Summary

Back-pain and lower-back pain are increasingly on the rise. Sitting for long hours in desk-jobs, poor lifestyle choices, less of exercise, and unhealthy diets are all compounding skeletomuscular challenges, leading to back and lower-back pain. Sleep is an important factor in good health. In addition to a healthy duration of sleep, what is required is a good mattress that ensures good sleep. In this article, we will learn how to choose the right mattress for comfort and long-term freedom from back-pain.

Introduction

Everyone is aware of the four pillars of good health: healthy diet, adequate exercise, mental rest, and sleep. While the first three are obvious and enough attention is given to them, sleep gets low priority at times. Everyone knows that he/she requires 7 to 8 hours of sleep per night. Yet, a hectic work-life, combined with professional or personal-life stress, can push sleep to the background and lead to insomnia over time.

While sleep deprivation once in a while is still natural, chronic sleep deprivation is deadly and even fatal. From cognitive decline to mood-swings to weakened immunity to lower sex-drive, poor balance and increased risk of diabetes, heart disease, hypertension, weight-gain and accidents, poor sleep can cause all of these and more.

In recent years, increased awareness has led to people paying attention to all aspects of sleep, including the mattress one sleeps on. Manufacturers of mattresses are cashing on this trend and offering a range of mattresses. They come in different material composites, and firmness levels. Mattresses are even being designed for people with orthopaedic issues or other conditions. This causes confusion in the buyer, given the plethora of choices. The first parameter to be settled is the hardness level. In this article, we will discuss this in detail.

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Also Read: Causes of mild to severe lower back pain

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Types of Sleepers

There are broadly 3 types of adults based on their sleeping pattern.

• Side-sleepers: These people spend a large part of their night sleeping on either side, and a lesser part sleeping on the back. Most people belong to this category.
• Back-sleepers: These people spend a large part of their night sleeping on the back and a lesser part sleeping on either side. These are lesser in number than side-sleepers.
• Stomach-sleepers: Also called front-sleepers, they spend a large part of their night sleeping on the stomach and a lesser part sleeping on the back or sides. These are the smallest of the 3 categories.

Types of Mattresses

Today, there are innumerable manufacturers of mattresses and different types. Mattresses vary in speciality (orthopaedic vs regular), composite materials used (what are the different layers made up of), different thicknesses (while mattresses purchased for home are generally of one thickness, hotels and hospitality sector in general use thicker mattresses) and finally different firmness levels. Since the word hard evokes negative sentiment, the industry uses the word ‘firm’. There is even a firmness scale of 1 to 10 used in some countries.

So, based on Firmness, there are 4 types of mattresses. While purchasing the mattress in a showroom, one can ask for the firmness level on this scale. Or one could do a squeeze test. Squeeze the top-edge of the mattress on any of the 4 sides and see how much it compresses. Some showrooms even allow the buyer to sleep on it for a few minutes. Some manufacturers offer a test-drive of up to 100 days, and one could return the mattress purchased if they are not happy with it.

• Hard/Firm: These are generally between 8 to 10 on the firmness scale. It feels like squeezing a mosambi (sweet-lime) or unripe banana. The compression is around 1 cm only. This type is reminiscent of the old, cloth-based mattresses that some people would have used in their childhood. They become hard quickly.
• Medium-Firm: This is 6 to 7 on the firmness scale. It feels like squeezing a ripened musk-melon or unripe tomato, with the compression being 2-3 cms.
• Medium: This is 4 to 6 on the firmness scale. It feels squeezing a ripe orange, or ripe banana, with the compression being 3-4 cms.
• Soft or medium-soft: This is less than 4 on the firmness scale. It feels like squeezing a balloon or soft-cushion, with the compression being around 5-6 cms. Some hotels have a preference for this type.

At this juncture, its important to note that while some countries offer all the above 4 types of mattresses, in most countries of the world, there are only 3 types – firm, soft and medium. So don’t let the nomenclature of firmness number bother you. Just squeeze the top edge of the mattress by hand, or lie down on it, and you will get a good idea. Some manufacturers even offer hybrid mattresses where the top half is firm, while the lower half is medium. One can switch between the 2 types by turning them upside or downside.

Pros and Cons of Firm Mattress

Pros: Firm mattresses offer good support for the body and prevent it from sinking in. One can enjoy feeling of sleeping on top of a mattress. This makes moving around in sleep easy, and getting up from bed easy. They also keep the person cool as the entire body is exposed to air, as against being sunk into a cushion which reduces air exposure making the person feel hot.

Cons: Firm mattresses don’t offer good pressure relief. Side-sleepers feel a lot of pressure on their shoulders and hips.

Who should choose a Firm Mattress?

• Stomach sleepers: For them, a firm mattress offers good support for the entire body including the hips. This helps the spine stay in perfect neutral alignment.
• Some back sleepers: Back sleepers, especially those on the heavier side would prefer firm mattresses as it offers good support while allowing their hips to sink in a little.
• Larger people: People on the heavier side, irrespective of whether they sleep on the side or back can benefit from this type.
• People who like to sleep on top of their mattress: People who hate cushions that make them sink a lot, or who move around in sleep, or need to rise quickly from the bed, prefer this.
• Cool sleepers: Since soft mattresses trap body-heat and direct it back to the sleeper, people who like to stay cool would prefer a firm mattress.
• People with mobility issues: People with injuries or any medical condition that prevents them from moving easily should choose a firm mattress. It will be easier to get out of bed, or change positions, without getting stuck.

Pros and Cons of Soft Mattress

Pros: Soft mattresses offer good pressure relief. There is less pressure on the hip or shoulder joints. Side-sleepers, especially those who are medium built (neither too thin, nor too heavily built) would find this comfortable.

Cons: Soft mattresses are not suitable for people who are on the heavier side and sleep on the back or stomach. Moving around or getting up from the bed is difficult and since the person has sunk inside, there is less exposure to ambient air, so the person will get hotter. Soft mattresses also come with the disadvantage that they curl up on the edges and become flatter in the centre after a few years of use.

Who should choose a Soft Mattress?

• Side sleepers: As explained earlier, there is less pressure on the joints, from soft mattresses.
• People with pain: People with joint pain (hips, knees or shoulders) will find better relief, irrespective of whether they are light or heavy, whether they sleep on the side or back.
• People who like to sink into their mattress: Lighter people and those living in cold countries may not mind sinking into a soft mattress.
• Couples: Soft mattresses, particularly those that have memory foam can handle motion transfer better. What this means is when two people are lying on a soft mattress, even if one moves a lot, the other person will not be disturbed.

How mattresses can alleviate back-pain?

The right mattress can play a positive role in managing pain of the back or lower-back.

• A good mattress provides the right support to the spine and reduces pressure on joints or other sensitive areas. This helps the muscles to relax while the person is sleeping, and is soothing. The spine alignment and support ensure a restful sleep with minimum discomfort.
• A high-quality mattress, which may be on the costlier side comes with specific support zones, or target support zones. These provide additional cushioning and support reinforcement at all those points in the body where these are required.
• A good mattress features memory-foam or latex. These understand the body-shape or contour of the person, thereby distributing pressure evenly on the body and reducing stress on sensitive areas like lower back, hips and shoulders.

To summarize, the right mattress provides good pressure relief, better spinal support and reduces pain, thereby offering better quality of sleep and promoting overall well-being. At this juncture, its also important to note that, with time, all mattresses, no matter how reputed the brand is, will deteriorate with time. So, mattresses should be changed every 8 to 10 years.

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Also Read: 5 Signs your Back Pain might be an Emergency

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The best mattress for those with back-pain, and in general

So, what is the verdict? Soft or firm mattress, for back pain? Its difficult to give a blanket answer. It depends on various parameters: the age of the person, the weight, the skeletomuscular health, level of pain and other morbidities present in him/her. So, a doctor, especially an orthopaedic doctor, is best qualified to answer this. The person will anyway be consulting such a doctor. He/she will recommend the right kind of mattress.

For others, who do not have any pain, a medium or medium-firm mattress is ideal. This is irrespective of whether he/she is a side-sleeper, back-sleeper or stomach sleeper, he/she is on the lighter side or heavier side, and whether the partner is on the heavier or lighter side. Such a mattress optimizes the pros and cons of both soft and firm mattresses. That is why, they are most popular and sold in large numbers.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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