Soft or Firm: Top 4 Factors You Need to Consider When Buying a Mattress if You Have Back Problems

Soft or firm? Most health experts in the know say that the best mattress is the one that makes you most comfortable. However, research claims that mattresses of medium firmness yield the most painless sleep.

In a study published by The Lancet, the world’s leading independent general medical journal claims the same. The researchers randomly placed the 313 people who had a backache into either a firm or a medium mattress. They evaluated them for pain reduction and disability after 90 days.

They found out that participants who sleep in medium-firm mattress had significantly less pain and disability throughout the study compared to participants in the firm mattress.

Dr. Michael Perry, medical director of the Laser Spine Institute in Tampa, Florida agrees that medium-firm mattress is the way to go. However, he added that for those with spine pain, one size does not fit all. A number of factor needs consideration.

Mattress With Pillow

Your Medical Status

If you have a spinal condition, selecting a mattress is about more than just how hard or soft the item is, Perry says. Medical history needs some consideration so you can tailor the mattress to your needs.

Perry recommends asking questions like your medical conditions and your current diagnosis or diagnoses. For example, for people with spinal stenosis, selecting a mattress is not a big issue. The symptoms of this condition are present only when you are standing or walking. If this is you, the best mattress would be the one that makes you feel comfortable the most.

However, it’s a different issue if you have degeneration along with stenosis. For example, if you have spinal arthritis without stenosis, disc problems or non-specific back pain, consider purchasing a firmer mattress.

For people who had undergone multiple surgeries, sleep support may not be necessary. Several surgeries could alter the tissues making them stiffer. If this is you, softer mattress best fit you.

Your Sleeping Position

The sleeping position also makes a difference when selecting a mattress. Depending on your what type of sleeping position you are comfortable with, whether you buy mattress online or in any store, Dr. Perry had some recommendations:

Side Sleepers:  For this sleep position, Perry recommends a slightly softer mattress such as one from the Tempurpedic brand. The foam is made to conform with your body especially in the thoracic and lumbar regions of the spine.

Stomach Sleepers: A medium firm bed surface is recommended for stomach sleepers. A softer mattress might irritate the back as it encourages the abdomen to sink into the bed. It will increase the arch in your low back and cause pain.

Back Sleepers: For back sleepers, medium-firm mattress is recommended. A mattress that is too soft will not keep the body in straight line. A too rigid mattress will put undue pressure on the neck and back. For extra support, put a thin rolled towel or pillow under the knees and low back, Perry recommends.

How Old is Your Mattress?

Mattress springs break down over time making your bed softer. Dr. Perry warns that this can aggravate a patient’s back.

In a study published in the Journal of Manipulative and Physiological Therapeutics measured the pain, spine stiffness and quality of sleep in 22 adults. The researches give them a new and “prescribed” bedding system for 28 days. They found out that the new and prescribed bedding mattress improve all the three measures significantly. For this reason, sleep surfaces do relate to sleep discomfort and replacing it will help reduce the pain

The mattresses we sleep on were not designed to last forever. The research found that the usual lifespan of a mattress is roughly eight years, but it varies by the type of mattress and manufacturer. Consider purchasing a new one when your mattress is old and visibly sags in the middle.

Your Personal Preference

Basically, the one size fits all does not apply in choosing a mattress. Any mattress that makes someone feel the most comfortable and allows him to sleep without pain and stiffness is the best mattress for him.

The best way to buy a mattress is to make your own research and base it on your particular need for support and comfort. Understand the physical components of the mattress, ask and have the seller explain each layer.


Wrong mattress choice can cause or worsen lower back pain. If the mattress does not match the individual preference, sleep comfort is also sacrificed. Choose a mattress that provides comfort and back support that supports proper spine alignment allowing you to enjoy the rest of the night.

Remember that we spend a third of our lives in bed and our mood in the morning is sometimes dictated by the sleep quality we get on the night. With this being said, choosing the right mattress is really a big issue. Read the tips above to avoid regrets with your purchase.