Medium-Firm Mattress Is Helpful for Low Back Pain

Sleeping on a mattress of medium firmness is beneficial to people who suffer with chronic low back pain, reports a new study in The Lancet (2003;362:1599–604).

Chronic low back pain is one of the most common debilitating ailments afflicting people in Western societies. Low back pain affects the region of the back from the bottom of the rib cage to the folds beneath the buttocks, restricting movement of the entire body. It is often exacerbated by poor posture and certain physical activities. Treatment includes bed rest, stretching and exercise, applications of heat, spinal manipulation, massage, acupuncture, and anti-inflammatory and pain-relieving (analgesic) medications. The effectiveness of these therapies in relieving low back pain and reducing disability, however, is limited.

Mattress firmness is believed to be another factor influencing the course of low back pain, although that issue has not been subjected to rigorous scientific study. One study found that people with low back pain were more sensitive to the firmness of their mattresses than were people without back pain. While 76% of orthopedic surgeons answering a survey recommend a firm mattress to patients with low back pain, the optimal type of mattress for such people is not known.

The current study enrolled 310 people who had experienced low back pain while lying in bed or on rising. The pain had been present for at least three months, but the study participants were otherwise healthy. They were randomly assigned to receive either a firm or a medium-firm new mattress. Levels of low back pain and disability due to low back pain were scored using questionnaires at the beginning of the study and after 90 days. Improvements in disability scores and in overall scores for pain on rising were significantly greater in the participants receiving medium-firm mattresses than in those receiving firm mattresses.

These findings suggest that sleeping on a medium-firm mattress is helpful in managing chronic low back pain and reduces disability related to the condition. Furthermore, a medium-firm mattress appears to be more helpful to people with low back pain than a firm mattress. Future studies are needed to confirm these findings, to compare the effects of sleeping on other kinds of mattresses, and to assess the long-term benefits of this intervention.

Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, VT, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.

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