I tested the best mattresses for back pain and sleep quality in 2024 – here’s what I discovered. This article was written in paid partnership with SBLY eCommerce Brands.
First, What Can Cause Back Pain When You Sleep?
After doing a ton of research, I found that back pain while sleeping can be caused primarily by the following.
- Spinal Misalignment
- Pressure Points
- Incorrect Firmness
(1) Spinal Misalignment
If your spine isn’t in neutral spinal alignment when you sleep, you have a much higher likelihood of waking up with back pain.
Most mattresses are one consistent firmness throughout the mattress – however, most of our bodyweight lies in our torso. This can cause your midsection to sink into the mattress and misalign your spine.
In order to have neutral spinal alignment, you need a mattress that is the right firmness AND that has zoning (but more on that later).
(2) Pressure Points
If you don’t have a mattress that distributes your pressure across your body, it can lead to pressure points, especially in your joints and other bony parts of your body. If you sleep with these pressure points, you also have a much higher likelihood of waking up with back pain.
(3) Incorrect Mattress Firmness
According to research, the best mattress for back pain is one that is medium firm – too firm or too soft is not good, but you definitely want a mattress on the firmer side:
Results of this systematic review show that a medium-firm mattress promotes comfort, sleep quality and rachis alignment.
Source:
Results of a Systematic Mattress Health Study
Essentially, if you want to truly eliminate back pain while sleeping, the science says there are a few essential elements a mattress needs to have:
- Medium-Firm Feel (Balanced Support). To specifically deal with back pain, you need a mattress that isn’t too soft or firm. That “goldilocks zone” in the middle is known as “medium-firm” and is the best for back pain.
- Pressure Point Relief. Your body doesn’t have even weight distribution, which means certain parts of it press into the mattress harder. Your shoulders, hips, head, and lower back all need to be cradled and supported to effectively reduce pain.
- Spinal Alignment. Keeping your spine in a neutral position is extremely important to overall health, not just back pain. An unaligned spine leads to pain, headaches, nerve damage, tingling, and a whole lot more. A proper mattress should maintain neutral spine positioning and keep things aligned, no matter the sleep position.
So, I went and tested 8 of the top mattresses for back pain to see which one was the best. My list ranks each one based on:
- Back Pain Relief
- Comfort
- Quality
- Customer Service
- Value
So, for any mattress I looked at, these are some of the benchmarks that I basically required since doctors and the current data show these things to work the best for back pain:
-
Spine Alignment
If your spine isn’t aligned, it causes a host of other issues. The best mattress should promote neutral alignment.
-
Medium-Firm Feel
Medium-firm is scientifically regarded as the best option for back pain and overall sleep comfort.
-
Pressure Relief
Different areas of your body need different levels of support, and the best mattresses have variable pressure point zones and relief.
-
Trial Period
It’s ok to not love something. We think a generous trial period lets you try our an investment as large as a mattress with little risk.
After trying them all out, here’s which ones I liked, ranked!
The Final Winner:
Back Pain Reduction / Support
10/10
Return policy / warranty
10/10
✓
Actually helped my back pain
✓
Provided neutral spine alignment
✓
Pressure-point memory foam
✓
3-Year Extended Warranty
After my reviews and testing, I can confidently say that the Dosaze DreamAlign Pro Back Relief Mattress came out on top. I was really shocked by how comfortable AND supportive this mattress was. I used to toss and turn constantly during the night, but this mattress kept me in place and helped to support my neck and spine in some transformative ways. Plus, it was just plain comfortable, and I always woke up feeling well-rested!
Here’s an example of me using my old mattress (on the above right). I often woke up with pain and had a lot of painful pressure points from the springs pressing into my ribs, ankles, and shoulder.
The Dosaze DreamAlign Pro Back Relief Mattress mattress is designed for neutral spine alignment. This essentially means that your spine is always in the right position and not under stress, as is the case with some other mattresses. For back pain and headaches, this is a game-changer since most of the time, your neck or back feels strained as you “sink” into one side or are raised “too high” by a too-firm mattress on the other.
Also, the balanced support played a big role in choosing this mattress as my favorite. The latest science says that balanced support is the best way to prevent back pain while you sleep. If a mattress is too soft or too hard, it can cause and even worsen back pain. Medium-firm support is a great balance that is still comfortable while holding strong, a balance that none of the other mattresses seemed to be able to achieve.
Plus, there was some underlying tech of the mattress (that I couldn’t see), which was the variable coils and the pressure-point memory foam. Variable coils make sure that the mattress is perfectly tuned since different areas of your body need different density levels from the mattress. Then, the pressure-point memory foam targets key areas on your body to cushion and support.
On top of that, Dosaze offers one of the most generous trials we’ve seen, which extends for 120 days and offers no-hassle returns.
I don’t think there are any other mattress companies that go as far as Dosaze to deal specifically with back pain.
Runner Up:
Back Pain Reduction / Support
9/10
Return policy / warranty
8/10
✓
high-quality materials
X
Extremely expensive for the features
X
Too plush for back-pain relief
The Saatva Classic is a great mattress, but boy, are they expensive without providing justification for it. They have some great customer service, and what I can find online reflects that. I found the mattress to be rather plush, which is a good thing to some and a bad to others. Personally, I don’t think that plushness is a bad thing… EXCEPT when you are dealing with back pain. The science is pretty clear that medium-firm is ideal, and something that feels a little too plush doesn’t deal with my issues in the way that I need.
Also, there is almost no movement isolation, so if you sleep with a partner and either one of you are light sleepers, beware (I learned about this from experience, unfortunately). Overall, the mattress is fine, but it isn’t anything special.
Cheaper Pick:
Back Pain Reduction / Support
7/10
Return policy / warranty
8/10
X
Not particularly back pain oriented
Nectar is another large brand that has appeared in the last few years, and I had heard of them before the test. I reviewed the memory foam mattress, which, as I understand it, is their standard mattress. It does come with a premium upgrade, but I didn’t opt for that this time around.
The mattress is significantly lower priced than the Saatva. That being said, it also feels like it is at its price point. Generally, this means its value is average, not above average. I found that to be true with the Nectar Memory foam, and that’s not a slight. It was fine. Just fine. There aren’t any special features, no cooling benefits, and no back-pain-centered technology. Overall, if you want a cheap mattress, you could go with the Nectar.
Luxury Pick:
Back Pain Reduction / Support
8/10
Return policy / warranty
8/10
X
no back pain specific features
X
need extra upgrades for medium-firm density
I had heard of Avocado from the brand’s mattress covers, but had never actually tried their mattresses until this review! The brand is known for higher-end products, and a queen-sized mattress from them is around $1,999. The mattress was pretty solid! This is quite expensive, but that’s basically what you can expect when you get something from Avocado.
It’s extremely comfortable and doesn’t require a mattress topper, which is a good thing in my book. It is extremely heavy, so if you like rotating your mattress every few months, you may need an extra person to help. It does use latex, plus organic wool and cotton, so if you have any allergies, it’s definitely something to be aware of (wool and latex both can cause allergies in some people).
BUT, there is an unfortunate catch. To get the proper “medium firm” density, you need to shell out an additional $680. Altogether, this brings a queen-sized total to over $2,799 pre-tax. That’s a hefty price tag, indeed.
Helix Midnight Luxe
From my research, the most prominent mattress for dealing with back pain from Helix is the Midnight Luxe, and it seems that the company pushes it as such. That being said, has some sneaky pricing. $2,373 before taxes is probably standard, but if you want cooling and the ErgoAlign layer, it’s going to be an additional $500. This brings the total to nearly $3,000 for a Queen, which puts this mattress on the higher-end of things.
That said, this mattress has plenty of other features. It offers zoned lumbar support via steel coils, special supporting foam, and a medium firmness ideal for back pain. Overall, I felt like this mattress was absolutely comfortable, and I loved it. The sad thing is that it’s just so expensive it’s hard to justify it. Especially when you can get something nearly identical with our number one pick.
Tempur-Pedic Adapt
The Tempur-Pedic Adapt collection is a line of mattresses specifically targeted at back pain relief. We all know about Tempur-Pedic, and they have quite a reputation in the sleep business. There are three versions: Adapt, ProAdapt, and LuxeAdapt. The cheapest of them all, the Adapt, runs you $2,199, while the ProAdapt costs $3,400 and the LuxeAdapt costs $4,299. For all but the bottom option, things are going to be pretty expensive.
I reviewed the standard model, the Adapt, since that seemed to be the most reasonable of them all. Overall, the mattress is great. It has pressure relief and a cooling cover and offers two versions, Medium and Medium Hybrid. If you like famous brands and are willing to pay a little bit more for them, Tempur Pedic is a solid option, albeit not unique in the field anymore.
Tuft & Needle Mint
Tuft & Needle is a mattress that I have a lot of experience with since I slept on one for years before moving a while back. Overall, it’s a good mattress with some decent features. It does make some compromises, but if you aren’t looking for the “best” back pain relief or anything, it’s a good option.
The Mint version offers adaptive support with foam edges, pressure relief foam, medium-firm feel, and some cooling elements like graphite. This is the middle-priced option of T&N’s lineup, with the Original and Mint Hybrid being the other two. The only issue I have with the Mint is that the mattress could be a little firmer to help with back pain. The Original has the correct feel for back pain, but the Mint has the features for back pain; you so have to compromise, unfortunately.
Also, this isn’t a hybrid mattress like many of the other options on our list. Essentially, this means that it only uses foam in its construction, and doesn’t have any springs, coils, or other long-term elements that can provide support. This is reflected in the price, but keep in mind you are losing a major facet of a mattress.
Casper Dream Max
The Dream Max is reportedly the most supportive mattress version coming from Casper. Casper is a well-known and generally well-liked sleep company, and the Dream Max was a solid mattress to review from them. The mattress was created for back pain, after Casper saw some success with the Nova and Wave Hybrid.
Unfortunately, we again run into issues with price. For middle-priced mattresses, the Casper is quite expensive, coming in at $3,125 without any discounts. You do get a lot for the cost, like medium-firm feel, breathable foam, and zoned support, but to be honest, the Dosaze DreamAlign Pro Back Relief Mattress once again gives you more for less.
Purple Restore Mattress
Purple has three “lineups” when it comes to mattresses: the Essential, Restore, and Rejuvenate. As far as I can tell, the Restore is intended to be the mattress that deals with back pain and sleep issues, so it’s the one I reviewed. There are three price points within the Restore lineup: the Restore, RestorePlus, and RestorePremier, of course.
The cheapest, basic mattress from purple will run you $2399, which is a little crazy. The Plus and Premiere are $2,699 and $3,299, respectively. Purple uses latex in their mattresses, which gives them a particularly bouncy feel that people may have to get used to, or be aware of if you have allergies.
As far as features go, the Purple has the famous grid pattern, along with core body support and alignment elements, but only on the two higher-end ones. Altogether, I like the way these mattresses feel, but you have to push over the $3,000 mark to get anything that’s actually designed for back pain. If budget isn’t an option, however, they are great!
