From the Guidelines
Patients with lumbar pain should use a medium-firm mattress, as firm mattresses are less likely to lead to improvement. The American College of Physicians and the American Pain Society recommend considering the use of a medium-firm mattress for patients with low back pain, as it can help maintain proper spinal alignment while providing enough cushioning to reduce pressure points 1.
When selecting a mattress, patients should consider the following factors:
- Test different mattresses for at least 15 minutes each
- Consider their sleeping position (side, back, or stomach)
- Look for mattresses with good pressure relief and spinal alignment features
The reasoning behind this recommendation is that a medium-firm mattress can help reduce muscle tension and improve sleep quality, which are both important factors in managing low back pain. It's essential to note that individual preferences may vary, and some patients might find more relief with slightly softer or firmer mattresses. However, based on the available evidence, a medium-firm mattress is the most recommended option for patients with lumbar pain 1.
Key characteristics of an ideal mattress for patients with low back pain include:
- A firmness level between 5-7 on a 10-point scale
- Good pressure relief and spinal alignment features
- Adequate support and comfort to reduce muscle tension and improve sleep quality
By choosing a medium-firm mattress, patients with lumbar pain can potentially alleviate their symptoms and improve their overall quality of life. As stated in the guideline, firm mattresses are less likely than a medium-firm mattress to lead to improvement in patients with chronic low back pain 1.
From the Research
Mattress Firmness and Lumbar Pain
- The firmness of a mattress can affect patients with lumbar (lower back) pain, with medium-firm mattresses showing better outcomes for pain and disability than firm mattresses 2.
- A systematic review of controlled trials found that a medium-firm mattress, which is custom inflated, is optimal for promoting sleep comfort, quality, and spinal alignment 3.
- The use of an innovative mattress overlay as an add-on treatment to low back pain rehabilitation has been shown to improve pain, perceived back disability, sleep, spine mobility, and lumbar multifidus size and structure in patients with low back pain 4.
Comparison of Mattress Types
- A study comparing three structurally different mattresses found that a waterbed and a body-conforming foam mattress seemed superior to a hard mattress in reducing low back pain and improving daily function and sleep 5.
- Another study found that advice to rest in bed is less effective than advice to stay active for people with acute low back pain, with little or no difference between bed rest and staying active for patients with sciatica 6.
Key Findings
- Medium-firm mattresses are associated with better outcomes for pain and disability in patients with chronic non-specific low-back pain 2.
- Custom inflated medium-firm mattresses are optimal for promoting sleep comfort, quality, and spinal alignment 3.
- Mattress overlays can be an effective add-on treatment to low back pain rehabilitation, improving pain, disability, and sleep 4.