Do mattress toppers help with back pain or make it worse? Experts respond

A woman with long dark hair in a light green jumper sits on a soft mattress topper holding her lower back because she has pain there
(Image credit: Getty Images)

If you're waking up with back pain every morning, it's easy to speculate that your mattress or mattress topper is to blame. After all, if you're sleeping on a topper all night only to start the morning with aches and pains, it is likely to do with your sleeping arrangement. But do mattress toppers help with back pain or make it worse?

We know from testing the best mattresses of the year that the right level of support  for your body type is essential to helping you feel comfortable enough to sleep well. If you don't have the right support, your spine could dip, leading to pain over time. A mattress topper can help deliver the right type of support, but if you choose the wrong topper for you it could make your sleep space worse, from causing overheating to lower back pain.

Here we'll look at whether mattress toppers help with back pain or if they cause it, and which topper you should choose if you want reduce back ache. We'll also look at some of the most common signs that your topper is causing you needs replacing, so you can tell whether it's time to buy new in May's Memorial Day mattress sales.

Do mattress toppers help with back pain?

While the wrong mattress topper can cause discomfort, the right mattress topper can actually prolong your mattress's life and prevent you from developing back pain. 

For example, if your mattress topper is too soft and it's leading to a lack of back support, a medium-firm or firm mattress topper can help to keep your spine properly aligned. Also, a topper can cover any sagging in an older mattress, working as a stopgap so your hips won't sink into the dip. 

A man sits on the edge of the bed holding his neck and back

(Image credit: Getty Images)

Can a mattress topper cause back pain?

The short answer is yes, and even the best mattress toppers can cause you some discomfort in the lower back if you've chosen the wrong one. It's often not because the mattress topper is of poor quality, it's often due to its firmness level. A mattress topper that is too soft can lead to hips sinking, and in turn the spine misaligning, which leads to lower back pain.

James Crow, a sleep posture expert recently told Tom's Guide that knowing how to sleep better with back pain comes down to how hard or soft your mattress or mattress topper is. "Medium-firm mattresses are generally better for back pain than soft mattresses, which can lack support, or hard mattresses, which can be too unforgiving," he says.  

While a lot of toppers are designed to add softness to your bed, this can exacerbate back pain among back and front sleepers, as it causes the hips to sink into the topper's surface and misalign the spine. Instead, go for a medium-firm or firm topper for extra support.

3 signs your mattress topper is causing back pain

1. Your bed topper is over two years old 

If your wondering how long mattress toppers last, the answer is that it's not as long as you think. If your mattress topper is feather or down then it could need replacing after just one year, while even the best memory foam mattress toppers can reach the end after two years. 

“It’s important to make sure to replace your mattress topper every one to two years, to help your mattress last longer,” says Lydia Lloyd, M&S Home's homeware textiles designer.

While wool or latex toppers last a little longer (five to ten years), the truth is toppers aren't supposed to be a long-term solution. Mattress toppers can start to sag and show signs of wear and tear early, which can leave your body unsupported and prone to misalignment and lower back pain. 

2. You back pain is worse in the morning

If you go to bed feeling fine, but wake up in the morning with back pain and aches, it's likely that your sleep surface is to blame. While back pain can arise from an injury or a daytime activity, back pain that's intense in the morning and fades throughout the day can usually blamed on a topper that is too soft to support your back or hip region. 

A man sits on the edge of his back while massaging his lower back

(Image credit: Getty Images)

3. You can't get comfortable at night

The majority of mattress toppers are made from memory foam, as it can add plush pressure relief and body-contouring comfort to firm mattresses. However, not everyone likes the hug of memory foam, and back sleepers and stomach sleepers may feel enveloped or even trapped by the sink-in softness. If this is the case it's likely that your back, hips and spine is unsupported, which can lead to back pain. 

How to choose a mattress topper for back pain

Trying to sleep with back pain is one of the hardest things Claire Davies, Senior Sleep Editor and Certified Sleep Coach, has had to do. Davies developed lower back and hip pain during the third trimester of her pregnancy and said it hugely derailed her sleep. "I was in agony within around 20 minutes of lying down, so as you can imagine my chances of feeling comfortable enough to fall asleep were pretty slim."

According to Davies, combining a pressure relieving mattress topper with a cooling hybrid mattress was her solution to reducing back and hip pain during sleep. "I remember at the time I was testing an Eve hybrid mattress, and it suddenly felt too firm and unforgiving around my hips and back. 

"So I decided to pair it with the Tempur-Pedic Tempur-Adapt mattress topper (from $191 at Tempur-Pedic) and it turned out to be the best decision I made for my sleep at that time."

When choosing a mattress for back pain, consider the following:

  • Firmness – If your mattress is too soft to support your back properly, causing it to dip and your spine to not stay properly aligned, pick a firmer topper to add the support you are missing. 
  • Suppleness – You can have a supportive topper while still enjoying some contouring and suppleness, which is essential to avoid feeling as though you're sleeping on a log. 
  • Ease of movement – Back pain will cause you to move around a bit in bed, so you need a topper that supports that instead of making you feel like you're wedged in the material.

Ultimately, if after a few weeks you're still waking up with a back pain, then you may need to increase or decrease the firmness of your topper. We'd also recommend speaking with your doctor to rule out any other causes.

Looking to replace your entire bed? Our guide to the three features to look for in a mattress for back and hip pain can help you make the right choice, with all the support and comfort you need.

Today's 3 best mattress topper deals

1. Tempur-Pedic Tempur-Adapt Topper:  | now $191.40 at Tempur-Pedic

1. Tempur-Pedic Tempur-Adapt Topper: was $319 | now $191.40 at Tempur-Pedic
This is the topper Tom's Guide's Senior Sleep Editor, Claire Davies, recommends for people with back and hip pain. The Tempur-Adapt Topper is made with NASA-developed memory foam for deep pressure relief. It will mould itself around your curves, creating an almost weightless feel as soon as you lie down. It does retain heat though, so if you sleep cool choose either the Casper or Viscosoft below instead. A queen size is now on sale for $335 (was $419) thanks to this 40% off Tempur-Pedic mattress deal.

2. Casper Comfy Mattress Topper: | now $169 at Casper

2. Casper Comfy Mattress Topper: was $199 | now $169 at Casper
In our Casper Comfy Mattress Topper review we rated it highly for soft comfort, remarking that it was like sleeping on a giant pillow. We therefore recommend it as the best option for making a harder bed softer. The perforated foam also regulates temperature very well, making it an excellent choice for hot sleepers with back pain. After a discount, a queen size Casper Comfy Mattress Topper is reduced to $254 (was $299) with free shipping.

3. ViscoSoft Active Cooling Copper Topper:  | now $249 at ViscoSoft

3. ViscoSoft Active Cooling Copper Topper: was $334 | now $249 at ViscoSoft
Overheating can make back pain seem so much worse, as then you have two major issues stopping you from falling asleep and staying asleep through the night. Viscosoft's Active Cooling Copper Topper is our top-rated pick for making a hot bed feel cooler, thanks to its use of copper-infused foam to dissipate heat. The sweat-wicking cover should also keep you dry. A queen is now on sale for $349 (was $469), which is a competitive price for a thick cooling topper of this quality.

Frances Daniels
Sleep Staff Writer

Frances Daniels is a PPA-accredited journalist and Sleep Staff Writer at Tom's Guide with an MA in Magazine Journalism from Cardiff University. Her role includes covering mattress and sleep news and writing sleep product reviews and buyer's guides, including our Best Hybrid Mattress 2024 guide. She is hugely interested in the relationship between good sleep and overall health, interviewing a wide array of mattress and sleep experts to create well-informed articles about important topics such as nutrition, sleep disorders (from sleep apnea to night terrors), lucid dreaming, sleep hygiene, and mattress care. She is also our specialist on mattress toppers — producing mattress topper reviews and taking care of our Best Mattress Toppers 2024 guide — and takes the lead on all content related to fiberglass-free mattresses for a clean, non-toxic sleep.