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 the best mattress for back pain.
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.
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.
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.
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.
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.
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.
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.
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.
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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 the 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.
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 you’re lower back to be forced into end of range extension.
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:
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.