Unfortunately there is no “ one size fits all” when it comes to choosing a mattress which will help you sleep better at night and to wake in the morning feeling refreshed and limber. When choosing a mattress, personal preference is an important factor and you should spend some time lying on the mattress in the shop to see if it still feels comfortable after, say, fifteen minutes.
There are some guidelines for what constitutes a good mattress
· Most people prefer a firmer mattress but if it is too firm for your body weight it will cause pressure points over your hips and shoulders if you sleep on your side. This can be a problem especially if you have trochanteric bursitis, gluteal tendonopathy or a shoulder problem . A good mattress should support your body so that when you are lying on your side your spine is horizontal and the normal postural curves of your back are maintained. See photo below. Your waist should not sag into the mattress, the mattress should support your waist. If you have a small waist and big hips you may need extra support under your waist such as a rolled towel or small cushion
If the mattress is too hard the hips and shoulders will not sink into the mattress and the waist will sag down as in the photo below which shows a person lying on a hard floor ( simulating a hard mattress) with no pillow which is the extreme hard mattress situation.
If you sleep on your back a good mattress should allow your bottom and shoulders sink into it so that your back is supported.
Once again look what happens when the mattress is too hard ( the floor for purposes of this explanation). See photos below. The lower back is not supported in either of these scenarios
Although a firmer mattress will give you more support it is not absolutely necessary as there are no major external forces at work while you are sleeping. If you wake up in the morning with a stiff and painful back ( having gone to bed with no significant back pain) then you do need to think about changing your mattress. Otherwise comfort is the main factor.
GENERAL SLEEPING GUIDELINES
There are no hard and fast rules when it comes to which position to sleep in except that it has to be comfortable for you. However here are a few pointers for those people with back, hip or shoulder problems
Osteoarthritis/spondylosis/degeneration of the low back/spinal stenosis. In general these types of low back problems are present in the older generation and these backs like to be held in a slightly flexed position. Try, either, on your side with the knees bent up in the foetal position or on your back with a couple of pillows ( or more) under the knees. A pillow under the waist and a couple of pillows between the knees may also help.
Lumbar disc problem
If you have a lumbar disc problem it is usually better to sleep on your stomach. However this is not always the case and comfort should be the guideline. It depends on the direction of the disc problem. Even if lying on your stomach makes your back more painful but relieves your leg pain then it is a good position. This is something you need to discuss with your physiotherapist.
Lying on your back: You may find it more comfortable to have a pillow under your arm
Lying on your side.
· If you are lying on your “good” shoulder you may find that having 1-2 pillows under your upper arm will relieve the pain in your sore shoulder
· If you are lying on your sore shoulder you can take the pressure off the shoulder by having two pillows under your neck and one pillow under your ribs with your shoulder in the hollow in between the pillows. Try to keep the sore shoulder directly underneath the top shoulder.
If you have a painful hip due to a strain or arthritis you will probably find it easier to sleep on your side with one to two pillow between your knees or on your back with one to two pillows under your knees
If you have an inflamed bursa on the side of your hip (trochanteric bursitis/gluteal tendonopathy) then a firm mattress will be uncomfortable and you may need an “eggshell” topper pad as well as a couple of pillows between your knees for when you are sleeping on your side