Kovacs FM1, Abraira V, Peña A, Martín-Rodríguez JG, Sánchez-Vera M, Ferrer E, Ruano D, Guillén P, Gestoso M, Muriel A, Zamora J, Gil del Real MT, Mufraggi N.Author information1Scientific Department, Kovacs Foundation, Palma de Mallorca, Spain. AbstractBACKGROUND: A firm mattress is commonly believed to be beneficial for low-back pain, although evidence supporting this recommendation is lacking. We assessed the effect of different firmnesses of mattresses on the clinical course of patients with chronic non-specific low-back pain.METHODS: In a randomised, double-blind, controlled, multicentre trial, we assessed 313 adults who had chronic non-specific low-back pain, but no referred pain, who complained of backache while lying in bed and on rising. Mattress firmness is rated on a scale developed by the European Committee for Standardisation. The H(s) scale starts at 1.0 (firmest) and stops at 10.0 (softest). We randomly assigned participants firm mattresses (H(s)=2.3) or medium-firm mattresses (H(s)=5.6).
We did clinical assessments at baseline and at 90 days. Primary endpoints were improvements in pain while lying in bed, pain on rising, and disability.FINDINGS: At 90 days, patients with medium-firm mattresses had better outcomes for pain in bed (odds ratio 2.36 [95% CI 1.13-4.93]), pain on rising (1.93 [0.97-3.86]), and disability (2.10 [1.24-3.56]) than did patients with firm mattresses. Throughout the study period, patients with medium-firm mattresses also had less daytime low-back pain (p=0.059), pain while lying in bed (p=0.064), and pain on rising (p=0.008) than did patients with firm mattresses.INTERPRETATION: A mattress of medium firmness improves pain and disability among patients with chronic non-specific low-back pain.PMID: 14630439 DOI: 10.1016/S0140-6736(03)14792-7 [PubMed - indexed for MEDLINE] Publication TypesClinical TrialMulticenter StudyRandomized Controlled TrialResearch Support, Non-U.S. Gov'tMeSH TermsAdultBeds*Chronic DiseaseDouble-Blind MethodFemaleHumansLow Back Pain/rehabilitation*MalePain Measurement
Despite newer and better materials, inner spring mattresses still rank below average for pain relief. Advancements in technology, design and materials have greatly expanded the market for mattresses in the 21st century. The primary function of any mattress is to provide comfort and relieve pain so your body can rest and rejuvenate. A good mattress provides adequate support where it is needed, while also cushioning pressure points. Comfort of the shoulders, hips and back is of particular importance in providing restful sleep. The best mattress for both support and comfort depends on your needs, as no single mattress type can cover everyone's needs. Addressing Shoulder Pain Most people tend to sleep in one of three positions, on their side, on their back or on their stomach. Although it's uncommon to stay in just one position all night, it's not uncommon to favor one position. Side sleepers may experience more issues with shoulder pain than those who spend more time on their back or stomach.
The American Academy of Orthopaedic Surgeons lists four common causes of shoulder pain: tendon inflammation, instability, arthritis and bone fractures. If you suffer from acute or chronic shoulder pain or spend most of your time sleeping on your side, you need a mattress with firm support that also conforms to your body to cushion your shoulder. Natural latex and memory foam contour to the body, relieving pressure points while also providing support, making them a good choice for shoulders. Lower Back Pain Mattresses that are too soft can exacerbate lower back problems. Sagging from compression of the material is a common problem, causing the lower spine to rest in an unnatural position. Support is an important factor in preventing and alleviating back pain. According to Sleep Like the Dead, an unbiased, independent research company that reviews and compares mattresses, traditional innerspring mattresses have the highest rating for causing pain and have the most problems with sagging. Waterbeds also tend to lack adequate support for the lower spine.
Memory foam provides good support, although it can also develop problems with sagging over time. Latex mattresses provide good support but some owners complain they are too firm. Airbeds rate the best for causing the least amount of pain, due to excellent support and adjustable firmness to suit personal preferences. Firmness and Sleeping Positions The best sleeping position for those with shoulder or back pain varies from one individual to the next. Medium to firm mattresses often work best for back sleepers. Pressure is more evenly distributed when you sleep on your back. Those who sleep on their side are more comfortable with medium to soft mattresses, as it helps relieve pressure on hips and shoulders. Stomach sleepers need medium firmness to avoid too much pressure on the knees. Too much softness can make it difficult to breathe if you have sunk deep into the mattress and may also cause neck pain. Additional Options Compare pros and cons of mattress types before comparing brand names.
You can upgrade the comfort and support of an innerspring mattress by adding a mattress topper, which comes in a variety of materials such as memory foam, featherbeds, latex, fiber and wool. However, these products also have pros and cons. Mattresses that rank high in pain relief and support, such as an air mattress or memory foam used on an adjustable bed, may help with certain conditions such as osteoarthritis and spinal stenosis. Finally, research customer reviews of brand name mattresses before heading out to mattress showrooms to try them out yourself. "Consumer Reports" recommends laying on a mattress for 15 minutes, altering the positions you sleep in most to determine a mattress's comfort level. References Spine-Health: Choosing the Best Mattress for Lower Back PainSleep Like the Dead: Best Mattresses for Pain Relief and Bad BackPlushbeds: Best Mattress for Shoulder PainConsumer Reports: Mattress Buying Guide Photo Credits Hemera Technologies/PhotoObjects.net/Getty Images Suggest a Correction