Begin main content

Mattresses for Chronic Back or Neck Pain: A Review of the Clinical Effectiveness and Guidelines

Last updated: May 14, 2014
Project Number: RC0553-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Report in Brief

Chronic back and neck pain are common conditions that result in significant costs related to care, absenteeism, and early retirement. The pain can be moderate to severe and debilitating. While back and neck pain often resolve with little or no intervention, in some cases the pain recurs frequently.

Physical therapy, exercise, and analgesia are frequently recommended for reducing non-specific back and neck pain, and associated disability. However, it has been suggested that the use of specific types of mattresses may be another treatment option, as some mattresses may contribute to back and neck discomfort or pain depending on their firmness and construction.

A review of the effectiveness of different mattress types for treating adults with chronic back or neck pain, and of evidence-based guidelines on mattress attributes to reduce chronic back or neck pain, will help to inform treatment decisions for these patients.

A limited literature search was conducted of key resources, and titles and abstracts of the retrieved publications were reviewed. Full-text publications were evaluated for final article selection according to predetermined selection criteria (population, intervention, comparator, outcomes, and study designs).

The literature search identified 377 citations, with 4 additional articles identified from the grey literature. Of these, 17 articles were deemed potentially relevant, with 5 meeting the criteria for inclusion in this review — 4 guidelines and 1 randomized controlled trial.

Key Messages

  • A firm mattress is the least effective intervention, when compared with a waterbed mattress and a foam mattress, for treating adults with lower back pain (based on limited evidence).
  • No evidence was identified that examined mattress interventions specifically for chronic neck pain.
  • There is a lack of evidence on which to base mattress recommendations for the treatment of chronic back and neck pain.


  1. What is the evidence for the effectiveness of different mattress types for adults with chronic back or neck pain?
  2. What are the evidence-based guidelines for mattress attributes to reduce chronic back or neck pain?

Key Message

Limited conclusive evidence was identified regarding the efficacy of specific mattress types for treatment of back and neck pain. One trial was identified presenting evidence that firm mattresses may be the least effective treatment for lower back pain. Four guidelines were identified that found a lack of evidence to form a basis for mattress recommendations for the treatment of chronic back and neck pain of musculoskeletal origin.