Is your mattress causing back pain? How to fix it
Cause 1: The springs are wrong for your weight
I'd say 60% of mattress-related back pain comes from the wrong spring tension. The best mattress for back pain starts with getting the springs right.
If the springs are too firm for you, your body can't sink in, and your spine is misaligned. You get pressure points on your hips and shoulders. Side sleepers deal with this the most. You need the mattress to cushion your shoulders and hips whilst still supporting your torso. This is a common cause of back pain for lighter people, and it's why the "firm mattress for back pain" advice is so often wrong.
If the springs are too soft for you, your hips sink too much, your spine curves into a hammock shape, and you spend 8 hours in a position that stretches your lower back. This is what most people mean when they say their mattress "lacks support." It's the most common cause of back pain for heavier people, and I see it constantly with bed-in-a-box mattresses where the foam layers have dipped.
The fix: choose the springs for your body weight. Here's the guide I use:
| Mattress | Medium springs | Firm springs |
|---|---|---|
| Cloud | Under 80kg | 80kg and over |
| Aurora | Under 100kg | 100kg and over |
| Cooper | Not available | Always |
Cause 2: The comfort layers are worn out
I pull apart mattresses every week in our Gladesville factory. In 99% of cases, the springs are fine. It's the foam layers on top that have given up.
Here's what happens: polyurethane foam and memory foam break down over time. The foam compresses permanently where your body lies, and you end up sleeping in a dip. Once that dip forms, your spinal alignment is gone. Your body's natural alignment is compromised for the entire mattress surface you sleep on. No sleeping position is going to save you. The back pain only gets worse as the dip deepens.
How long do they last? Here's what I've seen from pulling apart hundreds of mattresses:
- Low-density polyfoam: ~1 year before noticeable sagging
- Medium-density polyfoam: ~4 years
- High-density polyfoam: ~7 years
- High-density memory foam: ~6 years
- Natural latex: 15–20 years+
Memory foam is popular but can cause problems for lower back pain. Memory foam stores heat and uses this heat to conform to your body. Your body heat softens the memory foam further as you sleep. You actually sink deeper at 3am than you did at 10 pm.
It's why I only use natural latex. It lasts 3–4 times longer than polyfoam, doesn't trap heat the way memory foam does, and provides consistent support and pressure relief for years.
The fix: if your mattress has a visible dip or body impression, the foam layers are done. You need to find the best mattress replacement or new comfort layers. If you're shopping for the best mattress to replace it, skip polyfoam and memory foam mattresses. Go with a hybrid mattress that has pocket springs underneath and latex on top.
Cause 3: Your bed base
This happens all the time. Many customers don't believe it when I tell them it's the bed base causing back pain because they have spent thousands on it.
Here's how to test: put your mattress on the floor. Sleep on it for a couple of nights. If the back pain improves, your base is the problem.
Flexible slats cause back pain constantly. They're the biggest problem with a bed base. So many beds are so poorly designed that they kill mattresses and backs. Engineered wood slats are cheap, so manufacturers use them to cut costs. The issue is that they flex where you lie, causing the mattress to dip.
Your options:
- Use plywood in the centre third as a temporary fix for back pain
- Buy a new base with solid, flat pine slats (at least 19mm thick)
- Do nothing and keep waking up with back pain
If you get a new mattress without fixing the base, it won't be long before the new mattress does the same thing. The best mattress foundation is dead flat. Get as close to a concrete slab as you can.
Cause 4: The mattress doesn't suit your sleeping position
Different sleeping positions need different things from a mattress:
Side sleepers need the most pressure relief. Your shoulders and hips are the contact points, and the mattress needs to let them sink in whilst supporting your waist. A hybrid mattress with micro springs or thick latex on top works well. Without that pressure relief, side sleepers get hip and shoulder pain that radiates into their back. For side sleepers, we usually recommend the Cloud.
Back sleepers need support under the lumbar region. Too soft, and the hips drop. Too firm, and there's a gap under the lower back. Back sleepers with back pain should focus on getting the spring tension right for their weight, then choose just enough cushioning to maintain the spine's natural alignment. People who sleep exclusively on their backs often prefer the Aurora for its balanced feel: generous cushioning, but you stay on top.
Stomach sleepers have it tough. A soft mattress lets the hips sink and the lower back arch, which causes pain. Stomach sleepers who like it really firm usually prefer the Cooper for its flatter, more direct surface. Otherwise, we usually recommend the Aurora with firm springs. The main spring support still comes from body weight.
Combination sleepers move between back and stomach positions, or side and back, through the night. You need responsive materials – latex adjusts instantly, memory foam is slower. A hybrid mattress with latex gives combination sleepers the responsiveness for a better night's sleep without sacrificing pressure relief.
Should you get a firm mattress for back pain?
Sometimes.
If you have a bad back and ask me what's the best mattress for back pain, I tell you the same thing I tell everyone: the one that fits. Then I fit you to something that keeps the spine aligned with no pressure points.
The exception: some conditions, like slipped discs, can require an extremely firm mattress to stop the vertebrae from compressing the swollen disc. If your doctor tells you to go firm for your back pain, go firm. But for most back pain sufferers, the best mattress is one with surface feel, support and cushioning matched to you – that's the better bet for pain relief.
The problem is that "firm" and "soft" mean nothing without context. A mattress that feels medium firm to a 90 kg person feels rock hard to a 55 kg person. Mattress firmness is relative to your body, which is why I start with how you sleep and your body weight.
What to avoid
One-size-fits-all mattresses. Everyone gets the same springs regardless of weight. A poorly suited mattress isn't a defect – it's a design choice.
All-foam memory foam mattresses. No springs means the memory foam can't provide adequate support once it breaks down. Not a recipe for a better night's sleep. The memory foam layers degrade, you end up in a dip, and the entire mattress loses its ability to maintain spinal alignment. Memory foam also tends to trap heat, which changes how the mattress feels through the night.
Ultra-firm "orthopaedic" mattresses (unless prescribed). These create excessive pressure points, especially for side sleepers. The best firm mattress for one person is a torture device for another.
Low spring counts. A king mattress should have at least 1000 pocket springs for proper pressure distribution and motion isolation. The coil layer is the foundation of a hybrid mattress – skimp here and no amount of foam on top will fix it.
Mattresses with poor edge support. If the edges collapse easily, you're losing a usable sleep surface and proper support. A mattress with solid edge support and a supportive coil system gives you ample support across the entire mattress, not just the middle.
How do we solve this at Ausbeds?
I own Ausbeds, so take this with that in mind. But the reason I built the company this way is precisely because of the problems above.
We make three current models using the same natural latex, honeycomb pocket spring structure and zippered cover:
- Cloud – soft latex over 3,200 micro springs in a queen. Usually preferred by side sleepers who like it soft.
- Aurora – medium latex over the same 3,200 micro springs, for a balanced feel. Usually preferred by side, back or combination sleepers who want to stay on top.
- Cooper – medium latex over a foam layer with firm springs. Usually preferred by stomach sleepers and people who want a very firm bed.
Pick the mattress by how you sleep and the feel you like, then choose medium or firm springs for your body weight.
If your back pain doesn't improve or your first setup isn't right, we adjust – two free firmness swaps during the 7-month trial.
Frequently asked questions about mattress back pain
Why does my back hurt after I wake up?
This is the most common form of mattress back pain.
Morning back pain that gets better through the day is almost always your mattress or your bed base. Quality sleep is impossible on the wrong surface. If your back pain appeared around the time you got a new mattress, or if your back pain has gradually worsened over a few years, the mattress is the likely culprit. The springs are either too soft (your hips hammock) or too firm (your pressure points can't sink in), and you've spent 7–8 hours in a sleeping position that doesn't maintain spinal alignment. Put your mattress on the floor – if the back pain improves, your base is the problem. If not, the mattress firmness doesn't match your weight. A certified sleep science coach or mattress fitter can help you find the right mattress, but the simplest test is lying down and feeling whether the mattress keeps your spine in a neutral position without creating pressure.
Why does my mattress hurt my back?
A mattress causes back pain when the springs don't match your weight, the memory foam or polyfoam has sagged, or the bed base has failed. An ill-fitting mattress forces your body's natural alignment out of shape. The best mattress for back pain is one where the spring tension matches your weight, the comfort materials provide pressure relief at your pressure points, and the mattress keeps your spine in a neutral position through the night.
What type of mattress to avoid for back pain?
Avoid all-foam memory foam mattresses – the memory foam degrades and retains warmth, changing how the mattress feels overnight, and back pain follows once the foam dips. Avoid a plush pillow top over springs that are too soft for the sleeper; that combination can cause hammocking. Avoid "orthopaedic" or extra-firm mattresses unless your doctor prescribes one. A soft mattress with no support is just as bad as an overly hard mattress with no give. A soft mattress might feel good in the showroom but causes hammocking overnight. The best mattress for back pain is always going to be a hybrid mattress with weight-matched springs, good pressure relief, and materials that won't break down within a few years.
How to relieve back pain due to a mattress?
Check your base first – mattress on the floor test. If the base is fine, the issue is mattress firmness. Too firm? You may need to move from firm to medium springs or use a more cushioned comfort layer to relieve pressure and tension at your pressure points. Too soft? A soft mattress needs firmer springs to prevent hammocking. A mattress topper can help with back pain temporarily, but it's a bandage. The real solution for back pain relief is choosing the right spring tension for your weight and making sure the comfort materials provide enough pressure relief for your sleeping position. The right mattress should let you sleep pain-free.
What's the best mattress for a bad back?
The best mattress for back pain is the one that fits your weight and sleeping position. A 55 kg side sleeper with back pain needs a completely different mattress from a 100 kg back sleeper with back pain. Research shows that a medium firm mattress customised to the individual provides the best outcomes for sleep quality and pain management. Look for weight-matched springs in a hybrid mattress, quality comfort materials (natural latex outlasts memory foam by years), good motion isolation, strong edge support (edge support matters more than people think), and adjustability. A certified sleep science coach can help find the best mattress. The best mattress for back pain isn't the most expensive – it's the best mattress for YOUR body.
Should I get a firm mattress for back pain?
Not for most people. A firm mattress creates pressure points, causes back pain, and can force your spine into an unnatural position. The exception is specific conditions like slipped discs. For most back pain sufferers, a medium firm mattress matched to your weight gives better pain relief. A medium firm mattress improved pain and disability more than a firm mattress in the Lancet's randomised controlled trial – and the systematic review of 39 studies on sleep quality and back pain backed that up. What you need is the right mattress for back pain matched to your weight, and that might be medium firm or even medium.
Does memory foam help with back pain?
Memory foam provides good pressure relief in the short term – it conforms to your body shape, alleviating pressure points. The problems with back pain are longevity and heat. High-density memory foam shows permanent impressions within 5–6 years, and the mattress's ability to maintain spinal alignment declines. Memory foam absorbs body heat, making the memory foam softer overnight. A copper-infused memory foam or gel-infused memory foam comfort layer won't fix durability. A hybrid mattress with a memory foam comfort layer over pocket springs is better than all-memory foam, but I'd choose latex over memory foam for long-term back pain. Memory foam has its place, but for back pain sufferers, it's not the ideal mattress material. If you go memory foam, look for high-density memory foam (50 kg/m³ or above) with a good coil layer underneath.
How often should I replace my mattress?
How long a mattress lasts depends on its materials. Low-density polyfoam sags within a year. High-density memory foam: 5–6 years (even quality memory foam degrades). Natural latex: I haven't seen one fail. If your mattress has dipped, the entire mattress is no longer providing support for your spine alignment – time for a replacement. For pain-free mornings and restorative sleep, you need a sleep surface that delivers consistent support. Rather than replacing a new mattress every few years, consider a modular design where you replace the foam layers or support layer independently. Better for your wallet, better for a restful night's sleep, and better for getting a better night's sleep long term.
Does edge support matter?
Edge support matters if you share the bed or sleep near the edge. A mattress with excellent edge support prevents the edges from collapsing, so you get support across the entire mattress. When shopping for a mattress for back pain, look for a hybrid mattress where the edge support comes from the coil layer design rather than a foam border. For side and back sleepers, strong edge support means room for a better night's sleep. Good edge support also improves motion isolation – and motion isolation matters more as we age, and good motion isolation means fewer disturbances from a partner.
How important is sleep position for back pain?
Very. Back sleepers are generally in the safest sleeping position. Back sleepers put the least stress on the spine, as long as the mattress provides lumbar support and maintains the body's natural alignment. Side sleepers need more pressure relief at the hips and shoulders. A medium-firm hybrid mattress with good motion isolation works well for back and side sleepers – medium firm is the safest starting point for finding your ideal mattress. Stomach sleepers are highest risk because the sleeping position arches the lower back. For side and back sleepers, match the firmness to your weight and sleeping position. The ideal mattress adapts to your sleeping position without forcing your spine out of alignment.
How much does back pain cost Australians?
In 2024, nearly 3 million Australians had chronic back problems. Back pain costs the health system $4 billion a year, and a Monash University study projects $638 billion in lost productivity over the next decade. Low back pain is the leading cause of disability worldwide – 619 million people in 2020, projected to hit 843 million by 2050. Back pain robs you of restorative sleep. It's not just a mattress problem, but when you spend a third of your life on a sleep surface that's working against your body's natural alignment, you're not helping yourself. Getting the right mattress won't fix all back pain, but it removes one of the biggest controllable factors in your back pain.
About the author
Karl owns Ausbeds. Tired of mattresses that failed too soon, he set up a Sydney workshop to make them properly: honest materials, adjustable designs. He also gives straight mattress advice on Reddit, Whirlpool and OzBargain.
