Is a Firm or Soft Mattress Better for Back Pain?

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Statistics say that an estimated 16 million Americans struggle with chronic or acute, daily back pain. Back pain is one of the most common health conditions, and it can happen due to hereditary conditions like arthritis, or injuries.

Pain and discomfort are common for people with back injuries or conditions related to the spine. Symptoms can build up over a day’s worth of tension and stress, but back pain often becomes worse throughout the night and in the early morning.

The way in which you sleep – and what type of mattress you do most of your sleep on – has everything to dow ith what your back is going to feel like when you wake up.

It turns out that there’s no single answer for everyone, even though their symptoms might be similar. There are different types of sleepers, and there are different levels of injury or discomfort. For example, there are side-sleepers with hip pain, or front-sleepers with lower back pain.

For a comfortable night’s sleep, it’s extremely important to seek the right balance between mattress firmness and comfort. The mattress you choose for your sleep also has to be one that matches up with the type of injury you have (and when it doesn’t, that’s when people toss and turn all night).

Here’s everything to know about the different types of mattress firmness and how it defines the way you sleep.

What is Mattress Firmness?

Waking up with neck pain
Choosing a mattress that best supports your particular sleep style and body type is paramount to easing discomfort.

Mattress firmness is an element that defines different mattresses on the market.

The firmness is something you can feel, but also something that the manufacturer of the mattress can calculate during the making of the individual mattress.

Mattress firmness is the amount of softness and “sinking in” you will feel when you sit or lie down on the mattress top, versus not.

Most mattress companies and retailers categorize their mattresses by the different levels of firmness. People have different preferences for how hard or soft they prefer to sleep, and some injuries might also show preference for one or the other.

If you buy a mattress specifically for back pain, the level of firmness and support will matter almost as much as the budget you can afford to pay for it.

Firmness vs Support: What’s the Difference?

Firmness and support are two terms that you will see often whenever mattresses are talked about, but they are not the same thing.

Firmness means firmness, and it exclusively refers to the amount of softness or hardness the mattress has.

Support on the other hand, is offered by other facets of the mattress: the type of fabrics used, the thickness of the memory foam used ,and the usually diamond-like pattern on many mattresses that add to the level of support it can offer the sleeping human body.

Mattress Firmness Guide Chart

All mattresses are not made or advertised the same.

Mattress firmness, measured in numbers, is one of the first criteria you will notice if you are shopping around for another mattress. Low numbers mean a softer mattress, while higher numbers indicate a firmer surface to sleep on.

Which firmness level you choose can be up to your sleeping position, or whether you are hoping to relieve back or hip pain. Most bedding companies use a scale of 1 to 10, with 1 being the softest and 10 being the firmest.

Every manufacturer will have its own scale, the mattress firmness scale below is what Saatva uses.

ScaleFirmnessSleep Position
3 – 4SoftSide Sleepers
5 – 7Medium FirmBack Sleepers
8+FirmStomach Sleepers

Is It Better To Sleep on a Hard or Soft Mattress For Lower Back Pain?

How to choose the best pillow for neck pain?
Many back pain sufferers think their best bet to reduce pain is sleeping on an uncomfortably firm mattress, yet experts say that’s not the case.

According to Harvard Studies, the most common myth about mattresses and firmness could be wrong. While experts have been recommending very firm mattresses to people with back pain for years, a survey of more than 250 people revealed the opposite.

Experts and even mattress manufacturers have been in a debate about mattresses for a long time, though science and surveys have brought us closer to the real answer.

According to the information from Harvard, most people part of the study reported that they actually preferred medium to soft mattresses for relief from back pain.

If you suffer from low back, hip or neck pain, a softer though supportive mattress (soft to medium firm) could be what you need – hard or ultra-firm mattresses could just lead to more discomfort than you can handle.

After having said this, it’s important to remember that the answer can still be very individual to things like your body type, your injury type and your weight.

For some people, the answer is a firmer mattress – while for others, the answer is a mattress with some more softness.

What are you supposed to do if you have already bought a mattress?

The good news for uncomfortable sleepers is that most mattresses can be adapted to be softer (or firmer) without having to go out and buy a whole new mattress.

How To Make a Firm Mattress Softer

Woman sleeping on her side on the bed
Side sleepers do best on a softer mattress.

If the mattress you bought is firmer than you would like it to be, here are four recommended ways to make the mattress a softer way to sleep:

1. Mattress Toppers

Mattress toppers are made from sponge or memory foam, and are created so they can fit over the top of any mattress that matches its size. Mattress toppers are, like mattresses, available in different sizes and levels of firmness.

If you would like a softer mattress, just include a mattress topper with a lower number. Memory foam toppers can relieve pressure, align the back and turn a harder mattress into soft.

2. Time

Firmer mattresses can sometimes just need to be “broken in” over a few weeks of use. Mattresses are naturally stiffer and firmer when they first leave the factory, though most mattresses settle into their actual grading in the first weeks of use.

If your mattress feels too firm out of the box, you might just need to give it some time.

3. Flip Around

Many mattresses are made to flip from one side to the other. If you have a mattress that allows for a flip, changing the side you sleep on from the top to the bottom can give you a softer way to sleep.

As the one end of the mattress experiences wear, the underside remains untouched – and can still give you a great way to sleep.

Air your mattress and vacuum it regularly to remove dust, particles, hair and odor. You can invest in a mattress protector, which will protect the mattress from stains and dust.

4. Memory Foam

Comfort Lift mattress topper
Lift Memory Foam Mattress Topper by Amerisleep™

Memory foam toppers like like the Lift by Amerisleep™ Mattress Topper are made from memory foam, and are usually thicker than regular sponge layers. If you would like to change a mattress from firm to soft, the right memory foam topper or cover could be what you needs.

Memory foam is a great alternative to a hard mattress, and some of them are even comfortable enough to be recommended for back pain.

How To Make a Soft Mattress Firmer

If your mattress has gone soft over time, there are just as many ways to bring back the firmness to a mattress if that happens to be what you prefer for a night’s sleep.

Here are four ways to make a soft mattress firmer.

1. Mattress Toppers

A plush or firm mattress topper made of memory foam
Nolah Mattress Topper, Firmness Plush by Nolah Sleep

The great thing about mattress toppers is that they can take you in either direction – from firming up a soft mattress, to softening up a firmer one. If you would like a firmer mattress, choose a topper that has a firmness number higher than that of your mattress like the Nolah Mattress Topper (Plush Firmness) for a good night’s rest.

2. Plywood Reinforcement

The softness of a mattress can have a lot to do with what’s going on under it, much like the Princess and the Pea – except, it can be excruciating at night and stop you from getting a great night’s sleep.

If you would like to firm up your mattress, place a piece of plywood between the mattress and the base to secure a harder sleeping surface or try placing your mattress on the floor.

3. Re-Layer

Mattress layers can wear out over time. If your mattress needs firming up and it’s not a recent purchase, it could be time to send your mattress in for a re-layering.

The process is much like reupholstering a couch, but instead made to spruce up older mattresses. Select manufacturers will let you select a firmness number for the end-result – and in this case, aim high for a firmer sleep.

4. Change the Base

Plywood isn’t the only solution that can cater to the base of your mattress and change the way you sleep. Switch out the base of your mattress for a different, harder one or place your mattress on a flat surface.

Changing the base can work especially well for older mattresses, or ones that you’ve had to flip to get more comfort out of.

Male sleeping on his stomach on the bed in his bedroom
Stomach sleepers do best on a firm mattress.

How Long Does It Take To Adjust To a New Mattress?

It can take anywhere from a week to three months to feel your body and back adjust to a new mattress. It can take about the same amount of time for a new mattress to adjust to your body – for example, as the springs or sponge settle to your individual shape.

If you have just bought a new mattress, wait at least one week before deciding if it’s a comfortable way to sleep. For most bed manufacturers and stores, this is well within their warranty period.

Finding Your Comfortable Sleep

Chronic low back pain significantly affects quality of sleep.

If you aren’t yet sure which type of mattress will be the best to alleviate low back, hip or neck pain, visit a bed store – or check a firmness chart like the one suggested above.

The best way to judge if your mattress is right is by listening to your body. If you start waking up with back pain every morning, it’s time to make adjustments or buy a new mattress.

Mattress toppers, memory foam and base adjustment can make all the difference when you’re trying to adjust a firm or soft mattress. The best way to judge if your mattress is right is by listening to your body.

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DisclaimerNothing on this website is intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The contents of this website are for informational purposes only.