Mattresses for Back Pain: What They Can and Can't Do

Is it even the bed's fault?

Rarely, if you ask those affected: In the 2020 Swiss Back Report, only a few respondents cited a poor-quality bed as the cause of their back pain or stiffness.

When Should You See a Doctor? According to the Swiss Rheumatism League, ordinary back pain usually goes away after two to four weeks or subsides noticeably after four weeks; in such cases, a medical examination is not necessary. If the pain does not subside after four to six weeks, the Swiss Rheumatism League advises seeking further evaluation. You should see a doctor immediately if you experience back pain following an accident or if you have any of the following warning signs: fever without a prior infection, numbness or tingling in the arms or legs, difficulty moving the legs or arms, signs of paralysis in the legs or arms, bladder or bowel problems, unexplained weight loss, or a general feeling of illness. In the case of ankylosing spondylitis, an inflammatory disease of the spine, the Rheumatism League notes that pain typically occurs at night and wakes the affected person, often accompanied by morning stiffness; the first symptoms usually appear between the ages of 15 and 35. The Schulthess Clinic also lists night pain, night sweats, pain that does not subside at rest, and a history of cancer among the warning signs.

For the Back Report, 1,041 people aged 16 to 81 in German-speaking and French-speaking Switzerland were surveyed online from February 26 to March 4, 2020. Respondents were asked about “back pain or stiffness,” and they themselves cited the reasons: These are self-reports, not measured causes.

• Reasons: Of the 1,018 respondents who had experienced such symptoms, 57% cited muscle tension, 38% cited overexertion, 37% cited an awkward movement, and 33% cited stress, worries, and problems; multiple answers were allowed. A poor-quality bed was among the reasons cited only occasionally, along with lying down for too long and poor posture.
• Sleep: Of the 936 respondents who reported symptoms, 45% said their sleep was affected—more often than any other area of life. Among those with symptoms lasting longer than twelve weeks, the figure was 59.5%.
• Prevention: 26% of the 1,041 respondents buy a new mattress or pillow to prevent back pain. According to the same report, there is very little evidence that back pain can be prevented before it first occurs: The figure reflects what people do, not what actually helps.

For ordinary back pain, the Rheumatism League advises staying active: Staying in bed for several days is ineffective and can even be harmful.

What if your back hurts in the morning but feels better as soon as you start moving? That alone doesn’t point to the mattress. In a study in which 13 rheumatologists evaluated 20 patients with chronic back pain and suspected inflammatory spinal disease, improvement with movement was the strongest of five signs of inflammatory back pain; the criteria were tested on 648 additional patients.

The mattress can still play a role: In a review of 47 studies conducted from 1999 to 2023 involving adults and young adults, medium-firm support was associated with less morning stiffness. The definition of “medium-firm” in these studies is explained in the firmness guide.

Which mattress is best for my back?

One that suits your body and sleeping position: According to a review of 47 studies involving adults and young adults, this is what you should consider when making your choice, in addition to age and sensitivity to heat.

Zones that provide different levels of support for the shoulders, waist, and pelvis, as well as adjustable systems, showed potential benefits in the same review; however, the studies were too diverse to be evaluated together. The best way to find out if a zoned mattress is right for you is to try it out.

You can find out how to check this in Mara Vital's guides, which answer these questions in more detail:

• Body Type and Firmness Level: To learn how your sleeping position and body type affect the firmness level, see the " Sleeping Position and Body Type" section of the Firmness Guide; to find out whether a firmer mattress is better, see the " Firmer Mattress" section.
• Sleeping on Your Side: This guide for side sleepers explains what matters most for your shoulders, pelvis, and waist—including how to test a mattress, choose a pillow, and select a slatted frame or mattress topper.
• Sleeping on your back or stomach: The Firmness Guide also explains how to tell if a mattress is too soft in these positions; the models suitable for these positions are grouped into the " back sleepers " and " stomach sleepers" categories.
• Old Mattress: To find out how to tell if it's worn out, check out the guide on cleaning mattresses.
• Testing Mattresses: At our showrooms in Volketswil and Dagmersellen, you can test mattresses by appointment—free of charge and with no obligation—and receive personalized advice. The Volketswil showroom features over 30 mattresses, and the Dagmersellen showroom has over 50.

At home, you can try out a Mara Vital mattress for up to 100 nights and return it for free during that time, according to the Terms and Conditions; the FAQs in the guide explain how this works.

Read more in the guide

Mattress Firmness Level

Read the hardness levels and match them to the model.

What does a health claim on a mattress mean?

According to Swissmedic, only drugs and medical devices may be advertised for their medical effects in Switzerland, and medical devices are not subject to regulatory approval.

Whether a product is a medical device is determined by its intended use: According to Article 3 of the Medical Devices Ordinance (MepV, SR 812.213), a product is considered a medical device if its manufacturer intends it for a medical purpose, such as the treatment or alleviation of a disease. Before it is placed on the market, its conformity is assessed, and the manufacturer issues a declaration of conformity (Art. 21–29 MepV).

Bernd Kladny, secretary general of the German Society for Orthopedics and Trauma Surgery, told Stiftung Warentest: “The health claims made by manufacturers must be scrutinized critically because there is a lack of scientifically validated studies.”

Anyone looking for an “orthopedic mattress” should check the product details in three steps:

Do the mattress studies also apply to herniated discs?

Not explicitly: The 2021 and 2026 systematic reviews on mattresses provide recommendations for nonspecific back pain; they do not specifically address herniated discs.

According to the Rheumatism League, a herniated disc is one of the specific causes that together account for about 15% of back pain. Once it has been diagnosed, discuss your mattress options with your doctor or your physical therapist. No mattress can treat a herniated disc: “A good mattress can support your back, but it can’t heal it,” Bernd Kladny told Stiftung Warentest in 2022.

Although the 2026 overview includes a measurement of disc stress, it is based on 16 healthy students: it says nothing about people with a herniated disc.

The findings from studies involving people with nonspecific back pain and firm and medium-firm mattresses are outlined in the Firmness Guide, while information on how the shoulders and pelvis should be positioned when lying on your side can be found in the Guide for Side Sleepers.