When it’s taken you ages to fall asleep, only to toss and turn all night, the sound of your morning alarm can be painful enough. It’s even worse when literal pain is what’s preventing you from getting a good night’s rest.

You’ve tried everything: sitting up straight, buying an ergonomic desk chair, going to the chiropractor. Nothing is working. The pain is still there, day after day, night after night.

Could your mattress have something to do with it? It’s certainly possible.


Identifying and Diagnosing Back Pain

Most people will experience back pain at some point. According to research from Georgetown University, chronic back pain (that lasts for 12 weeks or longer) affects about eight percent of American adults. It’s one of the most common reasons employees take sick days and one of the leading causes of disability worldwide.

While some people may experience pain in multiple regions simultaneously, for most, discomfort is concentrated in the lower, middle, or upper back.

Back pain causes vary from musculoskeletal disorders to occupation and lifestyle. The location of your pain may provide some clue as to what’s causing it.

Lower Back Pain

Many different circumstances can lead to lower back pain. For example, some people are born with skeletal irregularities, such as scoliosis, lordosis, or spina bifida.

Sprains and traumatic injuries, and degenerative problems, such as arthritis, spondylosis, or intervertebral disc degeneration, are also common. According to the National Institute of Neurological Disorders and Stroke, nerve and spinal cord problems, including sciatica, spinal nerve compression, spinal stenosis, herniated or ruptured discs spondylolisthesis, infections, fractures, and osteoporosis may be to blame as well.

Other causes may include obesity, poor posture, endometriosis, fibromyalgia, tumors, or pregnancy. Improper lifting techniques or sitting for prolonged periods may contribute to lower, mid, or upper-back pain too.

Middle Back Pain

Mid-back pain occurs in the thoracic spine located between the neck and bottom of the rib cage. Most of the same issues that cause lower back pain—including scoliosis, sprains and trauma, degenerative problems, sciatica, fractures, ruptured discs, poor posture, obesity, and fibromyalgia—can all contribute to mid and upper back pain as well.

Kidney trouble, especially kidney stones, may cause pain just below the rib cage, affecting either the lower or middle back or both.

Upper Back Pain

While poor posture can affect all back areas, the upper spine is particularly vulnerable because slouching can create quite a bit of pressure on the neck and shoulders. Whiplash is another leading cause of neck and upper back pain.

Aside from where the pain is located, there are three main categories of back pain: nerve or neuropathic pain, muscle and ligament pain, and bone and cartilage pain, as explained by Spine Universe.

  • Nerve or Neuropathic Pain: As Spine Universe explains, nerve or neuropathic issues typically cause shooting or radiating pain. Often, the pain travels from the lumbar spine to the legs or cervical spine to arms and hands. Herniated discs are often the cause of this kind of pain because the misplaced disc tissue can exact pressure on the nerve roots. To solve this issue, a doctor will need to relieve stress on the nerve.
  • Muscle Strains and Ligament Sprains: Similar to sprained ankles, muscle strains or ligament sprains in the back typically occur from trauma or strenuous activity and are exacerbated with specific movements. Such injuries usually resolve on their own with time and “RICE” (rest, ice, compression, and elevation).
  • Bone Pain: Bone pain is less common than nerve or muscle and ligament issues. Fractures are typically immediately recognizable, causing sharp, severe pain. But other problems, such as osteoporosis, may cause a constant ache, as Spine Universe explains. Besides osteoporosis, which increases the risk of compression fractures, other far less common causes of bone pain include infections and certain types of cancer.

With so many potential back pain causes, it is essential to seek professional medical advice to determine the source of your pain. Most issues are not life-threatening or even particularly dangerous (although painful), but even so, they can significantly impact your health and wellbeing.

Back Pain Relief and Treatment Options

The first step in back pain treatment is determining the problem’s source. But even if you’re not yet sure, you can use these suggestions to find back pain relief.

Yoga and other exercises for lower back pain can be very effective. Moves that strengthen the abdominal and back muscles are particularly beneficial as a stronger core can better support the spine, leading to better posture and less pain. Some of the best yoga poses and stretches for lower back pain include downward facing dog, cat-cow, cobra pose, sphinx pose, and child’s pose.

Illustration of man and woman doing back stretches

Walking and swimming can help as well, as these are low-impact, whole-body exercises that can improve overall fitness. Shedding excess pounds may also help take some pressure off the spine and joints, providing pain relief.

Over-the-counter pain relievers, such as aspirin, Tylenol, or Ibuprofen, may assuage some of your discomforts. Hot or cold packs, a hot water bottle, or topical pain relief balms and gels can help too. If the pain is intense, your doctor may prescribe prescription medications, including pain relievers or muscle relaxers, depending on the source of the issue.

Many people find chiropractic care an effective, safe form of back pain relief. Massage and acupuncture are also commonly used in upper, middle, and lower back pain treatment as well.

If you’re experiencing severe symptoms, you may need to take it easy for a couple of days. Try lying on your back with a pillow or rolled-up blanket under your knees to support a neutral spine position for lower back pain relief.

You can also lie on the floor with your knees bent at a 90-degree angle, propped on the couch or a chair. Just be sure not to be sedentary for too long, as this can do more harm than good. If pain has not subsided after a couple of days of rest, talk to your doctor.

If none of the above have helped, your doctor might recommend treatment options such as cortisone injections, an anti-inflammatory, to address neuropathic pain.

Radiofrequency neurotomy and implanted nerve stimulators are other options, which involve interfering with neurological pathways responsible for transmitting pain signals from the body to the brain. Traction, a technique used to re-align misplaced spinal discs, ultrasound therapy, and transcutaneous electrical nerve stimulation (TENS) are also potential back pain treatment options.

In some cases, surgery may be necessary, although this is usually a last resort.

How Your Mattress Can Help or Hurt Your Back

The Wrong Mattress Can Exacerbate Back Pain

Low-quality mattresses, old mattresses, and those that are not the right firmness, design, or material for your body type may exacerbate or even cause back pain, especially in the low and mid-back.

Poor sleep posture can have just as much effect on spinal health as slouching during the day. Likewise, lack of spinal support from your mattress may worsen spinal misalignments and strain the muscles.

Too-soft mattresses and those that have deteriorated over time tend to be worst in terms of supportiveness. On the other hand, a too-firm bed could push the hips and shoulders too far, inhibiting spinal neutrality and exacerbating pain.

The Right Mattress Can Offer Support

A quality mattress of just the right firmness, on the other hand, can contribute to back pain relief and better overall health. The best mattress for back pain is one that supports a healthy sleep posture and overall body alignment. Below are some more tips on choosing a quality model.

Mattress Shopping Tips for People with Back Pain

Determining which mattress is best for you will depend mainly on personal preference. But certain types are better than others, especially for those with musculoskeletal problems. Here’s how to choose the best mattress for back pain.

1. Identify Your Pain Points

As with determining the best overall treatment plan, identifying and diagnosing the source of the problem is the first step to finding the best mattress for back pain. Pinpoint your problem areas and keep these in mind as you shop.

2. Shop with Your Sleeping Position in Mind

Your sleep position plays a role too. Sleeping on your side, back, or stomach puts pressure on particular parts of the body.

Certain mattress types and firmness levels are more conducive to certain sleep positions than others. Side sleeping is the most common, but sleeping on the back is often recommended as the healthiest position for back pain sufferers.

If you sleep on your side, propping your knees or mid-section up with a rolled-up blanket or pillow may assist you in maintaining better spinal balance and relieve pressure points. Of course, a good mattress can help too.

3. Understand Contouring vs. Pressure Relief

When reviewing mattress descriptions, you’ll likely find many products that have contouring and pressure relief properties. The terms, often used in conjunction, are both critical for back pain sufferers.

Contouring is usually associated with memory foam and involves a reactive material that conforms to the body’s shape.

On the other hand, pressure relief refers to an ergonomic design feature intended to take pressure off pain points such as the hips or shoulders. Some manufacturers accomplish this with an added layer of material, while others shape the mattress or its inner components in such a way as to provide different levels to support different body parts.

Memory foam is usually ideal for back pain sufferers, while traditional innerspring mattresses are most likely to exacerbate discomfort and pain. Latex is typically a good middle-ground, providing less contouring than memory foam but more even pressure relief than innerspring models.

4. Look for Zoned Support

Zoned support consists of built-in “comfort zones” and distinct levels of support at different parts of the mattress. These mattresses tend to be a bit more expensive, but they can be well worthwhile for people with back pain and other sources of discomfort.

These mattresses typically have the highest degree of support around the back and stomach and softer, contouring sections to gently cushion the hips and shoulder area.

5. Read Reviews From People Your Weight

Bodyweight and composition also factor into determining what mattress will be ideal for you. Someone of average weight who is a side sleeper needs about three inches of comfort layer cushioning for a perfect night’s rest.

However, someone who is much lighter may not need quite as much. On the other hand, a heavier person will likely want more layers, as their body will compress further into the mattress.

To get an accurate idea of how well a mattress could work for you, look for reviews from customers of a similar weight to yourself. Also, look for mattresses that come with a good sleep trial (at least 30 days), so you can try it out for yourself risk-free.

Pain-free Nights for Better Days

The quality of your sleep can significantly impact your day and, more importantly, your overall health. Investing in a quality mattress is just one piece of the puzzle when it comes to finding pain relief and a good night’s sleep, albeit an important one. For more tips on choosing the best mattress for your body, talk to your chiropractor or physician.