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Speaking as someone with a persistent neck issue, sleeping with spinal pain can be a nightmare. Even if you’re lucky enough to sleep through the night, you might wake up in agony or unable to get out of bed at all. Perhaps the worst part is the myriad possible causes, making it difficult to fix.
“Back pain can result from multiple different conditions including arthritis, degenerated discs, and even more serious conditions such as stenosis affecting the nerves, or traumatic injuries,” says Dr. Peter Whang, M.D., orthopedic spine surgeon at Yale Medicine. “However, one of the most common causes of back pain is issues affecting the soft tissues of the spine such as the muscles and ligaments. Back pain can often be worse at night due to the day’s activities. The spine can also frequently be put in an uncomfortable position in bed, which can give rise to symptoms significant enough to affect sleep quality, or even wake you up at night.”
“80% of people will experience lower back pain in their lifetime,” adds Dr. Elizabeth Stroot, PT, founder of Core Wellness & Physical Therapy. “The most common causes are related to poor posture, lack of exercise, and poor lifting or movement. The combination of these over time yields poor biomechanics and makes people prone to muscle strain or ligament sprain. Having an injury like this can result in having pain both in motion and at rest. Sleep is typically one of my patients’ greatest concerns, and they are eager to learn how to optimize their sleeping environment to help facilitate healing.”
While there are many possible routes toward a less painful night’s sleep, a mattress topper is one worth considering, since they let you adjust your bed’s firmness, breathability, and/or comfort level without the cost of buying a whole new mattress. (If the latter is a concern, read our guide to the best mattresses for back pain.) With that in mind, below are our picks for the best mattress toppers for back pain.
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Back pain is bad enough without the added discomfort of feeling your wallet getting gouged, but there are, at least, a few less expensive options worth considering. “If you’re looking to save money, consider buying a memory foam mattress topper with a higher density,” advises board-certified family medicine physician Dr. Laura Purdy. “This mattress topper offers excellent support and relief from pressure at an affordable cost.”
Read the full review: Serta ThermaGel Cooling Memory Foam Mattress Topper Review
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“The most comfortable mattress topper for back pain is one that has a combination of memory foam and a soft, breathable fabric,” says Dr. Purdy. “The combination of comfort and support will help relieve back pain. This one is a great foam mattress topper—so comfortable and it has great reviews!” It also comes with a breathable, washable cover and straps to secure it tightly to the mattress, so you can take extra comfort in knowing it won’t slide off the bed.
For those with back pain, it’s vital to avoid putting any extra pressure on your spine while sleeping. “Choose a topper with a contoured shape that targets spinal alignment,” suggests Purdy. “This will help you maintain proper posture while sleeping, which reduces strain on your back.” John Merwin, CEO of 3Z Brands, recommends the Nolah mattress topper for this, saying that, “It combines cooling, cushioning, and comfort into one elite topper. Made with two inches of Nolah’s award-winning AirFoam, it also dissipates heat 20% faster than traditional memory foam, keeping you cool and comfortable all night long.” Shopping tip: Nolah also made our list for the best mattress for side sleepers.
Read the full review: Nolah Mattress Topper Review: A Supportive and Affordable Upgrade
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As a side sleeper, I can personally confirm it’s not always the best way to sleep when it comes to your back and neck—so a little help can go a long way. “For side sleepers with back pain, look for a mattress topper that relieves pressure while still maintaining spine alignment,” says Dr. Purdy. “Choose a topper made of memory foam or latex with a moderate level firmness. This one is great because it takes pressure off your hips and shoulders, which often hold pressure with side sleepers.”
Read the full review: Tuft & Needle Mattress Topper Review: Relief Where You Need It Most
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“Best mattress toppers for back sleepers with pain are medium firm ones that encourage proper spinal alignment,” says Dr. Purdy. “Choose a mattress topper that provides a good balance between support and comfort.” Merwin recommends the TitanFlex topper, which features three inches of soft, contouring foam, designed to mimic the pressure-point relief of a latex topper.
Read the full review: Titanflex Mattress Topper Review: Can It Ease an Achy Night’s Sleep?
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One issue a lot of people have with mattress toppers—and memory foam in general—is it can get uncomfortably warm. If you’re a sleeper who likes your bed chilly, “Look for toppers with cooling properties, such as gel-infused memory foam or materials with breathable qualities,” says Dr. Purdy. “These toppers regulate the body's temperature, and offer a cool sleeping surface. This one works well because it has gel beads infused in the mattress topper, which also helps prevent overheating.”
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Even your dream partner can turn sleeping into a nightmare, especially if one of you needs perfect stillness to nod off, and the other thrashes around the bed like an angry badger. The fix, says Dr. Purdy, “is to reduce movement transfer, which is important to couples and individuals that are sensitive to motion during sleep. This mattress topper is excellent for motion transfer reduction—it’s super high quality and made from pressure-relieving foam.”
Read the full review: Tempur-Pedic Tempur-Adapt Topper Review
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Having a bad back doesn’t necessarily mean that you want a bed so firm, it feels like a slab of concrete. “For a soft feel, choose a mattress topper made of high-quality material,” advises Dr. Purdy. “The mattress topper should provide enough support for back pain relief. This one is a great hybrid mattress topper, as it's a mix of foam and feels like a pillow—the best of both worlds!” The added bonus here is you can experiment with using either the down alternative or gel memory foam layers—or use both together—to figure out which works best for you.
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“Best latex mattress topper for back pain would offer a blend of support and comfort,” says Dr. Purdy. “Latex toppers are made of natural rubber, a resilient material that provides excellent spinal alignment and pressure relief for people with back problems.” Merwin recommends Mattress Topper’s Talalay latex topper for this, saying, “Made with three inches of Oeko-Tex certified Talalay latex, this topper delivers an ultra-comfortable, buoyant, and hypoallergenic sleep surface. It’s a great pick for those seeking comfort from natural and sustainable sources.”
Read the full review: Talalay Latex Mattress Topper Review: Deep Sleep and a Painless Morning
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If being environmentally friendly is part of your sleep plan, organic is the way to go. As Dr. Purdy notes, toppers made from organic latex, “do not contain any synthetic material, which makes them healthier.” Merwin advises trying Birch’s Plush Organic topper, saying, “Both GOTS and GREENGUARD Gold certified, the Birch Plush Organic topper is responsibly sourced and sustainably produced. It features high-quality, domestically made Talalay latex and is eco-INSTITUT certified for low emissions.”
Read the full review: Birch Plush Organic Mattress Topper Review >>
I made my selections through a combination of expert advice, thorough research, and ensuring all of my picks had overwhelmingly positive customer reviews, especially in terms of comfort, support, and longevity.
Dr. Stroot offers the following advice on what to look out for when choosing a mattress topper.
“A mattress topper should meet the need you wish your mattress would, so if your mattress is too soft, you may choose a topper that offers more firm support. If it’s too supportive, you may choose a topper that molds to your body and has some suppleness to it. You want to find the appropriate amount of firmness needed to maintain good alignment, and easily transition into another position without waking from too much exertion. If you wake up with sore or achy areas, you may need to increase or decrease the firmness of your topper.”
“More breathability will allow you to slumber without getting too hot or cold, and will aid in thermoregulation, which is necessary to facilitate sleep cycles that leave you rested, refreshed, and restored. This is critical to your body for tapping into its healing potential. If you've already found the topper of your dreams but you're so hot you're waking up sweaty, consider changing your bed sheets to a more natural and breathable fabric like linen or bamboo, change your comforter to a more seasonal weight, or set your thermostat between 60 and 68 degrees overnight.” For more information, check our guide to the best cooling sheets.
“Comfort is the most subjective factor, and I like to use a more playful range to assess where you’re at. If you get into bed and let out a sigh of pure relaxation, and most importantly, upon waking still feel absolutely wonderful, I'd call that a 10/10! The other end of the spectrum, when you toss and turn and wake up feeling exhausted, is a 0/10. To find the sweet spot somewhere above a 6/10, experiment with the temperature of the room, texture and weight of linens, jammies (or no jammies), and how they work with your ideal topper. With all the options out there, playing around with each of these factors is sure to help you find the best choice for you.”
“Mattress toppers help with back pain by enhancing the support and comfort of your mattress, aligning your spine, and reducing pressure points,” explains Dr. Steven Siwek, interventional pain specialist and founder of The Pain Center of Arizona.
“Depending upon the material, a mattress topper may also be beneficial for regulating body temperature as well,” adds Dr. Whang.
“Performing gentle stretching exercises of the lower back, hips, and legs immediately before bedtime can be helpful for alleviating pain associated with sleeping,” recommends Dr. Whang. “Meditation and other mental exercises may also be an effective strategy for minimizing discomfort and improving sleep patterns. In certain cases, it may be appropriate to consider the use of medications, as recommended by a medical professional, as a method for reducing back pain at night.”
“Depending on the severity of back pain someone is experiencing, propping the body with additional pillows or bolsters is also worth considering,” suggests Dr. Stroot. “A flat or plush pillow can be placed behind the knees and lower legs when on your back. A pillow between the knees can help decompress your lumbosacral spine by keeping your pelvis neutral. A body pillow extending up to the shoulders will help keep the length of the spine from rotating too far one direction or the other when in a side-lying position. Maternity pillows, which are U-shaped, make rolling from side to side with support beneath the top arm and leg a cinch.”
“In general, it’s preferable to have a mattress topper that’s relatively firm, which is going to provide more support,” advises Dr. Whang. “One that is too soft can cause the spine to ‘sink’ into an unnatural position, which can lead to complaints of worsening back pain. However, it’s also important to select a material that is comfortable to lie on for an entire night.”
Here are Siwek’s pros and cons of each:
Certainly, if your bed is uncomfortable, it’s worth trying one out to see if it works. That said, it’s unlikely to fix the entire problem. “A mattress topper alone is rarely enough to help someone heal from back pain,” warns Dr. Stroot. “The key is to get to the root cause of the pain, and optimize the biomechanics of the regions affected with hands-on treatment from a physical therapist. It’s important to be properly evaluated to understand your triggers, and what lifestyle modifications and exercises are needed now and in the long term.”
“The choice between latex and memory foam for back pain depends on personal preference,” says Siwek. “Memory foam tends to contour to your body, while latex provides more bounce and responsiveness. Both can be effective for back pain, so it's important to try them out and see which one suits you best.”
“You'll have your topper for three to five years,” says Dr. Stroot. “You should replace it when it starts to lose shape, and you notice you’re physically sore and unrested after sleeping on it, especially if you notice how much better you sleep when in a different bed, and can rule out other reasons why your sleep quality may have changed.”
“For lower back pain, a medium-firm to firm mattress topper is generally recommended,” says Siwek.
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