scores of 7.5 or higher for back, side, or stomach sleeping. If you're a combination sleeper or you and your partner sleep in different positions, aim for good scores for all sleeping positions, indicating balanced support regardless of posture. This confirms the mattress performs well across positions rather than excelling in only one.
Back sleeping is the position most likely to help with back pain3, but you'll still want a mattress with enough support to keep your hips from sinking, without having an overly firm feel.
If you sleep on your side, pressure relief is even more important, since more weight is concentrated on smaller areas of your hip and shoulder. Whether side sleeping is good or bad for back pain may depend on how you sleep; putting a pillow between your knees or keeping one leg straight1 may be more supportive side-sleeping positions.
Stomach sleeping is more likely to make back pain worse3, so if it's most comfortable for you, a supportive mattress that prevents your back from arching is crucial.
Durability
Poor-quality, low-density foams are the chief cause of mattress sagging, which reduces support and worsens back pain over time.
Look for a mattress that includes at least some layers of good-quality foam:
- Polyfoam: > 26 kg/m³ (1.6 lbs/ft³)
- Memory foam: > 48 kg/m³ (3 lbs/ft³)
- Latex: > 48 kg/m³ (3 lbs/ft³)
These typically indicate better resistance to body impressions and sagging.
However, it's worth noting that many mattresses on the market use mostly or entirely lower-quality foam. If you can't find a durable model that suits you or your budget, it might be worth choosing a slightly firmer option, since lower-quality foams are more likely to soften over time.
Further Reading
If you're just beginning your mattress search, you might be interested in our broader How To Choose A Mattress article, which is also available as a video on our YouTube channel. To know more about mattress firmness and how we test it, check out our firmness guide. Finally, you can read more about our sleeping position scores for different weight categories.
Citations
1. Sweetman, B. J., & Sweetman, S. J. (2015). Various types of sleep disturbance due to different sorts of low back pain: 5: A clinical database analysis. International Musculoskeletal Medicine, 37(4), 153–163. https://doi.org/10.1179/1753614615Z.000000000112
2. Kovacs, F. M., Abraira, V., Peña, A., Martín-Rodríguez, J. G., Sánchez-Vera, M., Ferrer, E., Ruano, D., Guillén, P., Gestoso, M., Muriel, A., Zamora, J., Gil del Real, M. T., & Mufraggi, N. (2003). Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial. Lancet (London, England), 362(9396), 1599–1604. https://doi.org/10.1016/S0140-6736(03)14792-7
3. Saini, Y., Rai, A., & Sen, S. (2025). Relationship Between Sleep Posture and Low Back Pain: A Systematic Review. Musculoskeletal care, 23(2), e70114. https://doi.org/10.1002/msc.70114
4. Jacobson, B. H., Boolani, A., & Smith, D. B. (2009). Changes in back pain, sleep quality, and perceived stress after introduction of new bedding systems. Journal of chiropractic medicine, 8(1), 1–8. https://doi.org/10.1016/j.jcm.2008.09.002
All Reviews
The recommendations above represent the best mattresses for back pain for most people. We factor in performance, availability, and user feedback.
However, everyone has different needs and preferences when it comes to mattresses. Your needs depend on your weight, sleeping position, and personal priorities, such as cooling for hot sleepers or motion dissipation for light sleepers. If you'd like to choose for yourself, here's a list of all of our mattress reviews.