Related to Back Pain Best Mattress for Lower Back Pain Study Disputes Long-Held Belief by Some Doctors That Firmer Bedding Is Better Nov. 13, 2003 -- For years, many people with back pain have been advised to sleep on a firm mattress. But a new study shows that might just add to the nightmare of their morning-after misery. Researchers in Spain say that people who sleep on a medium-firm mattress were twice as likely to report improvements in lower back pain compared to those sleep on more firm bedding. They reach this conclusion after replacing bedding of 313 patients with a history of back pain with new "firm" or "medium-firm" mattresses. The patients didn't know which mattress type they received. This study, published in the upcoming issue of the Lancet, is among the first to test the popular belief -- at least among some orthopaedic doctors -- that the firmer a mattress is, the better it is at preventing or relieving lower back pain. While there's little hard scientific data to support that firm mattresses are better -- only a handful of studies have been conducted -- the Spanish researchers say that about three in four orthopaedic doctors recommend firm mattresses to their patients.
In fact, a survey of Atlanta-area orthopaedic surgeons indicates that two in three said they recommend a firm mattress to their patients, and most believed that a mattress' firmness had a definite role in managing back pain. This finding, by Emory University orthopaedist Howard I. Levy, MD, was presented at the 1996 annual meeting of the American Association of Orthopaedic Surgeons. But chiropractors have long argued that firm mattresses are not the best choice, says George McClelland, DC, spokesman for the American Chiropractic Association. "Traditionally, what we have recommended is that a moderately-firm works best, or when using a firm mattress, you should add a 1½- to 2-inch thick padding on top of it," he tells WebMD. "It's wonderful to be validated by some form of research." McClelland says that this extra padding -- or using a medium-firm mattress without the extra padding -- better adapts to the natural curvatures in the spine. This padding is available at most stores that sell mattresses or bedding supplies.
"The spine is not a straight line, and padding or a moderately firm mattress 'gives' better to the concavities and convexities of the spine," he says. "A younger spine may tolerate a firm mattress perfectly well. But as we get middle years any beyond, when back pain is more prevalent, we find that more equalized support seems to be better." The researchers, led by Francisco Kovacs, PhD, who operates an independent medical research company in Palma de Mallorca, Spain, say that a medium-firm mattress leads to better "pressure distribution" when lying in bed, resulting in less pain while lying or after getting up. But McClelland and others say you also shouldn't use a soft mattress, because it doesn't provide enough support. "From my own perspective, if a mattress is soft or too hard, it's not comfortable," says orthopaedic surgeon Dana C. Mears, MD, PhD, of the University of Pittsburgh Medical Center. "Something in the middle works best for me -- a medium-firm mattress.
If a mattress is too firm, you might as well be sleeping on the floor." When buying a mattress, McClelland advises against relying on store ratings as an accurate guideline. "These numbers are all over the place," he says. "Individual companies use different rating systems, so you don't really know what you're getting." In fact, in the U.S., firm mattresses typically have a higher rating number; in Europe, a lower number goes to firmer mattresses. His advice: "When testing for a mattress, don't push on it or bounce up and down, as many people do. What's better is to lie on it for 10 minutes or so -- on your back, on your side, every way. It shouldn't be too hard. If it is, get some padding to place on top of the mattress."PureBliss 3" Latex MattressToppers, Latex Pillows, Waterproof Mattress Protector. EverEden talalay latex mattress topper on the too firm Simmons Beautyrest. ILD rating on soft and medium all natural EverEden talalay latex mattress toppers?A good night’s sleep can do wonders for exhaustion and a bad mood.
But if you continually wake up feeling anything but refreshed, your mattress could be to blame. The wrong kind of support can lead to lost zzz’s and exacerbate back pain — or even cause it. But with all the options available, choosing the right mattress can be a daunting task. With some luxury mattresses costing $4,000 or more, you may worry that you’ll have to liquidate your assets for a good night’s sleep. But experts say to rest easy on that count. “Price and name brand do not necessarily equal quality,” notes Michael Gleiber, M.D., an orthopedic spine surgeon and a spokesperson for the American Academy of Orthopaedic Surgeons. “More expensive mattresses may not be comfortable for every person.” With that in mind, check out our guide to mattresses and what to keep in mind when shopping for one. “In general, soft mattresses are felt to be less than ideal for the back,” says Raj Rao, MD, a professor of orthopedic surgery and neurosurgery at the Medical College of Wisconsin in Milwaukee.
However, if you sleep pain-free on a softer mattress, it’s fine to continue. “The trick is to find a mattress that's soft enough to conform to the natural curves of the spine, but firm enough to provide good support so you don’t sink down too far,” Gleiber says. Low-back pain might seem best served by a hard mattress, but a recent study published in The Lancet found that one with medium firmness offered better support and comfort. According to the American Chiropractic Association, a mattress should support the whole body, without gaps between it and the curves of the body (which can happen with a too-firm mattress). Don’t be seduced by the term “orthopedic.”It’s a marketing term with no standard definition, says Gleiber. Just because it’s labeled this way doesn’t mean it’s any better for people with back issues than a non-orthopedic mattress of similar construction. Related:How to Help Your Teen Get Enough Sleep These two constructions are the most common types on the market.
One isn’t necessarily better than the other, say experts. Innerspring mattresses contain steel coils covered with padding; memory foam versions are made from polyurethane or latex foam and mold to the shape of your body. (Memory foam is generally the more expensive of the two). Memory foam mattresses may not be as good for menopausal women or people who tend to get hot, however, judging from numerous complaints in online forums.The foam tends to hold more heat than the innerspring mattresses, which causes women who have hot flashes to kick off the covers. One solution is to look for a thin or latex topper, or to try some of the non-electric “chill pads” that have come on the market and are designed especially for women having problems with hot flashes. Don’t even think about sleeping on a futon or waterbed, especially if you have back issues.If you still have a futon hanging around from your single days, it’s time to give it the heave-ho. “Most futons are cheaply made and don’t provide the best lumbar support,” says Gleiber.
Waterbeds fall equally short, he says, noting that they’re especially inappropriate for people with conditions like chronic back pain and degenerative disc disease. Even if you do all your shopping online, when it comes to mattresses, it’s better to try them out at a store. Talk with friends or check social media reviews to find a store with a good reputation and salespeople who are glad to answer your questions. If you feel pressured to make a quick purchase, go somewhere else. Shop with your partner, and take your time. The Better Sleep Council recommends lying down in a variety of positions — on your back, on your side, and so on — on several mattresses so you get a sense of how firm and comfortable they feel. It may feel a little embarrassing to lie down on a bed in public, and many people leap off a store mattress almost as soon as it touches their back.“It can take up to 15 minutes to relax enough to feel the true support of a mattress, so don’t rush it,” according to an advisory from the Better Sleep Council.
“The more time you take in a store, the less likely you’ll have buyer’s remorse later on.” Related:Block Blue Light and Sleep Better Tonight Different support needs are common when it comes to sharing a bed, so a little creativity may be in order. If you or your partner has a lot of trouble getting comfortable, mattresses whose firmness is adjust on each side (i.e., the sleep number bed) are one way to go. While it’s not very romantic, separate beds may be your best (and last) resort. Experts suggest placing two twin beds next to each other with two different mattresses on top. Sometimes trading a few snuggles for a good night’s sleep may be worth it. If you’re tempted to save money by buying a used mattress (or even finding one free online), be aware that mattresses may cost you a lot more in the long run. The National Pest Management Association reports that buying a used mattress or box spring is risky because it may contain bedbugs, which tend to bite at night and are notoriously hard to get rid of.