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This question is one we get asked quite frequently when treating patients, especially those with neck, back, and/or hip pain. Big mattress companies have us convinced that there is a magic bed out there, and if you can just find the right one, you can finally wake up in the morning without stiff joints. Or you can jump on the bed with a glass of wine a few feet away, whichever best helps you get your day started, I suppose.
The short answer to this question is that there is no single “best” mattress out there. As physical therapists, we usually can make some recommendations on selecting a mattress after we have the chance to perform an evaluation on a patient. The answer to the question depends on each individual’s anatomy and symptoms.
A quick personal story: One day a few years ago, my wife developed some SI joint pain that didn’t seem to have an apparent cause. She was absolutely convinced that our mattress was to blame. I wasn’t so sure. If you’re married, you know that we ended up with a new mattress a few days later. Her pain hung around for about 5 more weeks and resolved after some stretching and strengthening exercises. Because I was a few years into our marriage and wanted it to continue, I didn’t mention my observation that the new mattress didn’t seem to make her symptoms go away.
I include this anecdote because a more important question than ‘what should I buy’ is this: “How do I know if my mattress is responsible for my symptoms?” The thing is, many adults wake up in the morning with stiffness somewhere in their body. I certainly do some mornings (as I think about it, I seemed to start noticing it right around my 30th birthday). My advice to patients who report this is to try sleeping in a different bed for a few nights. If they suddenly start waking without pain and stiffness, I’d be more inclined to recommend a new mattress. If there is no change, I’m much less convinced that the mattress is the culprit.
A mattress certainly won’t turn into a pumpkin overnight. That is, it doesn’t suddenly go bad one night. So, the timing of the onset of the pain is an important clue to determine whether or not the mattress is a problem. Let’s use back pain as an example. If the pain began suddenly one day, or you wake up one morning with pain that you didn’t go to bed with, it is very unlikely that your sleeping surface is a problem. If, however, waking in the morning has gradually become more difficult over the course of many months or years, the mattress may actually be a problem. The material in mattresses gradually breaks down over time (just like most other things in life), so a slow, gradual onset of pain and stiffness in the morning correlates with the breakdown of the material.
My general opinion on mattresses as it relates to back pain is that a bit too much emphasis is placed on their importance in spine health. The conventional wisdom is that mattresses typically last about 10-15 years before the materials start to degrade. Consumer Reports did a nice synopsis on how to get the most from your mattress. There are many other things I would look at before I’d recommend buying a new product that can cost upwards of $2,000-4,000. These include examining activity level, muscular and joint balance, body-mechanics, and overall fitness. All of these are components of a thorough physical therapy evaluation. Even when a mattress may be part of the problem, it is imperative that other contributors be addressed as well.