The best mattress for back pain in 2023, recommended by an osteopath


Should you sleep on a hard or soft mattress with back pain?

“If you look at all the research that has been done on mattresses and back pain, medium-firm comes out as what you should have,” says osteopath Dave Gibson. “Firm, but not rock-hard. Remember, though, there’s no official grading of firmness. What one manufacturer calls firm, another might call medium-firm.”

Heavier people generally need firmer support, whereas lighter people can get away with softer mattresses. Whether you sleep alone or with a partner also has a bearing on your choice of mattress. You both want to be able to turn round without disturbing each other or adopting unhealthy sleeping postures.

To find the best mattress for you, Gibson suggests first lying on one in-store. “Although you won’t be able to tell if it will help with your back pain, you will be able to tell if it’s too firm or too soft for your liking, so that can be worth doing as a first step.

“But a better way to spot a good orthopaedic mattress is to see how long a trial the manufacturer will give you. Some do up to a year’s trial.  If they can afford to do that, you can be fairly sure it’ll be a good one. Certainly get one with at least 30 day’s free trial, because some of the research has shown that it takes four weeks for people’s back pain to reduce when they switch to a new mattress.” 

Which type of mattress is best for back pain?

Memory foam or hybrid mattresses contain foam that moulds to your body as you sleep, so are likely to have a slightly softer, more cocoon-like feel. “Memory foam mattresses these days will probably have two or three layers of foam,” Gibson says. “At the top will be open-cell foam, which has more breathability. That’s a big advance over older memory foams which held your body temperature.”

Traditional pocket-sprung mattresses might offer better weight distribution and feel slightly firmer (although there are sub-categories of firmness). Hybrid mattresses combine a layer (or multiple layers) of memory foam with pocket springs.

Gibson is skeptical of claims to be “contoured”, with different support zones for your shoulders and hips, because so much depends on the weight of the sleeper, among other factors. He also believes one of  the best things you can do to improve your sleep is to rotate or flip your mattress: “You’ll be blown away by how different it feels.” 

Finally, his biggest piece of advice is the simplest: get a bigger bed. “When you’re sleeping as a couple in a double bed, you’ve each only got the space that a baby in its cot would have. Someone with lower back pain needs to move around. What you need is a superking. Most of the research that you see on sleep quality indicates that the bigger the mattress, the better you sleep.”

How long does a free trial for a mattress last?

Mattress companies don’t offer ‘free’ trials: they sell you the mattress and allow you to return it for a refund if you decide it’s not for you. The periods can be very long: Emma offers 200 days while Simba, Tempur and Nectar offer up to one year. There is no set period, however. Some smaller mattress manufacturers offer 30 days or no trial period at all.

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