Short answer: There is no position that is best for everyone with back pain. There is research in which a medium-firm mattress did better than a firm mattress for chronic low back pain. What matters is that your spine stays in a neutral line, whatever position you lie in.
Firm or soft: what the research says
The persistent advice to "get a hard mattress" has been tested. In a randomised, double-blind study in The Lancet, 313 people with chronic low back pain were given a medium-firm or a firm mattress. After 90 days, the medium-firm group more often reported improvement in pain in bed and on getting up.7 A systematic review of later research came to a similar picture: medium-firm mattresses were most often associated with better sleep comfort, better sleep quality and better spinal alignment.8
Too soft is not good, but rock-hard is not either. You want a mattress that supports you without your pelvis or shoulders sinking in.
Which sleeping position for back pain?
A review of sleep position and spinal symptoms found no conclusive evidence for one best position. Positions in which the spine is twisted or bent for a long time do seem to go together more often with symptoms on waking.9 In practice it comes down to a neutral line:
- On your back: a small pillow under your knees takes tension off your lower back.
- On your side: a pillow between your knees stops your upper leg from rotating your pelvis.
- On your stomach: prevent your pelvis from sinking in. A thin pillow under your lower abdomen can help, and a firm base matters.
Back pain as a stomach sleeper
Stomach sleepers have two points of attention. The first is the pelvis: if it sinks in, your lower back arches. The second is the neck: to breathe you turn your head to the side, and that twist carries on into your upper back and shoulders.5 A firm base helps with the first, room for your face with the second.
SleepLab One combines the two. The core of resilient cold foam gives your pelvis a firm base, and the face opening lets you lie facing straight down with your spine in one line. We do not promise that your back pain will go away; back pain often has causes outside your bed. What you do remove are two well-known sources of strain from your stomach position.
When to see your GP
See your GP if the pain does not ease after a few weeks, if it radiates into your leg, if you feel tingling or weakness or if the pain wakes you at night. If you suddenly have problems passing urine or controlling your bowels, or numbness in your groin or between your legs, call straight away.
Read also: stomach sleeping: pros and cons, back, side or stomach compared and sleeping with neck pain.
Frequently asked questions
Is a hard mattress good for back pain?
Not necessarily. In a randomised study of people with chronic low back pain, a medium-firm mattress did better than a firm one.
What is the best sleeping position for back pain?
There is no position that is best for everyone. Most important is that your spine lies in a neutral line, for example with a pillow under or between your knees.
Can I sleep on my stomach with back pain?
Yes, as long as your pelvis does not sink in and your neck is not turned far. A firm base and room for your face help with that.
Updated on 22 October 2026.
SleepLab One is not a medical device and does not replace a diagnosis or treatment. If your symptoms persist, talk to your GP or physiotherapist. The studies the numbers refer to are listed in the references; they are about sleep position and mattresses in general, not about this mattress.