3 Things to Look for in a Mattress, According to a Physical Therapist

When choosing a mattress, physical therapists say you should prioritize spinal alignment, appropriate firmness, and pressure relief. Look for one that maintains a neutral spine position, supports your body based on your sleep style, and reduces pressure on joints. Medium-firm options often suit most sleepers, while memory foam is ideal for relieving pain and improving sleep quality.

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]

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Luxurious body-hugging feel and pressure relief with 3” of ultra-premium, high-density 5-lb memory foam.

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Memory Foam Hybrid Mattress

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Zenhaven Latex Mattress

Natural latex responds to every curve for pressure-free support and responsive comfort. Natural latex is supple, resilient, and durable, for the ultimate in elevated sleep. (It’s naturally hypoallergenic too.)

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Latex Hybrid Mattress

This hybrid mattress combines the pressure-free support of natural latex with the classic innerspring feel. Handcrafted with pure materials for the ultimate in cool and healthy sleep.

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Saatva Rx Mattress

Specially designed to give maximum support and pressure relief that can help alleviate discomfort associated with serious and chronic back and joint conditions like sciatica, arthritis, herniated disc, and scoliosis.

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Saatva HD Mattress

This luxury hybrid innerspring mattress is specifically engineered to support people weighing between 300 and 500 pounds. Plush upper layers made of foam and latex deliver comfort, while a high-durability coil base offers support.

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Solaire Adjustable Firmness Mattress

Featuring precise 50 firmness settings on each side of the bed for personal customization. Natural latex and gel-infused memory foam layers provide luxurious comfort and support.

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

  1. American Chiropractic Association. (2019). “Sleeping Positions and Spinal Health.” https://www.acatoday.org
  2. 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
  3. 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

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