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According to the Health Policy Institute, eight percent of adult Americans suffer from chronic back pain, and four times as many have experienced a recent back pain episode. If you suffer from back pain, keeping your spine properly aligned and supported while sleeping is a must.

While our guide to the best mattresses offers suggestions for all types of sleepers, back-pain sufferers are such a significant proportion of the population that we wanted to dedicate a buying guide to their needs.

Typically, a bed that feels medium-firm is best for back pain. A mattress will feel different depending on what you're used to, so we offer a range of firmness options among the picks in our guide. 

For this guide, I tested over 25 mattresses and consulted with two experts.

Find out more about how Insider Reviews tests and reviews home products.

Best mattress for back pain overall: Leesa Hybrid Mattress, $1,519.20 on Leesa (use code "INSIDER" at checkout) The Leesa Hybrid Mattress has great edge support and motion isolation. The mix of memory foam and pocket springs leads to an average firmness that makes it an outstanding solution for back pain sufferers of any sleeping style.

Best budget mattress for back pain: Helix Midnight Mattress, $949 on Helix While not bargain-basement cheap, the couples-friendly Helix Midnight Mattress is one of the most affordable mattresses we tested, and it doesn't compromise on comfort or quality.

Best foam mattress for back pain: Nectar Memory Foam Mattress, $899 on Nectar If you're a side sleeper who enjoys the feel of memory foam, the Nectar Memory Foam Mattress, with its excellent heat dissipation and long trial period, is your best bet.

Best adjustable bed for back pain: Sleep Number 360 i8 Smart Bed, $2,999 on Sleep Number If you and your partner can't agree on a mattress firmness, the Sleep Number 360 i8 Smart Bed allows you to customize each side to your perfect firmness, and the bed automatically makes adjustments based on your body's position.

Best mattress for hot sleepers with back pain: Bear Hybrid Mattress, $1,299 on Bear If you tend to overheat at night, consider the Bear Hybrid Mattress with its cooling Celliant cover.

The Leesa Hybrid Mattress has great edge support and motion isolation. The mix of memory foam and pocket springs leads to an average firmness that makes it an outstanding solution for back pain sufferers of any sleeping style.

Pros: Great motion dampening and edge support, pocket springs and foam balance heat dissipation and support, the average firmness is ideal for an array of sleepers, 

Cons: Hard to move, heavy

There are several reasons why I made the Leesa Hybrid Mattress our top pick for back pain sufferers. During the year I slept on the mattress, I had the least back pain since my initial injury. This was despite exercising heavily and playing roller derby every week.

The Leesa Hybrid is also great because it has an average firmness that will appeal to the broadest range of sleeping styles and body types. When sleeping on the Leesa, I preferred sleeping on my side, and it shaped to my contours, which kept my spine aligned.

The Leesa Hybrid is made of CertiPUR-US certified foam and pocket springs. The top layer is a cooling foam. Below that is a contouring memory foam for targeted support and comfort.

The following foam layer, the pocket coils, and the base foam layer add durability and support. The cover is made of a soft, cooling material that kept my body cool.

The mattress was heavy and hard to move, especially since I tested the king size. This made for a slower-than-normal setup. I recommend having a friend help you unbox the Leesa Hybrid to avoid aggravating your back. On the plus side, the mattress was virtually odor-free out of the box.

In addition to adding durability to the mattress, the 1,000+ pocket coils offered outstanding edge support, which was helpful when my wife tried to annex my side of the bed. The motion isolation was also excellent as the mattress passed my bowling ball test with flying colors. These results and my subjective experience suggest the Leesa Hybrid is an excellent solution for couples.

Save 20% on the Leesa Hybrid using the Insider-exclusive promo code INSIDER at checkout.

Read our full Leesa Hybrid Mattress review.

While not bargain-basement cheap, the couples-friendly Helix Midnight Mattress is one of the most affordable mattresses we tested, and it doesn't compromise on comfort or quality.

Pros: Exceptional edge support, good motion isolation, easy to maneuver, great for back and stomach sleepers, CertiPUR-US and OEKO-Tex certified

Cons: Poor heat dissipation, strong initial odor, may not be comfortable for side sleepers

The Helix Midnight Mattress has the medium-firm feel that our experts recommend for back-pain sufferers. As someone who prefers a softer mattress for side sleeping, I gravitated to my stomach while testing the Midnight. That suggests it's better for stomach and back sleepers or heavier individuals. 

While testing the Helix Midnight, I was recovering from a back-pain episode, and I found it did a great job of nurturing the healing process.

The Helix Midnight is made in the US of CertiPUR-US and OEKO-Tex certified materials. The top comfort layer is cushioning memory foam, followed by two layers of supportive, pressure-relieving foam. The base consists of individually wrapped pocket coils that help with motion isolation, support, and durability. The soft cover is designed for airflow, but I found the Helix was one of the worst at dissipating heat.

Setup was quick and effortless, taking less than five minutes. However, the Helix Midnight had an intense initial odor that took more than a day to dissipate. The mattress is in the middle of the pack weight-wise, but it didn't flop around, making it easy to move. 

This is also an outstanding bed for couples because of its excellent motion isolation. The Helix Midnight passed my bowling ball test, and I could barely feel it as my second-grader bounded onto the bed.

And the edge support may be the best of any mattress I've tested. I didn't sink much when sitting on the side of the bed, and I was on the very edge before I rolled off while lying down. 

If you're a side sleeper who enjoys the feel of memory foam, the Nectar Memory Foam Mattress, with its excellent heat dissipation and long trial period, is your best bet.

Pros: Great heat dissipation, soft feel perfect for side sleepers, lightweight, impressive motion isolation, 365-night sleep trial, forever warranty 

Cons: Sinks on the edges, not suitable for most stomach and back sleepers or heavier individuals

In addition to performing much better than the other foam mattresses I considered for this guide, the Nectar Memory Foam Mattress is unique because of its 365-night home trial and forever warranty. You can try it for an entire year and return it for a full refund if you don't like it. 

The Nectar mattress will appeal most to side sleepers thanks to its softer-than-average feel. For that reason, I wouldn't recommend it for back-pain sufferers who sleep on their backs or stomachs or who are heavier. The mattress did not aggravate my lower back as a side sleeper, and I remained free of pain throughout testing. 

The Nectar features a cooling mattress cover made of a Tencel-poly blend. The mattress is composed of three layers of CertiPUR-US certified foams: a top layer of gel memory foam, an adaptive-response transition layer to help relieve pressure points, and a base layer of supportive foam. 

Foam mattresses tend to trap heat, but that wasn't a problem with the Nectar. Even in a hot room, I didn't overheat while lying in one spot. When I got up, the heat dissipated quickly. 

Setting up and moving the mattress around was effortless thanks to its light weight. The Nectar came with two pillows, but I didn't find them exceptionally comfortable. There was an initial odor from the mattress that disappeared by bedtime. 

Couples will appreciate the excellent motion isolation, which passed my bowling ball test. However, the mattress fell short in the edge support department. The foam sank noticeably on the side whether I was sitting or lying down.

If you and your partner can't agree on a mattress firmness, the Sleep Number 360 i8 Smart Bed allows you to customize each side to your perfect firmness, and the bed automatically makes adjustments based on your body's position.

Pros: Above average edge support, built-in sleep tracker, 20 firmness options for each side of the bed, adjusts based on sleeping position, white-glove delivery included 

Cons: Sleeps hot, poor motion isolation, challenging to move 

What do you do when you and your partner have different comfort preferences? Adjustable air beds offer custom firmness on each side. The best we've tested for back pain is the Sleep Number 360 i8 Smart Bed.

The i8 has 20 firmness options. You can adjust each side of the bed to get the ideal medium-firm feel that experts recommend to reduce back pain. Additionally, there's an "automatic air" function that adjusts the firmness as you shift positions to provide consistent support and pressure relief around your hips and shoulders. I found this feature alleviated my back pain and facilitated undisturbed sleep. 

Another perk that will please back-pain sufferers is the included white-glove delivery. Sleep Number delivery people completed the whole setup and removed the packaging. They will also recycle your old mattress, so you don't need to do any heavy lifting. However, moving the bed on your own requires significant effort since the mattress is attached to the bed frame.

While the i8 has good edge support, its motion isolation is subpar. My wife said the mattress felt almost like a waterbed because it jostled her so much when I flopped down. Still, she likes the Sleep Number enough to use it as her regular bed while I continue to test new mattresses.

Lastly, I was initially unimpressed with the sleep tracker, which Sleep Number hypes as the main selling point of this expensive mattress. However, the accuracy and quality of the SleepIQ app (available for iOS and Android) have improved dramatically over the last six months.

If you tend to overheat at night, consider the Bear Hybrid Mattress with its cooling Celliant cover.

Pros: Stays cool, excellent heat dissipation, great for side sleepers, made of CertiPUR-US and Greenguard Gold certified materials, easy to move

Cons: May not suit stomach or back sleepers or heavy individuals, below-average motion isolation

Bear designs its mattresses for athletes looking for a bed that will help them stay cool and recover from grueling workouts. I consider myself a hot-sleeping athlete and found the Bear Hybrid provided cooling recovery. 

Bear mattresses feature Celliant covers. Celliant is supposed to help with heat dissipation, but I haven't found any scientific studies on mattresses that support this. Yet, in my experience testing mattresses, toppers, and sheets with Celliant, the material does run cooler than non-Celliant options. My objective tests with the Bear Hybrid showed it stayed cool and quickly dissipated heat when I got up from it. 

The Bear Hybrid has an average firmness, which catered to my side-sleeping preference. I was recovering from lower back pain when testing this mattress, and it was just what I needed. There were no follow-up pain episodes, and my back felt strong again after the testing period.

The Bear Hybrid features a combination of coils and CertiPUR-US and Greenguard Gold certified foams. The top foam layer is infused with a cooling gel. Below is a comfort foam followed by a transition foam for pressure relief.

Below the durable coils is a supportive foam base. All of these layers make for a thick, heavy mattress, but setting it up and moving it around was surprisingly easy since it tended not to flop around.

Lastly, the Bear Hybrid was in the middle of the pack in our motion isolation and edge support tests. It failed the bowling ball test, and I could feel movement on the bed while I lay on it, but it wasn't extreme.

Lying on the edge, I had to roll quite far before I fell off. However, the edge sank substantially when I sat on it. This is a good but not fantastic mattress for couples by those assessments.

I test a new mattress every two weeks. While I've tested dozens of models, I only considered 14 candidates for potential inclusion in this guide. Here are the beds we still recommend but that didn't make the cut.

What else we recommend and why:

Bear Mattress: If you're interested in checking out the cooling properties of Celliant fibers and want a firmer mattress, you might consider the medium-firm Bear Original. It's made of CertiPUR-US and Greenguard Gold certified foams, including a graphite gel memory foam that I found did a great job of cooling. However, it failed my motion isolation tests, and it wasn't comfortable for side sleeping. 

Casper Original Mattress: The medium-firm feel of the Casper Original will appeal to a broad range of back-pain sufferers, especially hot sleepers, since it has impressive heat dissipation. It was easy to set up and move around in our tests and features exceptional motion isolation. However, the edge support was poor. Read our full review.

Birch Natural Mattress by Helix: This latex hybrid is the most eco-friendly option we considered for this guide, and I love the pressure relief and ease of movement that latex mattresses provide. The luxury firm feel will appeal to back and stomach sleepers. You can also add the plush latex topper for $450 for a softer feel I preferred when sleeping on my side. This mattress also has impressive motion isolation and edge support, making it ideal for couples. Unfortunately, it wasn't tops in any category, so we didn't include it in our guide.

Puffy Lux Hybrid Mattress: I slept on the Puffy Lux while recovering from a back-pain spell, and I think it did a great job of facilitating my recovery. I also like that this mattress comes with a lifetime warranty, is easy to move around, and has great motion isolation. On the downside, it had an intense initial odor that took days to dissipate, the edge support is poor, and it will be too soft for many back pain sufferers.

Tempur-Pedic Cloud Mattress: The best foam pick in our mattress guide, the Tempur-Cloud is one of the top five most comfortable mattresses I've ever slept on. I love how the material molds to your body to keep your spine aligned. Each night I slept on it, I fell asleep within minutes and got a good night's sleep. However, the edge support is poor, and if you decide to return the bed, you have to pay for shipping. Still, if you don't mind paying $2,000 for a mattress, this is a terrific option. Read our full review.

Purple Hybrid Mattress: Purple mattresses are unique because they feature a gel grid layer that immediately conforms to the contours of your body to offer targeted support and comfort. I've tested all of the Purple mattresses, and this is the firmest, yet I still found it comfortable while lying on my side. I was also impressed with the edge support. However, the motion isolation was so-so, and it's a heavy mattress that you won't want to move around once it's set up.

Purple Hybrid Premier 4 Mattress: The Purple 4 is identical to the Purple Hybrid above, except the gel grid layer is 4 inches thick instead of 2. This makes for a softer and heavier mattress. I preferred the softness for my side sleeping, but it's unlikely to appeal to back pain sufferers who sleep on their stomach or back. Its impressive motion isolation and edge support will serve couples well.

Casper Wave Hybrid: I generally don't recommend the Casper Wave Hybrid. The priciest option in Casper's product line is also the worst, in my opinion. But while testing this, I worked out excessively, which usually causes my back pain to flare up. Yet, I felt great each morning waking up on the Wave Hybrid. Other than that, the edge support is awful, it's a pain to move, and the motion isolation is subpar. Read our full review.

Serta Arctic Mattress: If you're looking for the best firm mattress for back pain and are willing to spend over $3,000, the Serta Arctic in Medium Hybrid is a good bet. Couples will appreciate the impressive edge support and motion isolation. It also does a terrific job of staying cool. However, side sleepers may want to look elsewhere since it is so firm.

Check out our guide to the best mattresses for a complete listing of the beds we've tested.

I tested all of the mattresses in this guide. I put the beds through several objective tests and slept on them for at least 14 nights. Unless otherwise noted, I tried each model's queen size. 

I mostly sleep on my side, with some stomach and back time. I am 6 feet tall, 205 pounds, and sleep hot. Plus, I have chronic lower back pain. 

When shopping for a mattress for back pain, the most important factors to consider are comfort, motion isolation, and the home trial policy. To get additional information on what to look for in a mattress, I spoke with two experts: Tamara Huff, MD, a Georgia-based, board-certified orthopedic surgeon and health disparities advocate, and Amit Jain, MD, an associate professor of orthopedic surgery and neurosurgery at Johns Hopkins University School of Medicine and chief of minimally invasive spinal surgery at Johns Hopkins Hospital.

Test results for the main attributes we tested:

Here are the main attributes we look for and how we test them:

Comfort: Based on my years of experience testing dozens of mattresses, I subjectively assess how supportive the bed feels, how hot it sleeps, the firmness, and how my back feels in the morning. 

Heat dissipation: I rely on objective laser thermometer measurements. I take readings before lying down, immediately after spending at least an hour on the bed, and two minutes after getting up.

Motion isolation: Excellent motion dampening is a must if you are a light sleeper and share the bed with someone who moves around at night. To test motion isolation, I drop a bowling ball from 4 feet above the mattress, so it lands 12 inches from a can of soda pop. If the can falls over consistently, the bed has poor motion isolation. If the can stays upright, the mattress passes the test and has sound motion isolation.

Trial and warranty: The only way to know for sure if a mattress is going to be comfortable for your back is to sleep on it for an extended period. I looked at the trial periods for each bed and read the fine print of the return policy to see if there were any loopholes or hidden fees. All of the mattresses in our guide have trial periods of 100 nights, except the Nectar (365 nights.) A long warranty is also essential. Each of our picks has a warranty of at least 10 years.

Edge support: I lie on the edge and slowly roll off to test edge support. If my body reaches a roughly 45-degree angle to the mattress before I fall off, it has good edge support. Additionally, I sit on the side and put my socks and shoes on. I note how much the mattress sinks. Significant sinkage is a sign of poor edge support.

Portability: I look at how easy moving and rotating the mattress is, an essential task for ensuring your bed lasts. To test portability, I move the mattress several times from room to room and note how much it flops around, if it has handles, and how heavy it feels.

Setup: While I recommend that you get help, I set up each mattress on my own and timed how long it took. I noted unique aspects of the experience that made it harder or easier. I also sniffed for a "new bed smell." Then, when I went to bed at least 10 hours later, I assessed whether or not the odor dissipated. Lastly, I looked for in-home setup availability or white-glove delivery and its cost.

Both orthopedic doctors we talked to said that medium-firm mattresses are best for back pain.

Amit Jain, MD, an associate professor of orthopedic surgery and neurosurgery at Johns Hopkins University School of Medicine and chief of minimally invasive spinal surgery at Johns Hopkins Hospital, pointed to a 2015 study that found medium-firm mattresses led to better sleep quality for people with or without back pain.

However, according to Tamara Huff, MD, a Georgia-based board-certified orthopedic surgeon and health disparities advocate, the classification "medium-firm" is hard to pin down since there's no standardized way to assess mattress firmness. "When you look over the studies, no one can agree on what a medium-firm mattress is. So, in general, we recommend you not go for the firmest mattress," she said.

Huff recommends choosing a mattress that feels medium-firm to you based on what you're used to. If you are used to an incredibly soft bed, then a mattress that is just slightly softer than average might be your "medium-firm."

Recognizing the subjective comfort experience of mattresses, Huff stressed the importance of finding a bed that comes with a long, risk-free sleep trial. She was a fan of the custom feel of adjustable air beds and Tempur-Pedic foam mattresses. 

In addition to warning against very soft or hard mattresses, Jain recommended thicker mattresses and ensuring you purchase the appropriate base for your mattress. Jain also stressed the importance of reading reviews before you buy.

"Sleeping on your side with pillows between your knees is very effective for back pain reduction," said Jain. As a side sleeper with back pain, I rely on the Coop Home Goods Memory Foam Body Pillow to help keep my spine aligned.

Huff also said that a pillow between the legs is helpful for side sleepers. She added that it could reduce the chance of hip pain. She suggests lying on your stomach to take pressure off the spine as well.

Lastly, Huff emphasized the importance of taking time to improve your back health during your waking hours. "Doing core exercises — not just exercises for your back — and also working on your muscles in what we call the pelvic girdle, around your hip and pelvis, can help support your back more and help with your overall back pain," Huff said. 

For exercises that can improve your back health, she recommends visiting OrthoInfo.org, the American Academy of Orthopedic Surgeons website.

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