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: match the springs to your body weight. Here's the guide I use:
| Weight range | Spring tension | Latex type |
|---|---|---|
| Under 50 kg | Soft springs | Soft latex |
| 50–70 kg | Medium springs | Soft latex |
| 70–85 kg | Medium springs | Medium latex |
| 85–100 kg | Firm springs | Medium latex |
| 100-130kg | Very firm springs | Medium latex |
| Over 130kg | Very firm springs | Firm latex |
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. For people who exclusively sleep on their backs, we recommend the Aurora or Cooper.
Stomach sleepers have it tough. A soft mattress lets the hips sink and the lower back arch, which causes pain. Stomach sleepers usually need firmer springs for their weight, with just enough cushioning to be comfortable. Back and stomach sleepers both benefit from a flatter, more direct feel. We usually recommend the Cooper mattress.
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 a one matched to your weight – 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 weight – which is why I always start there.
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 mattresses – Cooper, Aurora, and Cloud. Same natural latex, same honeycomb pocket springs (986 in a queen), same cover. The only difference is the micro spring layers:
- Cooper – no micro springs. Direct, responsive feel. Best for back and stomach sleepers who want less cushioning.
- Aurora – 1,600 micro springs (queen). Balanced. Pressure relief without too much sink.
- Cloud – 3,200 micro springs (queen). Maximum cushioning. Our most popular. The micro springs provide pressure relief by absorbing shoulders and hips, which is why side sleepers and side and back sleepers tend to prefer it.
The springs are weight-matched. A 55 kg person and a 100 kg person get completely different spring units. This is how you get proper spinal alignment – match the support to the person.
The Cloud is our most popular mattress for back pain (around 70% of all our sales). The two layers of micro springs provide the pressure relief that side sleepers need. Back sleepers and combination sleepers benefit, too. But the right model depends on your sleep style and sleeping position – the Aurora and Cooper are a better mattress for back pain when it comes to stomach sleepers and back and stomach sleepers who prefer a firmer, more direct feel.
If your back pain doesn't improve or your first setup isn't right, we adjust – two free component swaps during the 7-month trial.
Frequently asked questions about mattress back pain
About the author

Karl is the owner of Ausbeds. He started the company after realising how many people were frustrated by mattresses that failed too soon and too often. So he built a workshop in Sydney and began making mattresses the way they should be made - with transparent materials, adjustable designs, and customer-first thinking. When he's not in the showroom/workshop, he's on Reddit, Whirlpool, and OzBargain, cutting through industry fluff with honest mattress advice.



