Do Doctors Recommend Firm or Soft Mattresses and Which is Better?

Fortunately for us, times have changed, doctors are well read and trained and have become educated in the ways of modern mattresses. As a result of this “extensive training,” many more people are sleeping better and receiving the healthy benefits of a properly diagnosed mattress.

Back in the day, doctors used to tell you the firmer a mattress was the better mattress was for you. Most physicians would go so far as to suggest putting a piece of plywood between your mattress and the supporting boxspring for extra firm support.

Before we recommend anything like that, lets learn about the mattresses first, and then we will address the doctors’ recommendations.

ps-plush-corner-300x225Hard mattresses often share the same internal components as their softer counterparts the plush topped and pillow top mattress. Firm mattresses are just what they say they are – stiff and firm and usually have very little to no give what so ever. In the mattress industry, the term support means to hold up, mold, take shape of the body by its very definition. Firm, hard, and nongiving does not lend itself to contouring, much less properly supporting the body.

Soft mattresses often offer the choice of comfy-cozy plush mattress tops or the popular pillow-topped surfaces. Their names are self-defining and without a doubt precisely describe their distinctive feel. Softer types of mattresses have plenty of give in order to support and contour to your body’s natural shapes and curves. The problem with these types of beds can actually be under buying. This can either be don by the persons who don’t know any better or salespeople who are inexperienced or don’t care. Neither seems to have a clue that sometimes individuals can be too heavy for a beds design. This allows anticipated support to slip into unbeneficial sagging. This by itself can create a whole bunch of other sleeping issues.

So Which Mattresses are Recommended and Prescribed by Doctors?

I feel the majority of us know our limitations when it comes to diagnosing sick people suffering minor to serious health issues. So why would we take it upon ourselves to dispense prescription medications to them?

The fact is that nearly all physicians know little to nothing about mattresses, mattress design, and just as important how one works to support your back. So why do doctors continue to suggest, prescribe, and recommend mattresses they know nothing about? Could some of them actually be getting paid for their endorsements?

How the Waterbed Changed the Mattress Industry

With the invention of the waterbed, which is quite soft, the entire mattress industry was turned upside down. Whether you like them or hate them, the way you sleep today has been affected by the now 40-year old hippie fad. Yes, waterbeds were hard to move, get in and out of and make, but people seemed to sleep well on these squishy soft mattresses.

Throughout this same time period, the mattress and boxspring industry was ramming the hard, firm, inflexible mattresses down our throats. Many of the admittedly untrained “sleep specialists” (doctors) followed suit by suggesting the addition of plywood between the mattress and boxspring for even more firmness. Shockingly many still recommend this today.

Stop Sleeping Uncomfortably

I am sure there are people that will disagree with this article, but I will point out one clear fact – when you or I attend a ball game and sit on the bleachers, our butt falls asleep very quickly, and the area can become numb and even painful from the restricted blood circulation.

I am curious why people can’t understand that the same thing happens with a hard, firm mattress. Poor circulation throughout the body is the primary cause of restlessness and constant repositioning throughout the night? Take that away and we are on our way at the very least to an improved night of sleep.

The problem will exist as long as humans continue to be creatures of habit. We fear change and unorthodox lines of thought such as mine. reported Kim Bergholdt, DC, of Denmark’s Funen Back Center attempted to find the answer. Her groups’ study had varied results, but the study concluded that more people find a soft bed slightly better for back pain.


Doug Belleville and his father Dave own and run STLBeds - a specialty sleep store located in Arnold, MO. The staff at STLBeds is highly educated about sleep, comfort and their special sleep products. STLBeds only carries high quality mattresses and bed-related products. You won't find the brand names here - just call and ask us why!

24 Comments Leave your comment »

After reading the April 21, 2008 article:
“Do Doctors Recommend Firm or Soft Mattresses and Which is Better?”, I am lead to conclude that the writer of that article knows little about mattress design or mattress comfort. I am not arguing the writer’s observation that doctors who prescribe mattress type are ignorant about mattress design and comfort. That may or may not be the case. Surely the writer of that article needs to learn about what makes a healthy mattress.

After some 45 years of trying various mattresses and designs, I have come to the following conclusion. IN GENERAL, the most comfortable and healthy bed must be designed as follows:

1. The bed must be a platform bed. A hardwoood platform with multiple supports so that the plank does not bend over time is important.
2. The base of the bed must be of cery firm mattress of polyurethane material with high ULD. This base MUST NOT be thicker than 4 inches.
3. The top layer must be of thickness 1 inch or less of heavy duty memory foam.
4. The two layers MUST be glued.
5. The entire mattress of thickness 5 inches max must be wrapped in a soft cover.
This will be the best sleeping platform for most everyone.


Annaswamy Natarajan


If the person has serious health issues, that person may need a different design.

Comment by Annaswamy Natarajan — July 20, 2008 @ 6:59 pm

Unfortunately Annaswamy your commentary shrugs off the important fundamental question I asked during a time when more and more doctors are over prescribing or incorrectly prescribing, a time in which it is becoming more common for doctors to spend less time getting to know their patients not to mention their needs. I’ll add it seems that more and more doctors are being persuaded into opinions however right or wrong those opinions may be through paid endorsements. All things I lacked to note in the blog.

It makes me sick the number of doctors / chiropractors that make bold or even ridiculous mattress diagnoses to their patients with no understanding of mattresses what so ever. One day they tell you sleeping on a waterbed is good, the next its bad, hard mattresses are the best; the next day soft mattresses are the best. Annaswamy the one thing we could probably agree on is that the doctors do not agree with one another on the subject of which mattresses are best. I would like to see some cold hard evidence of which mattress is better? I am not sure such evidence exists at this time.

Come on doctors and Chiropractors step up and speak you piece!

Annaswamy I mean absolutely no disrespect, however I would like to make a simple point by thanking you for allowing us all to say the words BYE BYE BACK PAIN. With that 45 years of trying various mattresses and designs, it seems you have single handedly solved the world’s mattress dilemma with one mattress, that so far Sealy, Serta, Simmons and Spring Air could not do with thousands. I hope you own a mattress retail store because you will make millions of dollars based on your GENERAL 5 Step mattress design you have so generously shared with us.

Annaswamy I am always willing to learn from people who will teach me what they know and I continue to read extensively on the topic of mattresses so I can help people sleep better and get better support every night. I don’t claim to know everything about mattresses and never will but throughout my mattress-selling career I have been honest and helpful. I will add that I have not once prescribed or recommend such things as hard, medium, or soft pillow tops or non-pillow tops, waterbeds, memory foam, latex, airbeds, or even hybrids something many physicians can’t say. Ok, I will admit I have my personal favorites and have made suggestions to customers, but I never told anyone that is what they have to have or forced my opinions or biases on a single Water Works Sleep Center or Sleep Station customer in my 22+ years of selling mattresses.

Annaswamy it is unfortunate your comment still leaves my readers looking for the answer to my initial question…
Do Doctors Recommend hard or Soft Mattresses and which is better which my readers still seeking the answer too. I did not ask the questions which mattress is better to sleep on a hard mattress or soft mattress, nor was the blog about mattress design or mattress comfort or even what makes a healthy mattress all thinks you criticized me on and challenged my lack of knowledge. However these would all be great blog ideas that I appreciate them and may very well write about such topics in future blogs, I hope you will come back and read them. In all my blogs my goal is to stay on topic. My principal goal is to assist people in mattress related Internet searches who seek out the answers to their mattress related questions.

Annaswamy, thank you, for your comment you are always welcome here and welcome to comment, even though we seem to disagree.

Comment by Doug — July 23, 2008 @ 11:29 pm

We have been using memory foam mattress for about a year and my wife has been complaining about neck and back pain since then.
Do you think memory foam mattress is the cause?

Comment by Nurali — January 31, 2009 @ 1:20 pm

I am no doctor, only a mattress salesman with a lot of experience on the job.

I do not believe that a good quality supportive mattress would be the cause of anyone’s neck or back pain. I also do not believe that a mattress can fix a bad neck or bad back. I just think they can enhance the comfort and give support. However sometimes a mattress may not have the support where you need it, (Possible cause of her problem) this is because you were not fitted to the mattress, but the mattress was generically designed as a one size fits all. (To save money)

My thought is that if memory foam caused back or neck pain, it wouldn’t be the number 4 selling mattress on the bedding market I would get a couple of medical opinions.

Comment by Doug — February 2, 2009 @ 8:09 am

A good, expensive plush (or firm if you prefer) innerspring mattress should be the right prescription for most people.

Many people go the mistake of buying a pillow top or Euro top. This is a huge mistake, as normally your heavy center area will sag lower than your feet, causing pain. Also, pillow top will normally end up with permanent sagging very quickly.

Another mistake is latex foam. While good for sleeping, it doesn’t give the right rebound for sex.

Most people will hate memory foam, so please avoid this at all costs.

It can be easy to tell the difference between a good quality innerspring and the usual cheap innerspring just by hopping on the side of a bed a few times in the mattress store. Then look at the topper, which should be integrated in with the mattress and not a separate section like in a pillowtop. Overall, the mattress should be no more than about 12 inches high, given 9 inches of spring and up to 3 inches of topper depending on your preference. Please believe me that more is not better.

Comment by iGuide — October 3, 2009 @ 10:44 am

i heartily agree that soft mattresses are better and more comfortable and you get a better night’s sleep.

we have been so hoodwinked by the “firm is better” view.

most bed salespeople are awful and know nothing!

most memory foam (except the extremely expensive one) is too hard in my opinion and i think it will be a fad that dies out.

Comment by jane — April 10, 2010 @ 1:58 pm

Before this year, I had never really paid attention to the firmness or softness of my mattress. I had a pretty firm one and bought a foam/egg-crate style topper that I used with it for years. It was great… really comfy and anyone who slept in my bed mentioned/noted how well they slept (about 4 people).

I recently got married and we moved my husband’s pillow top in… within a few days I had terrible back and shoulder pain and have been struggling with this ever since. It has gotten so bad that tonight I found myself on the couch with a lap desk behind my back and my arm suspended between two cushions to get relief. The pain is worst when I’m in bed and I wake up with it every morning. Note, that I had no such issues with my old firm bed.

I miss my firm bed with the soft topper and I can tell sleeping in this new bed that I am simply not getting enough support. I’ve read quite a few accounts of people who develop back pain from sleeping on softer mattresses so I really think you all should refrain from assuming that one level of firmness works best for everyone.

Like our original poster said… he may have his favorites… but it isn’t quite reasonable to assume that what worked for you is best and that anyone of a different view is deceived or mistaken :-)

Comment by Nefertiti — July 9, 2010 @ 3:34 am

I bought a simmons world class visco extra firm mattress after so much research for less than half price (little over 1k) from their outlet store. Just one night sleep made me and my wife sad and the whole night we could not sleep. Since I bought it from simmons outlet store, i cannot return it. I am trying to buy a topper and try again. Anyone has any suggestion which topper I should try.

I am now of the opinion that extra firm is not good.. at least for both of us. I bought this because I have back pain. My internet research says an extra fim mattress is better for your back pain. But mine got worse over night.

Comment by R CHUCK — November 11, 2010 @ 10:31 am

My second mattress in 80 days is a Ultra firm. This is causing me back pain. I was always sleeping on a firm. Is the ultra firm a cause of my back pain?

Comment by Amy Padgett — March 25, 2011 @ 12:20 pm

Hi Amy,
I enjoyed speaking with you. It sounds like you have had a rough experience. As I mentioned on the phone firm is, is not firm, is not firm. What I’m saying is their is no standards for what firm is, which means your firm may have been softer than the new one you purchased. It is possible that if you went too firm it may be causing some problems. You have the option to try to work it out with the store or you could opt for a mattress topper to cushion the bed surface with the hopes of making it more comfy.

Comment by Doug Belleville — March 25, 2011 @ 5:46 pm

i am in desperate need of a mattress that can address my lower back pain. i recently slept on a pillow top sealy posturepedic in Las Vegas on vacation. Best night sleep i have had in a long time. i am 100% against a pillow top for the long haul.. but i suffer from lower back pain since a motor cycle accident 4 yrs ago and now im a believer that my bed is contributing to it. my current mattress is a firm one, and im thinking about a more plush this go around.. but im 6’4 230 lbs and im concerned with sagging on anything that isnt firm. should i be?

Comment by mike g — April 18, 2011 @ 9:40 pm

I’m not really sure what you mean by “a mattress that can address my lower back pain” While it is true can mattress make you more comfortable, it is not going to fix a back that was damaged in a motorcycle accident. Mike if comfort and a good supportive mattress is enough to wake up in the morning without pain then it’s time to start looking for a new bed. If you’re 100% against a pillow top and it worked for you then it seems you have already ruled out a working option.

Comfort comes before durability and all mattresses won’t break down in weeks or months. However I would also mention a couple nights on vacation does not really give you the big picture unless this happens repeatedly. If your mattress is still in good shape consider a good quality mattress topper that could be replaced or adding one to a new bed instead of buying an attached pillow top.

Comment by Doug Belleville — April 19, 2011 @ 2:53 pm

HI there

My mattress sucks, to much give round the buttocks, I would say firmer rather then softer will always be better for ones posture and give a healther sleep (not that rock hard is a good idea). But I would more go towards this stupid use of pillows, I find them of little use, and when you look at the fact that you are putting strain on your next by lifting it higher all night, this might be a cause for alot of back pain, i mean you would walk around all day stick your head forward an inch. So a thin pillow at best. If you put strain on your next it will pull every muscle from there on down, which if you put strain on your lower back it will be less likely to put strain from there on up>>>>>>

Anyway thats my point of view…


Comment by Horse E — March 15, 2012 @ 12:12 am

This might only be anecdotal evidence but I am a strong believer of sleeping on a firm mattress. My wife and I bought a $1,000 mattress set which doesn’t require it to be flipped. It’s rated at medium/firm support. It “feels” very comfortable and cozy but I slept on that bed for a couple months and started to have lower back pains and numbness in the arm/hands. Having had enough, I went to a mattress store and bought the firmest/cheapest mattress and now I can hop out of bed with no pains, no numbness. The only issue with the mattress is that there’s hardly any padding so I can feel the coils on my hips. I fixed that by sleeping on top of a comforter.

P.S. I had a water bed when I was younger. It’s really not pleasant after a night of drinking.

Comment by Manny — July 23, 2012 @ 8:48 am

To mike g
I’m only 28 just done my back again slipped 2 discs 3 tears torn ligaments got compression on spine etc. was in vegas mirage hotel sealy posturepedic was amazing can’t find same model you can buy them from hotel but I live in oz postage would hurt more, I’m on to my 6th mattress in 3 years just bought new soft toper at weekend not too bad so far any help appreciated :-)

Comment by Chris — September 20, 2012 @ 5:52 am

I agree wholeheartedly that soft mattresses are the most comfortable and provide the best therapeutic night’s sleep. I never understood why anyone would want to torture themselves on a hard bed. The happier you are the more you need a soft mattress. And inner springs are vital because the mattress must springback when you roll over or change positions, otherwise you get stuck in a sinkhole. That’s the problem with memory foam-it remembers where you were and creates ditches that you can’t manage to climb out of. I’m not talking just about the collapsed saggy holes that come through time, but I’m talking about the indentations it take to long to pop up when just moving around the bed or rather attempting to. If I don’t wear satin or something really slick, I can’t move around on those beds at all. Martha Stewart had an old-fashioned mattress maker featured on one of her programs a few years ago and watch them build those wonderful old innerspring mattresses was a joy to see. Since then I found others that follow suit could still make good old-fashioned mattresses. If you pay attention and watch the old movies you will notice how soft and beautiful those beds were. I own a ridiculous way expensive mattress the van Gogh sunflower series, it even has cashmere in it. But it’s horribly uncomfortable and now has a big giant ditch where my bottom has been for the last year. I recommend that we start giving our business to these old-fashioned mattress makers that do it right the way they used to do it and give up on all these newfangled fads.

Comment by Laura Lee — April 10, 2013 @ 8:59 pm

About 27 years ago we were offered a soft-sided queen waterbed with dual mattresses and two heaters for NZ$1,000 because somebody wanted it out of their shop in a hurry. We’d never had a new bed (our first one had belonged to my mother, and the second one to one of my sisters-in-law) so we were tempted. Enquiries at two bed shops gave me to understand the bed’s price would normally have been $3,000, so we accepted the offer. I’ve just had reason to replace it and after much research I decided better the devil I know, etc., and bought another waterbed. I’m afraid I’m guilty of not looking after the old one very well, but this time I’m determined to put conditioner in when I’m supposed to, etc. I also bought a dust mite-proof, waterproof mattress protector, which I’m hoping will keep “body oils” away from the bladders and mean I won’t have to struggle too often with a zip so I can wipe down the bladders. While the bed was being set up I slept in a double sprung bed. Though it didn’t keep me awake (well, not too much) it was still way too firm!

Comment by Laraine — May 25, 2013 @ 11:58 pm

A few years ago, I babysat for a week at a friend’s house and slept in her waterbed. I HATED it! It bobbed me around all night, and when I tried to get out it took a gargantuan effort. To top it off, I hurt in every joint of my back. By contrast, I love camping out, sleeping in my sleeping bag on the ground, or sometimes in summer I will put down a thin foam mat and sleep on the living room floor, and wake up happy and not stiff at all. I think it’s safe to say that a very firm mattress is best for me. But I would suggest that anyone who isn’t sure should ask a friend with a waterbed, or another soft bed, for the favor of an overnight trial, and also try the camp-on-the-floor, too, and then you will know what suits you best. No one, doctor or salesman, can tell you as much about your body as you can yourself.

Comment by Marjorie — June 29, 2013 @ 5:39 pm

What about a slat system? I bought an organic latex matress, med firm and layed it on some Ikea Sultan Laxby slats. Fine and comfortable for a year and a half until I worked temporarily for a catering company (six days of standing for 12-15 hours per day) My back was in intense pain. Thought my back would be fine once the job was over. What I learned is that muscles don’t forgive or heal easily. For three years this pain while standing got worse. Even had to sit while brushing teeth. Was comfortable lying down or sitting. Finally started using another bed. it was a Monitor 266 matress and my back started getting slowly better instead of slowly worse. Moved after a month and a half and now using some type of pilowtop and my back is getting better too. So I’m left to wonder is it the rubber mattress or the super supple slats that were bad for my back muscles? Still have fatigue and pain but not nearly as bad. Ive only been off that rubber mattress for 3 months now, hopefully it will completely heal.

Comment by catherine — January 28, 2014 @ 7:43 pm

Hi Catherine, To the best of my knowledge there is not a case study that proves your theory one way or the other. It is my opinion however that it is very possible that a combination of time and perhaps even the changes you have made in your support could be the difference.
Please forgive me, I am not laughing at you but with you, after many years of sports injuries what I to have learned is that muscles don’t forgive or heal easily or quickly. Here’s to better sleep and comfort. Take care and hope you get continued improvement. Doug

Comment by Douglas Belleville — January 29, 2014 @ 7:56 am

I realize that no mattress will correct severe spinal stenosis; however, which type of mattress would you recommend for me with this condition, who lately can’t sleep because of alot of lower back & neck pain. Pain is almost non-existent when I’m up & mobile. Please address pillow top, euro top, firmness, etc., etc., etc. Thanks!!!

Comment by Ginny Jacoby — March 14, 2015 @ 11:36 am

I have have had 3 back surgeries and can not turn on my left or right side. Recently I had moved some of my furniture but hadn’t moved my bedroom furniture yet so I went out and bought a coleman mattress to sleep on a few days. It was very firm but it was the best night sleep I had in months. I want to know what type of mattress I would need to create this firmness. Please help me.

Comment by Brenda — March 18, 2015 @ 4:33 pm

Brenda, I am assuming that the Coleman Mattress you purchased was an air mattress. I am no physician but if the previous is the case then perhaps an air mattress of some type would be most comfortable for you. Comfort Air, Select Comfort, and similar brands may be what you would want to consider. Doug

Comment by Douglas Belleville — March 24, 2015 @ 8:27 am

Ginny, There is no carte blanche answer. Your pain, discomfort etc. Is unique to you. As you said mattresses cannot correct severe spinal stenosis; so which type of mattress? Get into a brick and mortar store and try pillow tops, euro tops, different firmness’s. Try many different types of mattresses like coil spring, latex, water, memory foam and air. Once you find mattresses that give you comfort, the support your are looking for, and most importantly minimize pain relief. Spend some time trying them and laying on them. Once you find one that meets your unique specific needs pull the string and purchase. I’m pulling for you. Doug

Comment by Douglas Belleville — March 24, 2015 @ 7:41 pm

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