If you have chronic back pain or want to avoid it, the right mattress — not too hard, not too soft — is essential. These tips can help you select the best one.

We spend about a third of our lives asleep, so the right mattress is important. And if you have chronic back pain, the best mattresses for back pain relief are those that give your spine just the right amount of support, in all the crucial areas.

"A firm, supportive mattress is best for the bony and muscular structures of the back in order to maintain the proper mechanics," says Harry N. Herkowitz, MD, chairman of orthopaedic surgery at William Beaumont Hospital in Royal Oak, Mich.

To understand how to maintain the proper mechanics of your spine, you need some spinal anatomy basics. Your spine supports your head, keeps your body upright, allows you the flexibility to bend and twist, and protects your spinal cord. Your spine has three sections and three normal, gentle curves that need to be supported when you are standing as well as when you are sleeping.

Your cervical spine includes seven vertebrae, supports your head, and has a C-shaped curve. Your thoracic spine includes 12 vertebrae, supports your upper body and has a reverse C-shaped curve. Your lower back, or lumbar spine, is your back's foundation, includes five vertebrae, and also has a C-shaped curve. If you don’t maintain these curves, you increase the stress on the bones and muscles of your back, and that can lead to chronic back pain.

Best Mattress Type for Back Pain

The reason your mattress is so important is because you spend about eight hours of every day lying on it. The idea that very firm mattresses for back pain are the best way to relieve or prevent chronic back pain is old news. The truth is more like what Goldilocks told the three bears. Not too hard and not too soft is about right. "A mattress that is too soft or too hard can put significant stress on the lower back structures," warns Dr. Herkowitz.

Here are tips for managing back pain and bed selection success:

• Support. Mattresses for back pain must support the heaviest parts of your body where the natural curves are located. These areas are the head, the shoulders, and the hips. Don't forget that you also need a good pillow to support your head.
• Back pain and bed selection. It's not just about the mattress. You also need a good bed foundation. Putting a new mattress for back pain on an old, worn-out bed spring is not a good idea. Most mattresses work best with a matching foundation or box spring.
• Space. If you are like most sleepers, you move around 40 to 60 times per night. If you are sharing your mattress with a partner, you may need to consider a queen- or king-size mattress to make sure you have enough space.
• Comfort. There are many mattress options, including springs, foam, water, and air. Any of these can work as a mattress for back pain, but you really can't tell what feels best for you until you lie down and try it.

When Do You Need a New Mattress?

You need a new mattress when your old one wears out and no longer supports you. "Your spine should never sink into your mattress," says Herkowitz. How long it takes for you to start sinking into your mattress depends on how you sleep and how much you weigh. Here are some tips:

• The average lifespan of a mattress is about five to seven years, but it depends on the kind of use your mattress gets. If you start waking up with aches and pains, especially chronic back pain, it is probably time to go shopping.
• Your mattress support needs may change over time. As you get older, you may need more support.
• Since the changes in your mattress occur gradually over time, it is a good idea to try out a new mattress after a few years to compare and feel the difference.

Of course, if you are living with chronic back pain, talk to your doctor. It may be more than your mattress.

Mattresses for back pain are mattresses that support the normal curves of your back. The best mattress type for back pain avoids putting stress on these important areas of your back while you sleep. The most important thing to remember is that everyone is different, and the best way to find the right mattress for back pain is to try it out before you buy.