Do mattress toppers help with back pain? Medical professionals explain what you need to know

How often do you hear people blaming their mattress for a bad back? I’d say – purely anecdotally, of course – about nine times out of ten. And sure, sometimes the mattress is the culprit. But if you’re waking up every morning feeling like the Tin Man before his oil can, could a mattress topper be the quick fix you need instead of splurging on a whole new bed?

When speaking to medical professionals while researching this piece, they were at pains to say that even if you buy the best mattress topper – and even best mattress – it won’t be a magical cure for back pain if there are underlying issues.

As a journalist with a special expertise in sleep, I’ve slept on well over 15 mattress toppers to find the best one. I’ve also suffered from back pain myself over the years. So I was keen to do a deep dive into whether a mattress topper could ever help with back pain - and what industry experts and medical professionals advised on mattress topper use.

Do mattress toppers help with back pain?

A mattress topper is designed to lie on top of your existing mattress and give it a boost. There are loads of different types of mattress toppers.

If pressure points are an issue – ie. you wake up with sore shoulders or hips – there are fluffy mattress toppers filled with wool, such as my personal favourite the Woolroom deluxe mattress topper. And if you’re finding your mattress is too soft, there are mattress toppers with more firm support like the Simba Hybrid topper that contains both memory foam and micro springs

So, depending on what is causing your back pain, yes in a lot of cases a mattress topper can help with your back pain. ‘Based on the research evidence, mattress toppers can help with back pain when chosen appropriately. A study by Price et al in Clinical Rehabilitation (2003) found statistically significant improvements in pain when using an air-filled mattress overlay (topper),’ says a physiotherapist with 20 years of experience and owner of NellMead.co.uk.

But before you nip out to buy a mattress topper to cure a slipped disc, take a moment. ‘It’s important to remember, though, that mattress toppers can’t cure back pain when it’s from a medical condition,’ says Dave Gibson, a sleep and well-being expert, registered osteopath and founder of thesleepsite.co.uk. ‘If you are experiencing severe or persistent back pain, always see your GP or seek professional support.

What type of mattress topper is best for back pain?

As with the best mattresses for back pain, your safest bet if you suffer from back pain is to go for a solid, mid-tension mattress topper. ‘The evidence suggests that (as with mattresses) medium-firm toppers are generally most beneficial for back pain,’ Nell Mead says in agreement.

‘A systematic review by Caggiari et al in 2021 (Journal of Orthopaedics and Traumatology) found that medium-firm sleeping surfaces promote comfort and proper spinal alignment,’ Nell continues. ‘The research particularly highlights air-filled toppers with adjustable firmness, memory foam toppers of medium firmness and latex toppers that provide even pressure distribution.’

A great memory foam topper with medium firmness would be something like the Panda London mattress topper, which we found supportive and cushioning in our thorough testing.

‘Typically, memory foam and latex toppers are recommended for lower back pain sufferers, as they contour to the body and offer tailored support for a relaxing spinal alignment,’ explains osteo Dave from The Sleep Site.

‘Latex is potentially more breathable and more durable [than memory foam] with a more moderate contouring effect. Hybrid toppers are also available, combining layers of foam, latex, and other materials such as fibre fillers.’

A great latex mattress topper I’ve tried is the terrific topper from Naturalmat. It’s springy and also has a layer of wool to help with temperature regulation.

How thick should a mattress topper be to help with back pain?

‘While there is no definitive research regarding optimal topper thickness, adequate support and pressure distribution are important, so I think we could generalise to say that for therapeutic benefits the "Goldilocks" answer is about 2-4 inches,’ says physio Nell Mead.

Anything thinner than this and a topper most likely isn’t doing much for you – ‘1-2 inches may not provide enough pressure relief,’ says Nell Mead. On the other hand, ‘toppers over 4 inches might compromise support and spinal alignment.’

‘A depth of around 3 to 4 inches would, in general, be the thickness recommended to provide the optimum combination of cushioning for pressure relief and support for correct spinal alignment,’ adds osteopath Dave Gibson. ‘If you are looking for firmness alone, you could reduce this thickness to around a 2-inch depth or even as low as 1 inch if you are a stomach or back sleeper, which needs a firmer base support.’

‘The ideal thickness of a topper also depends on your weight, the firmness of your current mattress, and your sleeping position,’ adds Dave Gibson.

Do mattress toppers help with shoulder or hip pain?

Yes, mattress toppers can help with shoulder and hip pain. I speak from experience on this one. As a side sleeper I often find I wake up with sore shoulders and hips. A mattress topper on my bed definitely has eased this significantly.

‘A study by Jacobson et al in 2001, in the Journal of Manipulative and Therapeutic Physiologics, showed that appropriate sleeping surfaces can improve both back and shoulder pain,’ weighs in Nell Mead. ‘The article emphasises that pressure point relief at hips and shoulders is crucial, and toppers can help distribute pressure more evenly across these areas.’

It’s worth noting though that you shouldn’t expect a mattress topper to absolutely makeover a tired, sagging mattress. If your mattress has seen better days, you are better off replacing the mattress to ensure you have solid support.

What can I put on my mattress to help with back pain?

A mattress topper is one of a few items that you can add to your bedding arsenal to help a painful back. Choosing the right topper is key though.

‘Based on the research evidence, effective options include a medium-firm mattress topper, an air-filled overlay system, a temperature-regulating topper (the article notes temperature's importance for sleep quality and comfort or pressure-distributing materials like memory foam or latex.

Temperature regulating toppers would include ones with fibres such as wool or an open-cell memory foam structure as fillings. These help air circulate around you and keep you at the right temperature all night.

Our tester found the Emma Premium mattress topper particularly good as a memory-foam option for hot sleepers.

‘Strategically placed pillows can make a big difference to help alleviate back pain at night,’ says osteo Dave Gibson. ‘For side sleepers, they should be placed between the knees to keep the spine in alignment. For back sleepers, smaller pillows could be positioned under the small of the back and under the knees. If you are suffering from neck pain, changing your pillow to one that supports your neck, such as a cervical pillow could help too.’

Should I get a medium or firm mattress topper?

Not to be contrary here, but really a medium-firm mattress is your best bet. Too firm and you’ll probably find those pressure points we talked about – hips and shoulders – are sore in the morning.

‘It's also important to remember that individual needs may vary based on factors like body weight, sleeping position, and specific health conditions,’ says Nell Mead.

Of course, you need to factor in what your current mattress tension is like too.

‘If your mattress is too soft and you feel it’s not supporting you, a firmer topper might be best. If you have very firm mattress, a medium topper would in general add more cushioning without

losing support,’ counsels Dave Gibson from The Sleep Site.

‘However, back pain sufferers would, in general, find that a very soft topper without as much support wouldn’t help and could even make things worse,’ warns Dave. ‘When it comes to sleeping position, side sleepers would typically need a medium topper to cushion the shoulders and hips, while for back and stomach sleepers with back pain, a firmer topper would improve support.’

And as with the best mattresses for heavier people, firmer tensions in a mattress topper are the best bet if you have a heavier body build.

Overall, yes, a mattress topper is good for bad backs. But you need to find the right topper for you - it’s not a one-size-fits-all situation here.

‘The research suggests that toppers can be beneficial when the topper is of the appropriate depth and firmness, as long as the underlying mattress is still structurally sound. If the underlying mattress is too badly degraded or compromised, then a topper alone might not be sufficient,’ reminds Nell Mead.