Despite a lack of scientific evidence, popular wisdom has long prescribed a firm mattress as the best antidote for lower back pain. Recently however, a Spanish research team from the Kovacs Foundation has introduced startling new evidence that dispels this popular myth. Led by Dr. Francisco Kovacs, the group found that medium-firm mattresses significantly out-performed firmer models in alleviating lower back pain and reducing associated disability.The Kovacs team assessed the effects of mattresses of varying firmness among 313 patients in a random, double blind, controlled, multi-center trial. Individuals included in the trial had reported non-specific lower back pain, and experienced backache while lying in bed and upon rising. Using a scale devised by the European Committee for Standardisation, which rates mattresses from 1.0 (firmest) to 10.0 (softest), the patients were issued mattresses with a rating of either 2.3 (firm) or 5.6 (medium-firm). After 90 days, the patients were evaluated in terms of lower back pain experienced while lying in bed, pain upon rising, and general disability.
Significantly, the individuals sleeping on medium-firm mattresses were 2.36 times more likely to report improvement in pain while lying in bed, 1.93 times more likely to experience a reduction in pain upon rising, and 2.10 times more likely to report a decrease in disability. In addition, the medium-firm group also experienced less daytime lower back pain throughout the study. Writes Kovacs, “[a] mattress of medium firmness improves pain and disability among patients with chronic non-specific lower-back pain.”
Overall, 82% of the individuals using medium-firm mattresses believed their back pain had improved, while only 68% of the firm mattress individuals reported the same. Notably, the authors suggest that the firm mattress group’s improvement percentage may be inflated because it was not possible to entirely disguise the type of mattress employed; therefore these individuals may have reported improvement simply because they expected that using a firm mattress would yield a reduction in pain.
So why would a medium-firm mattress prove superior in terms of reducing back pain? Generally, it is thought that a medium-firm mattress is probably better equipped to distribute the pressure from the body. A mattress that is too firm may not adjust to the body’s contours properly, and therefore fail to provide the necessary lower back support. On the opposite side of the scale, a mattress that is too soft does not provide enough support to the body, and fails to distribute pressure adequately.
This study is significant both in that it is the first to address this issue, and because it challenges the prevailing wisdom proscribing a firm mattress as the best choice for alleviating back pain. The Kovacs Foundation in Spain is a non-profit organization dedicated to medical research, health care, and advancement of public health.
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