Is An Orthopedic Mattress The Best For A Bad Back?

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Sandi Toskvig and Alan Davies could fill a whole episode of QI discussing mattresses. Admittedly it would not be a ratings-winner but there are numerous myths and misconceptions about the mattress market. They have also gone past series M but let’s not worry about that.

For example, how many springs would you expect to find in a 1000 pocket spring single mattress? It’s certainly not 1000. It’s more like half that as the number relates to how many you’d fit on a king size mattress.

Woman being given a massage
Will an orthopedic mattress help you look after your back?

Supportive rather than firm

One of the most enduring myths is that people with a bad back should have a very firm bed. I’m not a chiropractor but after starting to read mattress guides online I quickly realised that it’s not that simple. 

The British Chiropractic Association and the Sleep Council both say that what you actually need is a ‘supportive’ bed. For some people, that will be a firm mattress. For other people it will actually be quite a soft mattress.

Following the science

Back in 2003, academics in Spain carried out an interesting piece of research with about 300 participants. It was called ‘Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial’. The researchers were Kovaks, Abraira et al.

Some were given firm mattresses whilst others were given ‘medium-firm’ mattresses. The people taking part had some back issues. Patients were those who ‘had chronic non-specific low-back pain, but no referred pain, who complained of backache while lying in bed and on rising.

After 90 days, patients were assessed and the following conclusion was reached:

‘A mattress of medium firmness improves pain and disability among patients with chronic non-specific low-back pain’. 

Kovaks, Abraira et al, 2003

In more detail, the study found that those with the medium firm mattresses had less pain in bed and during the day.

‘Patients with medium-firm mattresses had better outcomes for pain in bed…pain on rising… and disability…than did patients with firm mattresses’. The medium firm users had ‘less daytime low-back pain…pain while lying in bed…and pain on rising…than did patients with firm mattresses.’

Kovaks, Abraira et al, 2003

Real-world application

Here’s key to getting a mattress that will look after your back.

Find one that creates a nice straight spine when you are lying on your side.

With a firm mattress, an 8 stone jockey will not sink into the bed enough so the spine will end up curvy. One guide I read said your spine would resemble a frowny face. Similarly, an 18 stone wrestler will be swallowed up by a soft mattress. They would need something firmer to help keep their spine straight.

The position that you usually sleep in plays a part in deciding how a firm a mattress you need. Side sleepers should go for softer mattresses than people who sleep on their front or back. This is because a very firm mattress will put a lot of pressure on your hips and shoulders if you are sleeping on your side.

You can achieve a straight spine with a memory foampocket sprung or latex mattress. Several bed comparison websites conclude that a good quality memory foam or latex mattress has the potential to offer superior support. However, you can certainly look after your back with a decent pocket sprung mattress.

The charity Versus Arthritis says that ‘many people find memory foam mattresses or toppers helpful’. Obviously that advice is specific to arthritis rather than bad backs in general.

The hard mattress myth is confused further because some manufacturers offer a mattress which they describe as ‘orthopedic’. It sounds kind of scientific and medical, much like those shampoo adverts with diagrams of hair strands. However, what it usually means in the mattress market is that it is extra firm. There’s no blanket rule that it will be the best option for your back. 

Confusing labelling

Another weird quirk of the mattress market is that no-one has ever decided what ‘firm’ or ‘soft’ actually means. One company’s ‘soft’ could be the same as another company’s ‘medium’ mattress. It’s much the same way that a medium t-shirt from one shop might be a large t-shirt in another. There is something called the ‘European Committee for Standardisation’. However, I’ve only seen passing mentions of it in relation to a 1-10 mattress firmness scale in academic papers. 

That’s terribly confusing for the mattress buyer, particularly if you buy something online. One option is to buy from a bed shop. However, they may not stock that award-winning mattress which you’ve read about. Alternatively, you can buy it online and hope that it is the right level of firmness for you.

Some mattresses offer a free return after a month or two of sleeping. See our guide to mattresses with a risk free trial for suggestions.

I’m rather too British and would be reluctant to return it unless it had completely fallen apart. 

A useful starting point

Here’s the best advice I’ve found online after many (many) hours of reading.

Put your hand flat underneath your back whilst lying on the bed. If you can’t fit your hand in, it’s too soft. If there’s a huge gap then the bed is too hard for you.

I’d like to see more bed companies offering a rating which explains that ‘this bed is ideal for people who weigh 10-12 stone’ or something similar. Vispring are one of the few companies to offer this. They recommend soft for up to 11 stone, medium for 11-16 stone and firm for 16 – 20 stone. They suggest extra firm for 20 stone+.

Until then, we’ll have to settle for awkward trips to the bed shop where we attempt to work out if our spine is straight.