The Physiotherapist’s Guide To Mattresses

I’ve had tons of questions about mattresses- having helped people for over 25 years recover from pain and injury. Some of the most common questions I’ve been asked about mattresses are:

• What is the best type of mattress?
• Should I buy a memory foam mattress?
• Is a firm mattress best?
• Will changing my mattress reduce my pain?
• How often should I change my mattress?
• Is my mattress causing my pain?

As physios we understand the pivotal role that sleep and the right mattress plays in your health, recovery, and overall well-being. Many of our patients struggle to sleep at night due to pain and discomfort. So I have written my “Physiotherapist’s Guide To Mattresses” to help answer some of these questions about mattresses.

The Purpose Of Your Mattress

Your mattress directly impacts the alignment of your spine, joints and muscles and plays a pivotal role in your sleep quality and physical health. Key roles of your mattress include:

✅ Spinal Support & Alignment – A good mattress helps maintain the natural curvature of the spine, preventing back and neck pain. Proper support ensures that muscles and ligaments relax and recover during sleep.

✅ Pressure Relief – A quality mattress distributes body weight evenly, reducing pressure points around hips, knees, shoulders and heels- reducing discomfort and enhancing circulation.

✅ Motion Isolation – For those sharing a bed, a mattress that minimises motion transfer ensures undisturbed sleep.

Medical Research On Mattresses and Sleep

Many studies have researched and explored the impact of mattresses on sleep quality and health:

Medium-Firm Mattresses for Pain Reduction – a literature review of 39 journal articles concluded that medium-firm mattresses improve sleep quality and reduce back pain, compared to soft or extra-firm mattresses.

Memory Foam Benefits – Some studies have indicated that individuals sleeping on memory foam mattresses experience decreased pain and fall asleep faster, perhaps due to their pressure-relieving properties.

Firmness Does Change Over Time – Studies have shown that firmness of both memory foam and pocket sprung mattress do degrade over time. Generally we recommend changing mattress every 7 years.

The Importance of Sleep in Health and Recovery

It is widely known that sleep is key to well-being and health. Adequate good quality sleep is fundamental to various physiological and psychological processes:

Physical Health – Sleep is essential for tissue growth / repair, immune function, and metabolic regulation. Poor sleep is linked to an increased risk of chronic conditions such as obesity, diabetes, and cardiovascular disease.

Mental Health – Quality sleep supports cognitive function, emotional regulation, and mental well-being. Sleep deprivation is associated with increased stress, anxiety, and depression.

Recovery & Performance – For individuals recovering from injuries or engaging in physical training, sleep aids muscle recovery, enhances learning, and boosts athletic performance.

Choosing the Right Mattress: A Physiotherapist’s Perspective

When selecting a mattress, consider the following factors to optimise comfort, sleep quality and musculoskeletal health:

1. Personal Choice

Sleep is a habit and comfort and personal preference are more important than what research says. Years of experience advising people on mattresses has taught me that personal choice and comfort is paramount- go with your gut!

2. Firmness Level

A medium-firm mattress is generally recommended for balancing support and comfort, helping with spinal alignment and pain relief.

3. Mattress Material

Memory Foam – Offers excellent pressure relief and adapts to body contours, reducing stress on joints. But many people dislike memory foam and find it too hot.

Pocket Sprung – Provides a more traditional feel and firm support, with a “bounciness” but may not distribute weight as evenly.

Hybrid – A combination of foam and coils, offering a balance of support and comfort.

3. Sleeping Position

Side Sleepers – May benefit from a slightly softer mattress to cushion the shoulders and hips.

Back Sleepers – Require a medium-firm mattress to support the lower back.

Stomach Sleepers – Need a firmer mattress to prevent excessive sinking at the lumbar spine and spinal misalignment. We generally advise against stomach sleeping.

Final Thoughts

Investing in the right mattress is a crucial step in enhancing sleep quality, which in turn supports overall health, recovery, and well-being. As physiotherapists, we encourage individuals to assess their sleep environment critically and select a mattress that aligns with their specific needs. Prioritizing sleep is not a luxury—it’s a fundamental component of a healthy lifestyle.

By choosing the right mattress, you are investing in better health, improved recovery, and enhanced quality of life. If you’re experiencing pain or discomfort related to sleep, a physiotherapist can assess your needs and recommend adjustments to your sleep environment for optimal rest and recovery.

Frequently Asked Questions (FAQ) About Mattresses

Q: What is the best type of mattress?

A: There is no one-size-fits-all answer, as the best mattress depends on your body type, sleep position, and any musculoskeletal conditions. However, research and our experience suggests that a medium-firm mattress provides optimal support and comfort for most people.

Q: Should I buy a memory foam mattress?

A: Memory foam mattresses can be beneficial for those needing pressure relief, as they contour to the body and distribute weight evenly. They are particularly helpful for individuals with joint pain or pressure-sensitive conditions. Sleeping on memory foam is very different to traditional sprung mattresses as there is no “bounce” provided by springs. Many of our patient love memory foam- others dislike it. Our advice is choose a memory foam mattress provider that gives you a free return option if you don’t like it.

Q: Is a firm mattress best?

A: If firm was best – sleeping on the floor would be ideal and we know that for most people this is not best! While firm mattresses provide support, they may not conform well to the body, leading to discomfort for some sleepers. Medium-firm mattresses tend to offer a better balance between support and comfort.

Q: Will changing my mattress reduce my pain?

A: If your current mattress is old (more than 7 years), sagging, or not providing adequate support, switching to a better-suited mattress can help reduce pain and improve sleep quality. Proper spinal alignment during sleep plays a key role in reducing back, neck, and joint pain.

Q: How often should I change my mattress?

A: Most mattresses should be replaced every 7-10 years, but this depends on usage, material quality, and personal comfort. If you notice sagging, lumps, or increased pain, it may be time for a new mattress.

Q: Is my mattress causing my pain?

A: If you wake up with stiffness, back pain, or discomfort that improves throughout the day, your mattress could be a contributing factor. An unsupportive mattress can cause poor spinal alignment and pressure buildup, leading to discomfort over time.