How do I know if my mattress is causing my back pain?

If you wake up with stiffness or pain that eases as the day goes on, your mattress could be to blame. Over time, sagging or uneven areas can throw your spine out of alignment – and if your mattress is pushing a decade, it’s probably time for a refresh. “Signs to look out for include visible sagging of the mattress, feeling unsupported in your usual sleep position, and noticing pressure on points such as in your hips, shoulders, and lower back,” says chiropractor Philippa Oakley. “Some of my patients tell me they can even see a body outline of where they sleep on the mattress – a sure sign that it needs changing!”

Even if it looks fine on the surface, your mattress may not be giving you the support you need. “Back pain caused by a mattress is typically down to the mattress failing to hold your spine in the proper alignment throughout the night,” explains Emma sleep scientist Theresa Schnorbach. “This leads to your back being put under undue pressure.”

Should you sleep on a hard or soft mattress with back pain?

A mattress that aligns your spine and cushions your pressure points can make all the difference, and for most people, that sweet spot lies somewhere between medium-firm and firm. “It’s important to pick a mattress with a level of firmness that allows for proper spinal alignment while you sleep,” says Hannah Shore, sleep expert at Silentnight. “The wrong level of support can quickly lead to aches and pains.”

But firmness isn’t one-size-fits-all. As Philippa Oakley puts it, “Much like Goldilocks, there’s a mattress for each of us that’s just right. Everyone will have slightly different preferences, and other factors like our body type, age, and sleeping posture will all play a role in what mattress you need to choose. Research suggests a medium-to-firm mattress is most often suited for people with musculoskeletal (MSK) pain, but the best mattress is the one that lets you wake feeling supported, not strained.”

So where does that leave us? Start with a quality mattress that keeps your spine’s natural curves in check. Firmer options tend to do the heavy lifting for sore backs and aching joints, while anything too soft may leave you feeling worse by morning. The key is a balance of comfort and support that works for your body – and lets you wake up without the wince.

How can you prevent back pain while sleeping?

Preventing back pain at night starts with getting your alignment right. “Try lying on your side and checking if your spine stays straight — your pillow height and mattress support play a key role in this,” says Hannah Shore. A firm but comfortable mattress helps maintain spinal alignment, and placing a pillow between your knees (or behind them, if you’re lying on your back) can ease lower back pressure. For neck pain, the right pillow is essential — one that supports your natural curve rather than forcing your head too high or letting it drop too low.

But spinal alignment isn’t the only factor. “Sleep plays a key role in reducing pain sensitivity,” says Philippa Oakley. “Beyond the usual suspects of sleep positioning and using pillows to support between or behind your knees, good sleep hygiene is key.” That means a regular routine, limiting screen time before bed, and keeping your bedroom dark and cool.

A good stretch before bed can help ease stiffness and tension that has built up throughout the day, she adds. “If you’re struggling, consider trying a different sleep surface temporarily (like a guest bed or mattress topper) to see if it improves your symptoms, or work with a healthcare professional, like a British Chiropractic Association chiropractor, who can assess your sleep habits as part of a broader, personalised treatment plan.”

In short? A bit of self-care, the right sleep setup, and a supportive surface can go a long way.

How long does a free trial for a mattress last?

It depends on where you’re buying from, but a typical mattress trial period will last between 30 and 100 nights — with some luxury brands even extending it to as long as a year. Also, it’s worth noting that it’s definitely not a ‘free’ trial — it’s just an extended period of time that you can return the mattress and get a full refund if you decide its not the right model for you.

How should I sleep with lower back pain?

“Generally speaking, sleeping on your back or side are the best options as both of these positions are less taxing on your spine than sleeping on your stomach,” Schnorbach explains. Can’t get to sleep if you’re not lying on your front? Help the spine stay in alignment by opting for a thin pillow under your head, and placing a more supportive pillow under your hips and abdomen to help prevent your lower back from sinking into a U-shape. This should help reduce some strain.

A top tip for back sleepers is to place a pillow under your knees to help support your spine’s natural curve, whereas side sleepers may benefit from tucking a pillow between their slightly bent knees to help ensure proper hip alignment, and reduce pressure on the lumbar region. Different sleeping positions require different types of pillows — so make sure you pick one that’s the right height, and helps keep your head aligned with your spine.

It’s also worth getting into the habit of incorporating a gentle stretching routine before bed to relax your muscles. And for overall wellbeing – including your spinal health – it’s good to maintain a consistent sleep schedule.

What type of mattress is best for the spine?

“Your sleep position will have a big impact on which mattress type will best support you,” Schnorbach explains. Here’s everything you need to know about the three most common types of mattress, including which one is best suited to which specific sleeping styles.

1. Memory foam

A pressure-absorbing material pioneered by NASA, memory foam has quickly become one of the most popular mattress materials. Ensuring spinal alignment by allowing heavier body parts like to sink deeper — while also removing excess pressure from the joints and hips — foam mattresses offer the perfect balance of sinkage and support, and are therefore a popular pick amongst side sleepers suffering with back pain and other orthopaedic issues. However, side sleepers who are taller or heavier will likely require more support — and back and stomach sleepers will definitely need a firmer sleeping surface.

2. Pocket sprung

Made up of thousands of tightly coiled springs that respond individually to any movement, pocket sprung mattresses are generally firmer — with a higher number of springs or coils equating to a higher level of support. Engineered to support the natural curvature and alignment of the spine, pocket sprung mattresses don’t provide the famous ‘sinking in’ experience of memory foam — but they can still generally be found in a wide range of different firmness levels. Providing optimal stability and pain relief for the lower back and lumbar region, pocket sprung mattresses remain the most popular orthopaedic pick amongst back and front sleepers — as well as side sleepers who are taller or have a heavier build.

3. Hybrid

Constructed with foam layers and innerspring coils, hybrid mattresses are known for their excellent pressure relief and motion isolation, and can be a godsend if you’ve been putting up with irritating back pain for far too long. Hybrid models tend to be great all-rounders, so if you’re struggling with your back but your partner isn’t, they’ll reap the sleep quality benefits, too — including preventative care. Due to their complex makeup and mix of materials, hybrid mattresses often come with a higher price tag, so if you’re looking to treat your back pain in the immediate, you may have to wait to save up your pennies.