DEAR DOCTOR K:
I have chronic low back pain. What type of mattress should I use?
Considering that we spend roughly a third of our lives lying in bed, this is a very good question. And you’d think medical science would have a very good answer.
I asked my colleague, Dr. Jeffrey Katz, professor of medicine and orthopedic surgery at Harvard Medical School, for his thoughts. He noted that there’s not a great deal of research on this topic, but a few studies offer some guidance.
In the past, doctors often recommended very firm mattresses for people with back pain. These are sometimes called “orthopedic mattresses” because they were widely recommended by orthopedic surgeons when I was in medical school. That was at a time when virtually no research had been done on the question. Doctors simply had opinions — sometimes strong opinions. And sometimes the worst kind of strong opinions: wrong strong opinions.
Dr. Katz cited one study in which 313 people slept on a medium-firm or firm mattress for three months. Those with the medium-firm mattresses reported less pain when lying in bed as well as less pain-related disability compared with those with the firm mattresses.
Another report surveyed 268 patients with low back pain and found that patients sleeping on orthopedic (very hard) mattresses experienced the poorest sleep quality. But patients experienced no difference in sleep quality between medium and firm mattresses.
A softer mattress that conforms to your body’s natural curves may help your joints align favorably. “Memory foam” mattresses fit this description well. But you might also sink in so deeply that your joints twist and become painful during the night.
Dr. Katz usually advises his patients to try sleeping on many different mattresses and beds to see which type feels best. For example, if you spend a night at a hotel or someone else’s house, note how you feel after sleeping on the “new” bed. You might also try placing a plywood board under your current mattress to dampen any movement from bedsprings. Or put your mattress on the floor to simulate the feeling of a firm bed. Before buying a new bed, go to a mattress showroom and try a variety of different models.
Finally, pay attention to your sleeping position. Sleep on your side if you can, and bend your knees toward your chest a bit. Also, choose a pillow that keeps your head level with your spine. Your pillow shouldn’t prop your head up too high or let it droop.
You asked what type of mattress is best for people with low back pain. My basic answer is: Try different types of mattresses and see which seems best for you.
You may be thinking: Dr. K spent all those years in medical school so that he could tell me that?
But all those years of medical training have taught me one thing: People are different. Studies tell us what’s best for the average patient in the study. But like the children of Lake Wobegon, you are certainly not average!