The best mattress for back pain depends how stiff your spine is. If you are very stiff in the back you need a slightly more yielding mattress. You need this because your spinal links (vertebrae) are unable to slide and glide imperceptibly past one another in the dead weight of sleep, with the result that you wake up stiff and sore throughout your body. It's as if your rigid spine and rigid mattress have fought it out till dawn and you wake as if you've been through a war zone.
This looks to be an awful mattress! Too soft and made of synthetic
Interestingly, in the photograph above the mattress is too soft, even for the stiffest spine. For the best mattress for back pain from a stiff back, you want the hand to depress to about half that depth with moderate pressure, and on releasing your hand the mattress should spring forcibly back towards you. For a stiff, stiff spine, the ideal sleeping surface is a 2'' mattress made of dense foam on a hard surface - preferably closely slatted boards. The photograph below also shows the mattress to be too soft, especially for a person the age of this model.
There's no excuse! Young spines need firm, resilient support
For very stiff spines, it's still true that the firmer you can tolerate the mattress the better it is for the overall life of your spine. The same holds true for seeking spinal decompression as delivered through a firmer surface. Always use a proper orthopaedic mattress with individual springs, so that when you sit down on the side of the bed it buoys your up vigorously, instead of depressing into a deep hollow under your weight. Another word of advice: always go for the firmest bed in the shop. Pretty well all modern beds are too soft.
The individual springs of a proper orthopaedic mattress should bear you aloft
With a firmer mattress you may have to use the support of pillows to bolster your lower back if you have a very rigid spine. Granted it is rather cumbersome in the bed, but a pillow under your waist will make all the difference in accommodating your stiff back to the firmer sleeping support. An 'H' configuration of three pillows is even more supportive when you a lying on your side.
Pillows help support a stiff spine on a firm mattress
But here's a word of warning! Most people have a spine with one or two stiff links only in the midst of the spinal machinery and they need a firmer mattress so they do not sag at the weak link. Remember! Most modern beds are too soft.
In the page Best Bed For Back Pain it is explained how a firm sleeping surface helps to decompress the spine by creating slight traction as the segments fall away from the prominent point of contact on the mattress. In side lying, the segments pulls away from the pelvis propped up on (say) the left hip and when lying on your back the segments drape away from the fulcrum of the sacrum at the back of the pelvis. In the peace of your sleep, the spinal segments pull away from one another like an elongated concertina pulling out, which draws fluid into the discs. If the bed is too soft this will not happen.
Spinal decompression should happen naturally while you rest
You will see in the graphic above that intra-discal pressure (the pressure inside the discs) is the lowest when lying on your back compared to side lying, thus encouraging important nutritional fluids to seep into the discs. In this way, lying on a firm surface on your back, in particular, creates critically important spinal decompression during sleep. Contrary to the spine-line drawn in the graphic below, most spines benefit from a firmer mattress that does not indent to accommodate bony prominences. Instead, the imaginary spine-line should curve up upwards by virtue of the left hip being fully supported on the mattress and providing gentle-but-important spinal decompression as you rest.
WRONG! Do not be taken in by the false-science that your spine must be kept straight during sleep
And finally, the best mattress for back pain should contain as much natural fibre as possible. Rubber and latex mattresses are not sufficiently supportive. They are also hot to sleep on. Indeed, one of the best mattresses for back pain is still the old-fashioned kapok, such as you see with Japanese futons.
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