From the Guidelines
Mattress firmness can significantly impact patients with lumbar pain, and a medium-firm mattress is generally recommended for optimal results. According to a study published in the Annals of Internal Medicine 1, firm mattresses are less likely to lead to improvement in patients with chronic low back pain compared to medium-firm mattresses. For patients with low back pain, choosing the right mattress firmness is crucial. Key considerations include:
- Testing different firmness levels to find the most comfortable option
- Looking for mattresses with a trial period to ensure long-term comfort
- Considering individual sleeping positions, as side sleepers may prefer slightly softer mattresses and back sleepers slightly firmer ones
- Ensuring the mattress provides adequate support to prevent sagging and maintain proper spinal alignment The ideal mattress firmness is often rated around 5-7 on a 10-point firmness scale, providing a balance between support and pressure relief 1. This balance helps distribute body weight evenly, reducing pressure points and maintaining the natural curve of the spine, which can lead to less pain and stiffness upon waking and throughout the day. While personal preference plays a role, and individual results may vary, the evidence suggests that a medium-firm mattress is a good starting point for patients with lumbar pain. Patients should pay attention to how they feel after sleeping and adjust their mattress firmness accordingly.
From the Research
Mattress Firmness and Lumbar Pain
- The relationship between mattress firmness and lumbar pain has been investigated in several studies, with varying conclusions:
- A study published in 2003 found that medium-firm mattresses (H(s)=5.6) resulted in better outcomes for pain in bed, pain on rising, and disability compared to firm mattresses (H(s)=2.3) 2.
- A systematic review of controlled trials published in 2015 suggested that a medium-firm mattress, custom inflated, is optimal for promoting sleep comfort, quality, and spinal alignment 3.
- A pilot randomized controlled study published in 2018 found that an innovative mattress overlay used as an add-on treatment to standard rehabilitation improved pain, perceived back disability, sleep, spine mobility, and lumbar multifidus size and structure in patients with low back pain 4.
- Earlier studies, such as one published in 1981, found that hard beds were preferred by patients with chronic low back pain and resulted in improved symptoms and signs 5.
- Another study published in 2008 found that waterbeds and body-conforming foam mattresses were superior to hard mattresses in reducing low back pain and improving daily function and sleep 6.
Key Findings
- Medium-firm mattresses may be more beneficial for patients with lumbar pain than firm mattresses 2, 3.
- Custom inflated mattresses and innovative mattress overlays may also be effective in improving sleep quality, pain reduction, and spinal alignment 3, 4.
- The optimal mattress firmness for patients with lumbar pain may vary depending on individual preferences and needs.
- Further research is needed to fully understand the relationship between mattress firmness and lumbar pain.