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Best Mattress for Side Sleepers with Back Pain

UPDATED

Written by Katie Kottemann

Reviewed by Dr. Michael Breus

Expert Tested

Table of Contents

Side sleeping is popular, but without the right mattress, it can lead to or worsen back pain. Side sleepers need extra support and cushioning at their shoulders and hips since these are the body areas that sink most deeply into a mattress. A mattress that provides a good balance of support and pressure relief in those areas can help keep the spine aligned, which may prevent discomfort for those with back pain.

If you’re a side sleeper with back pain, there are a variety of factors to keep in mind when choosing a mattress. A bed’s firmness and materials can determine how much support it provides, and finding a mattress that matches your sleep needs and body size is also important. 

We’ll discuss our top picks for the best mattress for side sleepers with back pain, as well as  what features you should look for in this kind of mattress. We’ll also cover strategies to help prevent or reduce back pain.

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Read on to see why the following four options made our top picks list of 2024’s best mattresses for side sleepers with back pain.

Sleep Doctor’s Picks

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Best Overall Mattress

Helix Midnight Luxe

Dr. Michael BreusReviewer Picture

The Sleep Doctor’s Review

The Helix Midnight Luxe was specifically created with side sleepers in mind, and our tests show this sophisticated foam hybrid works as intended. Plush surface layers cradle the body to target your sore spots, while the robust coil system pushes back against your midsection to prevent uncomfortable sinkage during the night.

Buy from Helix
Ideal For:

Midweight Side Sleepers

Firmness:

Medium Firm (6)

Feel:

Contouring Foam

Value:

Good Value

Pros

  • Luxury foam hybrid features a plush Euro-top, deep foam layers, and multi-zone coils
  • Two cooling cover options
  • Above-average pressure relief and motion isolation for a hybrid

Cons

  • Initial off-gassing odor can be fairly harsh
  • Expensive pricing may be prohibitive for budget-conscious shoppers

Helix’s Luxe hybrid line consists of six models, each intended for different body types and sleep positions. The Midnight Luxe was initially designed for side sleepers between 130 and 230 pounds, but we’ve found the mattress is a solid pick across most weight groups for people who use this position. The tried-and-true combo of thick foam layers and sturdy coils delivers the cushioning and support side sleepers need to reduce pain and pressure buildup in the shoulders and hips.

Why We Like It

Not surprisingly, the Midnight Luxe earned its highest marks from side sleepers between 130 and 230 pounds, but lighter and heavier side sleepers on our team also felt comfortable and adequately supported on the mattress and ratings were favorable across all three weight categories. We also found the mattress isolates motion well and provides enough cushioning to alleviate pressure — most competing hybrids struggle in these areas.

The foam layers may absorb some heat, but the moisture-wicking cover offsets this issue to a noticeable degree. If you’re an exceptionally hot sleeper, the GlacioTex cover upgrade may be worth the extra money. This cutting-edge material dissipates body heat and feels cool to the touch at all times.

How Does It Feel?

The Midnight Luxe’s comfort system contains two layers of plush memory foam. Memory foam softens when it comes into contact with body heat, so you’ll feel the mattress slowly mold to your body’s contours when you get into bed. Dense transitional foam pushes back against your weight as you sink into the mattress. For added pushback, the pocketed coils are thicker beneath your torso and hips.

Both cover materials provide some measure of cooling. Tencel is a eucalyptus-derived fabric prized for its breathability and moisture-wicking abilities, but the GlacioTex phase change material is your best bet if you feel excessively hot in bed or your local climate is prone to extreme conditions.

Read our full Helix Midnight Luxe review
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Best Value Mattress

Silk & Snow Mattress

Dr. Michael BreusReviewer Picture

The Sleep Doctor’s Review

The S&S Mattress from Silk & Snow delivers a comfortable, pain-relieving surface at an affordable sticker price. Three foam layers cushion the body to promote even alignment for side sleepers and minimize hot spots along the spine — a constant source of sleep loss for people who use this position.

Buy from Silk & Snow
Ideal For:

Spinal Alignment

Firmness:

Medium (5)

Feel:

Close-Conforming Foam

Value:

Great Value

Pros

  • All-foam design contours closely to promote spinal alignment and reduce pressure
  • Excellent motion isolation for co-sleepers
  • Below-average pricing and free pillows with each purchase

Cons

  • Foam layers may emit strong off-gassing odor at first
  • Insufficient support for many people over 230 pounds

High-quality memory foam mattresses can be expensive, but that isn’t the case with Silk & Snow’s flagship all-foam mattress. You’ll pay a below-average sticker price, receive two pillows with your order at no extra cost, and qualify for free shipping if you reside in the contiguous U.S. or any of the Canadian provinces. This sort of deal is hard to come by in the online mattress industry, and the S&S is well made to boot. 

Why We Like It

Memory foam mattresses like the S&S are usually big hits with side sleepers on our testing team, especially those with softer, more adaptive designs. This model was particularly popular among our side sleepers who weigh 230 pounds or less. Heavier side sleepers on our team noticed a bit of sinkage, so their ratings were slightly lower but still favorable. The mattress also earned high marks from back and stomach sleepers under 130 pounds.

Motion isolation is a major strength. All three foam layers absorb movement well and significantly reduce motion transfer, which is a major benefit for anyone who shares their bed with a restless partner. Although the top layer is infused with cooling gel and the cover promotes air circulation, you may notice some heat buildup — cooling sheets can help mitigate this issue.

How Does It Feel?

We’ve rated the Silk & Snow Mattress as medium (5) because it offers a nice balance of cushioning and support. The topmost layer is composed of memory foam that’s infused with cooling gel to offset heat retention and maintain a comfortable surface temperature. Transitional polyfoam provides extra cushioning while creating a buffer between your body and the support core, which is made of high-density polyfoam. A breathable poly-spandex cover encases the mattress.

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Best Mattress for Pressure Relief

Bear Elite Hybrid

Dr. Michael BreusReviewer Picture

The Sleep Doctor’s Review

The Bear Elite Hybrid excels at reducing your existing pressure points and preventing new hot spots from building up in sensitive areas. This quality — along with three firmness options — makes the mattress a solid match for any side sleeper with back pain.

Buy from Bear
Ideal For:

Hot Sleepers

Firmness:

Medium (5), Medium Firm (6), Firm (8)

Feel:

Contouring Foam

Value:

Good Value

Pros

  • Adaptive foam layers cushion and cradle the body without sinking too much or trapping excess heat
  • Available in three firmness levels to accommodate side sleepers in different weight groups
  • Zoned coils provide extra support for your heavier areas

Cons

  • Couples may notice some motion transfer during the night
  • Strong off-gassing odor for the first few nights

Bear’s Elite Hybrid is a solid choice for people who experience painful pressure buildup while they sleep. The foam layers contour evenly to distribute your weight, promote even alignment, and reduce pressure in sensitive areas like the shoulders and hips. Zoned transitional and coil layers also work to minimize sinkage and keep your body on an even plane.

Why We Like It

Our team tested all three of the Elite Hybrid’s firmness levels. Side sleepers weighing less than 130 pounds preferred the Luxury Plush, which registers as a medium or 5 on our 10-point firmness scale. This is the softest adaptive design, so lighter side sleepers get plenty of cushioning and won’t sink too much. Our side sleepers between 130 and 230 pounds gave the highest ratings to the Luxury Firm (6) design, citing its balanced feel as a key strength, while those weighing more than 230 pounds appreciated the robust support of the Firm (8) model.

All three designs sleep fairly cool. While foam can absorb and trap body heat, the Elite Hybrid’s top layer is infused with gel and the cover is woven with Celliant fibers intended to release heat from the surface. The coils circulate plenty of air for added breathability.

How Does It Feel?

Each firmness level has a distinct feel. The Luxury Plush is cushy and adaptive, the Luxury Firm lightly contours to the body, and the Firm withstands compression and feels even from head to toe. One notable feature is the transitional foam layer, which is divided into five zones with stronger support beneath your midsection and gentler cradling for lighter areas of your body. The coils are also zoned, so uncomfortable sinkage around the torso and hips shouldn’t be an issue as long as you choose a firmness level that aligns with your body type.

Read our full Bear Elite Hybrid review
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Best Adjustable Bed and Mattress Bundle

Puffy Cloud Smart Bed Set

Dr. Michael BreusReviewer Picture

The Sleep Doctor’s Review

I always tell people with chronic back pain that the right mattress paired with a well-made adjustable bed is a great investment. With the Puffy Cloud Smart Bed Set, you get both of these components without draining your wallet.

Buy from Puffy
Ideal For:

Frequent Back Pain

Firmness:

Medium (5)

Feel:

Close-Conforming Foam

Value:

Great Value

Pros

  • Each bundle includes a luxurious Puffy Cloud mattress and an adjustable base in the same size
  • Plush, all-foam design eases pressure off the shoulder and hips
  • Mattress cover is stain-resistant and fully machine-washable

Cons

  • Off-gassing odor can be harsh for the first 48 hours
  • Not available in twin or California king sizes

The Puffy Cloud is a plush, adaptive all-foam mattress that’s been popular among side sleepers on our team who weigh 230 pounds or less. Puffy’s Cloud Smart Bed Set includes the mattress along with the Serenity Adjustable Base. This bundle is reasonably priced, and using both products together can greatly reduce nightly discomfort for side sleepers with chronic or frequent back pain.

How Does It Feel?

The Cloud is medium (5) and contains foam layers that are progressively denser from top to bottom. Memory foam forms the top layer, creating a plush surface with deep contouring and cloud-like cradling for your sore spots. Underlying polyfoam layers deliver additional cushioning while pushing back against your weight. The cover is both stain-resistant and removable for machine-washing.

The adjustable bed’s massage mode produces gentle vibrations to alleviate your aches and pains. You can choose from three intensity levels based on your needs. The legs are adjustable, allowing you to create more under-bed storage space, and LED lighting helps you navigate your bedroom in the middle of the night. Please note the Serenity Adjustable Base is not available in twin or California king sizes.

Why We Like It

This combo is hard to beat in terms of cost, especially for those who deal with regular back pain. The mattress contours closely to distribute your weight, promote even alignment, and minimize pressure in the shoulders, lower back, and hips. Our tests indicate the mattress is a good match for side sleepers weighing up to 230 pounds. If you’re a side sleeper who weighs more than 230 pounds, a firmer mattress may be more suitable.

In addition to people with back pain, an adjustable bed can be beneficial for people with acid reflux, those with circulation problems, pregnant individuals, and sleepers prone to heavy snoring. Our testers were particularly fond of the customizable massage function.

Why You Should Trust Us

Our sleep experts have accumulated years of industry knowledge and expertise that can help you select the right mattress. Our team conducts hands-on testing of every mattress we review, focusing on features like firmness, pressure relief, and support, which are especially important for side sleepers with back pain. 

Our team includes testers with diverse body weights and sleep preferences. This helps us evaluate the performance of each mattress model for a variety of sleeper types.

Side Sleepers With Back Pain: What You Need to Know

For a good night’s sleep, side sleepers with back pain need a mattress that relieves pressure points and supports proper spinal alignment. We’ll cover all the details to help you find the right mattress for your sleep needs.

Why Do Side Sleepers Get Back Pain?

Side sleepers sometimes experience back pain because they require a mattress that supports their shoulders, hips, and lower back while also helping them to maintain a neutral spine position. If a mattress is too soft or too firm, it can increase the likelihood of back pain. 

What Do Side Sleepers Need to Prevent Back Pain?

Side sleepers need a mattress with a firmness level that matches their body weight. Their mattress should also provide proper support and cushioning to eliminate pressure points.

Which Mattresses Should Side Sleepers With Back Pain Use?

Side sleepers with back pain are best suited to hybrid, foam, or latex mattresses. Mattresses with these materials and construction can provide the support and pressure relief needed to avoid or reduce back pain.

Side Sleeping and Back Pain: How Your Mattress Plays a Role

While you sleep, your mattress cradles and supports your body. Side sleepers need extra support at the shoulders and hips because these areas sink the farthest into the mattress when sleeping on your side.

Without proper support, your spine may become misaligned. This can lead to or worsen back pain and cause pain in the joints and other areas.

What Can Exacerbate Back Pain for Side Sleepers?

A mattress that doesn’t support proper spinal alignment can make back pain worse for side sleepers. These sleepers also require a bed that provides a good balance of cushioning and support for the shoulders, hips, and lower back

  • Misalignment of the spine: If you sleep on your side, you may be susceptible to spinal misalignment, which can cause or worsen back pain. By choosing a bed with the right level of support and contour to lift and cushion your shoulders and hips, you can ensure that your spine stays aligned as you sleep. 
  • Pressure points on the shoulders and hips: Side sleepers’ hips and shoulders sink the farthest into their mattress, which can lead to pressure build-up. This is especially true if the mattress is too firm, but it’s important to note that one that’s too soft can lead to sagging in these areas.
  • Lack of support for the lower back: Lack of support for your shoulders and hips, especially if a mattress is too soft, puts pressure on your lower back. Some mattresses offer targeted lumbar support or zoned layers to enhance lower back support for this reason. 

Preventing Back Pain While Side Sleeping

Maintaining proper spinal alignment is one of the most important ways to prevent back pain while sleeping on your side. If your spine is misaligned, it can cause or worsen back pain. Choosing a mattress that supports and cushions your body and is firm enough for your body size can help prevent this problem. 

Key Mattress Features for Keeping Your Spine Aligned

TIf you experience back pain, it’s important to keep in mind several specific mattress features. For example, your body weight helps determine your ideal firmness. And the right mattress will offer a balance of support and pressure relief. 

Mattress FeatureDescription
FirmnessMattress firmness ranges from soft to firm. Your body weight and sleep position can help determine which mattress firmness suits your needs. Sleepers over 230 pounds usually need a firmer bed, while those under 130 pounds often require a softer one.
SupportA supportive mattress provides good support while also cushioning potential pressure points and helping to keep your spine aligned. Some beds include zoned support that targets areas like your shoulders, back, or lumbar region.
Pressure ReliefA mattress that supports the shoulders and hips can help keep a side sleeper’s spine aligned. In addition to being supportive, a mattress that provides some level of contouring may reduce pressure points and prevent a side sleeper from waking up with aches and pains.

Choosing the Right Firmness Level

We rate mattresses using a 10-point firmness scale, where 1 is the softest and 10 is the firmest. The optimal range for side sleepers falls between soft (3) and firm (7), with most sleepers preferring a medium soft (4) to medium firm (6) feel.

In addition to sleep position, body weight plays a big role when it comes to finding your ideal firmness. Side sleepers under 130 pounds typically need a softer mattress, while those over 230 tend to need the support of a medium firm (6) or firm (7) bed. Those between 130 and 230 pounds should try for a balance between soft and firm.

Body WeightIdeal Firmness for Side Sleepers
Under 130 lbs.Soft (3), Medium Soft (4)
130-230 lbs.Medium (5)
Over 230 lbs.Medium Firm (6), Firm (7)

Balancing Support vs. Pressure Relief

Finding the right balance of support and pressure relief can help reduce back pain. Side sleepers need a mattress that supports the shoulders and hips while still providing enough soft cushioning for pressure point relief.

Other factors, such as your body weight and the construction of the mattress, can also affect how you respond to different firmness levels.

Other Mattress Qualities to Keep You Comfortable
In addition to support and pressure relief, there are a few other mattress qualities side sleepers should consider for a restful sleep. 

Responsiveness and ease of movement: Back pain may make it more difficult to change positions or get in and out of bed. Mattresses made with responsive materials can be extremely helpful for those with mobility issues. 

Temperature regulation: Maintaining a cool sleep surface is important for those who sleep hot. A breathable mattress with cooling features can help you sleep more comfortably if you’re prone to overheating during the night.

Edge support: Foam beds tend to compress at the edges, which can make it more challenging to use the bed’s entire surface. This may also make it more difficult to get in and out of bed, as well as limiting the available sleep space, especially for couples.

Quality materials: Choosing a high-quality mattress can ensure its durability and longevity. Lower-quality materials tend to break down more quickly, and a sagging mattress could worsen back pain.

Best Mattress Types to Ease Back Pain for Side Sleepers

Side sleepers need a mattress that balances support and pressure relief. A bed with these qualities can also help ease or prevent back pain. Different kinds of mattresses can offer help in these areas.

Mattress TypeWhy It’s Good for Side Sleepers with Back Pain
HybridThe foam or latex comfort system found in hybrids relieves pressure points, while the coil core adds support, responsiveness, and ease of movement.
FoamFoam that contours closely to the sleeper’s body can relieve pressure, especially around a side sleeper’s hips and shoulders.
LatexLatex contours the body without giving you the feeling of being hugged by the bed. Latex can also offer good support, and it tends to be bouncier than foam.

Hybrid Mattresses

Hybrid mattresses generally include a foam or latex comfort system and a support core of pocketed coils. These beds provide both cushioning that can cradle pressure points and a supportive core that helps align the spine. 

Foam Mattresses

Foam mattresses are constructed with several layers of foam. They typically provide a high level of body contouring that helps relieve pressure points. These beds are well-suited for side sleepers who like the feeling of sleeping in the bed instead of on top of the bed’s surface. 

Latex Mattresses

A latex bed is made with layers of synthetic or natural latex. It’s springier and more breathable than foam but offers less body contour. Instead, latex cushions the sleeper’s body while making it easier to move around on the bed.

Additional Tips to Keep Your Spine Aligned
In addition to finding the right mattress, there are many other ways to ensure proper spinal alignment for side sleepers. 

Use a medium- to high-loft pillow: When sleeping on your side, having a pillow with the right height and firmness is important to keep your neck aligned. Look for a  medium- to high-loft pillow to cushion the space between your neck and the bed, and stick to a medium or firm pillow to keep your head elevated and your neck aligned.
 
Try body and knee pillows for additional support: Using a body pillow, especially between the knees, can also help you avoid back pain. Hugging a pillow props up your shoulders, and knee pillows help keep your hips aligned.

Look for mattresses with zoned support: Some beds include zoned foam or coils designed to target specific body areas. This zoned support usually focuses on pressure-prone areas like the lower back, shoulders, or hips.

About The Author

Katie Kottemann

Staff Writer, Sleep Products


Katie is a writer, editor, and researcher based in Englewood, Colorado. With a doctorate in English from the University of Louisiana at Lafayette, she has written and edited for Peterson’s and Innerbody Research as well as been a writing professor. Katie is passionate about helping consumers make more informed choices.

  • POSITION: Side sleeper
  • TEMPERATURE: Hot Sleeper
  • CHRONOTYPE: Dolphin

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