There are a lot of factors to consider when shopping for a new mattress. As a physical therapist, though, there are three key features I think you should focus on when choosing a mattress.
From my expert perspective, your main goal should be to find a mattress that supports the natural curve of your spine, reduces pressure points, and enhances your overall sleep quality.
Ahead, I’ll explore each of these factors in-depth to help you select the perfect mattress for you—and your back.
What to look for in a mattress, according to a physical therapist
1. Neutral spine position
A mattress should support the natural curves of your spine—especially the cervical, thoracic, and lumbar regions—while keeping your body in a neutral position.
This prevents unnatural twisting, which can lead to pain or discomfort. When lying on your back, your head, shoulders, and hips should align.
For side sleepers, the mattress should allow the hips and shoulders to sink in enough to maintain spinal alignment without causing an excessive curve in the lower back.
According to the American Chiropractic Association, the ideal sleeping posture requires the spine to remain aligned in a neutral position, which reduces stress on the vertebrae and intervertebral discs. [1]
2. Firmness level
A medium-firm mattress is typically ideal for most people, though this can vary depending on body weight and preferred sleeping position.
A mattress that’s too soft may cause excessive sinking and poor alignment, especially for back and stomach sleepers. Conversely, a mattress that’s too firm can create pressure points on the shoulders, hips, or lower back. [2]
Here’s a breakdown of ideal firmness level by sleep position.
- Back sleepers: A medium-firm mattress is often best to support the natural curves of the spine.
- Side sleepers: A slightly softer mattress may be better to reduce pressure on the shoulders and hips.
- Stomach sleepers: A firmer mattress can prevent the lower back from arching excessively.
3. Pressure and pain relief
A mattress that provides proper pressure relief can reduce the likelihood of developing pressure sores or exacerbating musculoskeletal pain. Memory foam is often recommended for its ability to distribute body weight evenly and relieve pressure.
According to a small study in the Sleep Science journal, memory foam mattresses have been shown to reduce pain and improve sleep quality in older individuals with chronic pain. [3]
FAQs
What mattresses do physical therapists recommend?
Physical therapists often recommend mattresses that promote spinal alignment, such as medium-firm options or memory foam mattresses. These provide balanced support and pressure relief for various sleep positions.
What qualities should I look for in a mattress?
Choose a mattress that maintains a neutral spine position, offers the right firmness for your sleep style, and reduces pressure points.
What type of mattress should I avoid if I have back pain?
Avoid overly soft mattresses that cause excessive sinking and poor alignment as well as overly firm ones that create pressure points on the hips, shoulders, or lower back.
References
- American Chiropractic Association. (2019). “Sleeping Positions and Spinal Health.” https://www.acatoday.org
- Kovacs, F. M., et al. (2003). “The effect of mattress firmness on chronic low back pain.” Journal of Chiropractic Medicine, 2(3), 127-133. 10.1016/S0140-6736(03)14792-7
- Ancuelle, V., et al. (2015). “Effects of an adapted mattress in musculoskeletal pain and sleep quality in institutionalized elders.” Sleep Science, 8(3):115–120. 10.1016/j.slsci.2015.08.004