Many people wake up in the mornings with lower back or neck pain, and it’s almost always due to their mattress. You may know your mattress isn’t right for you, but it can be difficult to know what to look for. Here’s everything you need to know about choosing a mattress to prevent back pain.

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1. The shape of your spine is the most important element of mattress support

Your spine is an incredibly strong structure, comprised of 30 different vertebrae. Vertebrae are small bones that connect to each other like building blocks from your tailbone to the base of your skull.

Your neck is comprised of seven cervical vertebrae that span from the base of your skull to the center point where your shoulders begin. Your neck, or cervical spine, has a concave shape known as a lordotic shape. This is why it’s important to support your neck during sleep with the correct sized pillow for your body.

From your neck, your spine becomes your middle back or thoracic spine which spans all the way down to your lower back. Your thoracic vertebrae attach to your ribs, making this part of your spine a convex or slightly kyphotic shape.

Your lower back, or your lumbar spine, runs from L1 to L5 where it joins your sacrum and then coccyx. Your lower back has a natural arch, making it a concave or lordotic shape.

When you add the concave shape of your neck to the convex shape of your middle back plus the concave shape of your lower back, you get an ’S’ shape.

Your spine’s ’S’ shape must be maintained by your mattress, otherwise, the structures in your spine can be placed under excessive strain causing soreness

2. The firmness of your mattress matters

When a mattress is too hard or too soft, the natural ’S’ shape of your spine can become compromised. Because of this, mattress firmness is almost always the culprit of morning back pain.

A. What happens when a mattress is too hard?

Very hard mattresses aren’t only uncomfortable, they put excessive strain on your lower back. When lying on your back on a very hard mattress, the natural arch of your lower back is forced to increase, placing increased load through your L3,4 and L5 vertebrae.

This can cause the facet joints of the vertebrae to become stiff and unable to slide on one another properly. Facet joints need to slide to enable you to move from lying to sitting, to standing, and if they’re stiff, these movements will become painful.

You may feel very stiff and sore when you transition from a lying position, to sitting on the edge of your bed in the morning on a hard mattress

If you sit at a desk all day for work, you will likely have tight hips too, which compounds the effect of loading the lower back on a hard mattress.

B. What happens when a mattress is too soft?

Soft mattresses may feel luxurious when you first snuggle onto them, but after a few hours, your spine’s natural curves will be forced to sag, causing an excess load to be placed on the joints within your spine.

If you’re lying on your back on a soft mattress, instead of the mattress supporting the lordotic shape of your lower back, it sags into a convex or slumped shape. As your lower back is not designed to spend long periods in orientation, the discs and facet joints within your spine will become irritated. The same will happen when lying on your side, but the sag will occur laterally.

When you get up from sleeping on a soft mattress, your lower back will ache after sagging into the mattress

3. How to know which level of firmness suits your spine

As you age, your spine loses some of its flexibility. If you sleep on a soft mattress but have very little range of motion in your lower spine, your lower back will not sag significantly as it doesn’t have the available movement.

  • If you have significant mobility loss of your spine and suffer from significant spinal stiffness, a slightly softer mattress may suit you best.
  • Conversely though, if you have very mobile joints; you will need a mattress that is moderately firm. If your mattress is too hard, your lower back will arch too much, but if it’s too soft; your lower back will sag too much.

4. Sleeping positions can influence back pain

Sleeping on your back

You’ll know if your lower back is in a good position if you can only just fit your hand in the arch of your lower back. When lying on your back on a well-suited mattress, your spine can easily maintain its natural ’S’ shape, so if you’re a back sleeper, your spine will thank you for it.

Handy tip for back sleepers: If you find your mattress is quite hard and forces your lower back to arch excessively, try placing a pillow underneath your knees. This reduces the arch of your lower back and restores your natural spine position.

Sleeping on your side

If you sleep on your side with your knees bent up, your lumbar spine will be curved and you’ll lose the natural arch of your spine. If you have irritated lumbar discs from years of desk work without seeking treatment, they can get slightly pinched in this position and cause pain and stiffness.

Conversely though, if you have facet irritation of your lower spine; eased throughout your day by sitting and bending forwards; your spine will feel better after sleeping on your side vs. lying on your back.

Handy tip for side sleepers: Try not to bend your knees too much and your lower back will maintain its natural arch even on your side.

When I had neck and back problems I slept on our guest bedroom mattress and loved it so much we replaced our sleepnumber bed with a Nuvanna mattress. They are amazing! I recommend them to everyone!

Andrine John

Published on Friday, May 4, 2018

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Is sleeping on your stomach bad for your back?

No, but it is bad for your neck. Take a moment and sit with your head turned as far to one side as you can. You will feel you want to return your head to center after a few moments. When sleeping, this position is maintained for hours! Stomach sleeping causes a lot of force on the facet joints of the cervical spine and is a common cause of neck pain and headache, particularly in people over 50 years old.

If you’ve been sleeping on your stomach all your life and you just can’t change, that’s OK. Ensure you choose a very thin pillow to minimize the extension force on your cervical spine.

Sleeping on your stomach is only bad for your lower back on a very soft mattress, as it causes your stomach to sag into the mattress and your lower back to be forced into end of range extension.

How to choose a mattress for your back in a nutshell

When choosing a mattress if you’re not sure how flexible your spine is; a medium firm mattress is often the best option. By adding a good quality base, you can enhance the integrity of your mattress and add extra support to your spine.

When you find a mattress you like, test the support with these steps:

  • Lie in your favorite sleeping position
  • Place your head on a pillow and place hand on your neck and observe the shape of your cervical spine
  • Then place your hand on your lower back and feel the shape of your lower spine

If the mattress has allowed your spine to maintain its natural ’S’ shape, it will work for you.

Remember, everyone’s spine is different, you need to choose the best mattress for your body.