Firmer Mattresses May Not Help Back Pain

Goldilocks may have been onto something. When choosing a mattress, a new study says, go for one that is not too hard, not too soft, but just right.

For years, many people with back pain have thought that a hard mattress is best for their back. But a new study now shows that firmer does not mean better.

The research, published in this week's issue of The Lancet, examined 313 people who suffer with chronic back pain and morning achiness. They were given new spring mattresses that were either "firm" or "medium-firm," but were not told which type they had.

After sleeping on the mattresses for three months, the subjects who slept on medium-firm mattresses had fewer aches and pains than those who slept on firm ones. They had less daytime low-back pain, less pain on lying and rising from bed, and fewer limits in activity.

Though the study was done in Spain, most specialists feel the results are easily applied to mattresses in the United States.

"The principles of previous research are in support of the conclusions [of this study]. However, this is by far the largest and best-conducted study of its type," said Dr. Gunnar Andersson, an orthopedic surgeon at Rush-Presbyterian-St. Luke's Medical Center in Chicago.

No More Floors?

Lower back pain is one of the most widely experienced health problems in the United States, affecting more than 65 million people. It is the second most frequent reason for visiting a doctor, generating approximately $24 billion per year in health-care costs.

In the past, patients were often advised to sleep on a firm mattress or even on the floor to relieve back pain, but most specialists now agree that there is little scientific support for this recommendation.

"I am not surprised by this study. These are the recommendations I have given to my patients for a long time," said Andersson, a specialist in spine and back injuries.

Andersson says some patients misinterpret their perception of comfort on a hard surface. "They confuse worn mattress springs for bed softness. What's most important is that beds provide an evenly supportive surface."

Finding the Right Support

Treatment of chronic low back pain can be complex, and back specialists agree that a mattress providing adequate support is important. Mattresses that lack support may allow back movements that increase pressure and pain.

"Remember, you spend up to a third of your life in bed, so investing in a good resting place is well worth it," said Dr. Robert Bray, founding director of the Cedars Sinai Institute for Spinal Disorders in Beverly Hills, Calif.

"Changing beds will not cure chronic back pain, but in the right setting (e.g., the person has an old, worn-out mattress), a change to a more comfortable mattress will give more rest and that will make the next day more pleasant," Dr. Nathan Lebwohl, an orthopedic surgeon at the University of Miami, said in an e-mail to ABCNEWS.

Overall, many orthopedic surgeons agree that patient comfort is the leading factor in choosing a mattress.

"If your mattress is old (more than 10 years for most types), it may not be giving the support that is comfortable, so consider replacing it," said Dr. Michael Bolesta, an orthopedic surgeon at the University of Texas Southwestern Medical Center in Dallas.

How do you decide which mattress is best for you?

"Recline on several in the showroom and do not be in a hurry. If you can arrange for a trial, great, but dealers may not like that idea. If you have a friend or relative with a brand you are considering, they might let you nap for a test run," Bolesta said. "It ultimately is quite personal."

Ayanna V. Buckner, a member of ABCNEWS' Medical Unit, has a medical degree from Meharry Medical College.

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