Sleep Away Aches With the Best Mattress Toppers for Back Pain

If you suffer from back pain, and your old mattress has you waking achy, a mattress topper can be a great investment to help align the contours of your spine without investing in a new mattress. Toppers are typically one to four inches thick and made from foams of varying firmness. Strap them onto your existing mattress and you’re adding a layer of body-cradling support, which, when combined with a healthy sleep routine, can help you alleviate pain, sleep better and wake with more energy.

Physical therapist Karena Wu, PT, DPT, recommends mattress toppers for the extra support and comfort for your joints, but also to prolong the life of your mattress. American Chiropractic Association spokesperson, Robert Hayden, DC, PhD, agrees, noting that because people often buy a mattress without sleeping on it first, it’s common to end up with something that just doesn’t feel right. Toppers allow you to change up your sleep setup, without tossing your existing mattress. 

Start shopping around for mattress toppers, and you’ll be bombarded with manufacturer claims of “incomparable” this and “unparalleled” that. So, we tasked our editors with testing 17 popular toppers, comparing like for like, in parallel, in a controlled lab setting. Over three days we ran tests evaluating performance in terms of comfort, support, durability, breathability and overall quality. A physical therapist from our Medical Expert Board reviewed the content in this article about mattress toppers and how they can help alleviate lower back pain.

Our Top Picks

• Best Overall Mattress Topper: Casper Comfy Mattress Topper
• Best Cooling Mattress Topper: GhostBed Memory Foam Topper
• Best Budget Mattress Topper: Linenspa 2-Inch Gel Memory Foam Mattress Topper
• Best Mattress Topper for Combination Sleepers: Lucid 4-Inch Down Alternative and Gel Memory Foam Mattress Topper
• Best Mattress Topper for Side Sleepers: Nest Bedding Cooling Topper
• Most Comfortable Mattress Topper: Nolah Mattress Topper
• Best Latex Mattress Topper: Sleep On Latex Pure Green Natural Latex Mattress Topper
• Best Mattress Topper for Pressure Relief: Tempur-Pedic Tempur Adapt+ Cooling Mattress Topper

Best Overall Mattress Topper

Casper Comfy Mattress Topper

$299 $250 at Amazon $250 at Target $299 at Nordstrom

Why We Like It

Firm and supportive, and with a solid construction that doesn’t budge, this topper delivered superb comfort at an accessible price point. Comfy in all sleep positions—though slightly too firm for side-sleepers if matched with a firm mattress—it offered great bounceback after compression. Tossing and turning, we had no issues finding the sweet spots, with the top layer of memory foam cradling our bodies and reducing pressure on our hips and lower backs right around the bed. Throughout testing it topped our metrics for comfort, support, breathability and value.

It’s Worth Noting

This topper is heavy, and requires two people to place it safely on the mattress. We also found it a little too firm for side sleeping, when placed on top of a firm mattress.

Product Details:

• Sizes: Twin, Twin XL, Full, Queen, King, Cal King
• Material: Perforated foam + cotton
• Firmness: Firm
• Thickness: 3 inches
• Removable Cover: No

Best Cooling Mattress Topper

GhostBed Memory Foam Topper

$230 $216 at Amazon View on Ghostbed.com $492 at Best Buy

Why We Like It

Cozy yet cool, this topper brings together quality materials and thoughtful easy-to-use design to add a remarkable level of comfort and alignment for its mere three inches of foam. Soft and plush, we found this topper incredibly comfortable in any sleep position, and the elastic kept it firmly in place. We put its waterproofness to the test, with spilled water evenly distributed, easily absorbed, and didn't penetrate the waterproof backing. And while its breathability provided comfortable temperatures during summer, the materials also feel as though they’d adapt to provide a cozy environment in winter.

It’s Worth Noting

This is a soft topper, so it doesn’t provide much extra support. For people looking to firm up a soft mattress, take a look at the Nest Bedding Cooling Topper below.

Product Details:

• Sizes: Twin, Twin XL, Full, Queen, King, Cal King, Split King
• Material: Cooling gel memory foam
• Firmness: Soft
• Thickness: 3 inches
• Removable Cover: Yes

Best Budget Mattress Topper

Linenspa 2-Inch Gel Memory Foam Mattress Topper

$60 at Amazon View on Bed Bath & Beyond View on Linenspa.com

Why We Like It

This soft, plush topper gives your existing mattress a memory foam makeover for less than the price of a pillow. The breathable foam is infused with thousands of gel beads, delivering a noticeably cooling experience. It offered great contour support for our spines, though after being compressed it did take a minute or two to rebound to its original form. All in all, for the very reasonable price, this cooling foam layer delivered a big improvement in comfort and support.

It’s Worth Noting

Through testing, the bounceback after being compressed took noticeably longer than other toppers we tried. Which begs the question: how will it perform over time? Watch this space for updates.

Product Details:

• Sizes: Small Single, Twin, Twin XL, Full, Full XL, Queen, Short Queen, King, Cal King, 
• Material: Memory foam with cooling gel
• Firmness: Soft
• Thickness: 2 inches
• Removable Cover: Yes/No

Best Mattress Topper for Combination Sleepers

Lucid Down Alternative and Gel Memory Foam Mattress Topper

$160 at Amazon $144 at Kohls.com View on Lucidmattress.com

Why We Like It

The combination of supportive memory foam and plush down alternative upper makes this topper comfy and cradling to keep spines aligned in every sleep position. We loved that the volume of the down layer stayed consistent after tossing and turning. We felt like we were sleeping on a cloud. And, given its size, we were pleasantly surprised it stayed firmly in place even when subjected to significant movement. Best of all, for combination sleepers or couples with different preferences, the dual layers make for a comfortable middle ground, melding softness and rigidity to appeal to all kinds of sleepers.

It’s Worth Noting

While on our sides, we noticed a ridge between the memory foam and down alternative topper near the edges. So, this one’s not ideal if you prefer (or are relegated to) the edge of the bed.

Product Details:

• Sizes: Twin, Twin XL, Full, Queen, King, Cal King
• Material: Memory foam and cotton down alternative
• Firmness: Soft
• Thickness: 4 inches
• Removable Cover: Yes

Best Mattress Topper for Side Sleepers

Nest Bedding Cooling Topper

$176 at Nest Bedding

Why We Like It

The firm contour-hugging foam provided super pressure relief and stability in every sleep position. Given its low two-inch profile, we found the added level of support surprisingly effective while on our sides—we couldn’t even tell when there was an acupressure mat placed beneath it. Though the temperature-responsive foam wasn’t as cooling as other toppers we’ve tried, it felt breathable and cool to the touch. The four basic straps held it firmly in place, and the volume of foam stayed consistent, even after vigorous tossing and turning. 

It’s Worth Noting

Though initially this topper was noticeably cooling, over time the cooling effect decreased. It’s also not waterproof, so not the best option for kids and/or pets.

Product Details:

• Sizes: Twin, Twin XL, Full, Queen, King, Cal King
• Material: Temperature responsive foam
• Firmness: Firm
• Thickness: 2 inches
• Removable Cover: No

Most Comfortable Mattress Topper

Nolah Mattress Topper

$299 $195 at Nolahmattress.com

Why We Like It

The near perfect balance of support and softness had us comfortably cradled, removing stress from aching joints. The extra layer of cushioning provided superb pressure relief—especially given it’s only two-inches thick. The soft and breathable organic cotton cover wicks away moisture, helping alleviate night sweats. And though it’s a little cumbersome to fit to the bed at first, the weightiness of the topper plus straps meant it didn’t move an inch.

It’s Worth Noting

You need to apply a little extra care while removing fitted sheets, as it’s easy to dislodge the straps that hold this topper in place. And though it’s definitely breathable, this topper was not as cooling as others we tried.

Product Details:

• Sizes: Twin, Twin XL, Full, Queen, King, Cal King
• Material: Nolah AirFoam™, organic cotton cover
• Firmness: Soft
• Thickness: 2 inches
• Removable Cover: Yes

Best Latex Mattress Topper

Sleep On Latex Pure Green Natural Latex Mattress Topper

$165 at Amazon View on Sleeponlatex.com

Why We Like It

Plush yet supportive, this topper instantly reacts and adjusts to your body shape, making it easy to find comfy positions whether back, side or stomach sleeping. Constructed from organic Sri Lankan latex, the topper provides a great balance of comfort, durability and breathability. The materials felt cooling, even for hot sleepers. And the two-inch thickness of the model we tried (they’re available in one-, two-, or three-inch thicknesses) offered superb support without allowing us to sink too deep into the foam.

It’s Worth Noting

This topper is very heavy, and requires two people to fit it to the bed. And because it’s made of latex, you do get a slight rubbery odor, which is unnoticeable once you’ve fitted a sheet.

Product Details:

• Sizes: Twin, Twin XL, Full, Queen, King, Cal King
• Material: 100% organic latex foam
• Firmness: Soft
• Thickness: 2 inches
• Removable Cover: Optional

Best Mattress Topper for Pressure Relief

Tempur-Pedic Tempur Adapt+ Cooling Mattress Topper

$499 $290 at Amazon View on Tempurpedic.com $619 at Mattressfirm.com

Why We Like It

After initial concerns this topper would be too soft, within a few minutes the foam had conformed to our contours, relieving pressure for excellent comfort and spine alignment in all positions. At three-inches thick, this is a hefty chunk of foam, with cushioning so effective we couldn’t feel an acupressure mat placed beneath it. After compression, its thickness does mean it takes a little longer than other toppers to regain its shape. But the consistency of support lived up to the manufacturer’s claims of superior bounceback than memory foam, which can lose shape over time. The machine washable cover is also a handy feature, and means you can use the topper on various beds, as required.

It’s Worth Noting

This is a heavy topper, which requires a couple of people to maneuver into place. And there’s no getting away from the fact: this is an investment purchase. Still, given the level of pressure relief we gained, we’d recommend this topper as a great alternative to replacing your older mattress.

Product Details:

• Sizes: Twin, Twin Long, Full, Queen, King, Cal King
• Material: TEMPUR-Material™ + knit cover
• Firmness: Soft
• Thickness: 3 inches
• Removable Cover: Yes

More Mattress Toppers to Consider

While these mattress toppers didn’t top any of our categories, they may still be of interest to you.

Avocado Organic Latex Mattress Topper: We liked this topper for its soft, cushy feel, and the ease of placement on the bed. Getting in and out of bed, however, we found the topper shifted around and would benefit from some simple straps to hold it in place. And for the hefty price, we’d likely consider a new mattress instead.

Parachute Down Alternative Mattress Topper: Soft and plush, we enjoyed the cloud-like feel this topper offered in all sleep positions. It held its shape nicely, and held its position on the bed. The only thing we’d change? Extend the plushness just a little further around the sides to eliminate the hard edge. Beyond that, this topper scored well across every metric.

ViscoSoft 4 Inch Pillow Top Memory Foam Mattress Topper: With a superb combination of support and squish, this topper stayed cool through the night. It’s heavy, though, and we found it cumbersome and difficult to fit to the bed. The foam had a sticky feel to it, also, which felt like it caught us in position. And the underside of the foam tended to shed, making a dandruff-like mess in the bedroom.

Where We Stand

After testing 29 products in total, including 17 mattress toppers, our eight best-in-category toppers stood out due to the balance of comfort and contour-aligning support. The Casper Comfy Mattress Topper scored near perfectly across every metric, with its memory foam superbly cradling our bodies to reduce pressure. We’ll continue to test these top-rating toppers and update our recommendations if we notice any substantial changes over time.

Our Testing Process

Our 17 editors who completed testing comprise a broad range of stomach, back and side sleepers, and exhibit a wide range of physical attributes, including joint, muscle and back complaints. Each mattress was tested in our lab over a period of three days, with our editors evaluating performance in terms of comfort, support, durability, breathability and overall quality. We also tested water-resistance against manufacturer claims.  

Editors set up toppers with an acupressure mat placed beneath one side. They initially assessed ease of setup, noticeable odors, and ease of fitting generic sheets. They then completed a series of stationary and movement tests on both sides of the bed. For each of the criteria below, we rated the toppers with a score of one to five.

• Comfort: editors evaluated softness, plushness and cushioning, and overall comfort in a range of sleeping positions.
• Support: editors evaluated whether or not they noticed the acupressure mat beneath the topper, and assessed the consistency of volume of materials after tossing and turning, as compared to before they laid on the bed. They also noted the speed of bounceback after compression.
• Durability: editors measured how well the topper stayed in place during motion, and inspected the underside for any wear or tear as a result of the acupressure mat.
• Breathability: after five minutes lying on their toppers, editors noted any temperature changes, and evaluated cooling effectiveness against manufacturer claims.
• Quality: editors measured ease of maneuvering toppers into place, and noise emanating from the materials during motion, as well as any noticeable odors. 
• Value: editors compared their toppers when measured against the median price of $189, reflecting on whether they’d pay full price for the product and whether the quality of the topper matched the price point.

Our Experts

We consulted some professionals in the field to help determine our test methodology and key attributes we should be looking for in top-rated mattress toppers. Professionals we interviewed include: 

• Karena Wu, PT, DPT, OCS, COMT, CSCS, CKTP, CPI, FAAOMPT, Physical Therapist, Owner of ActiveCare Physical Therapy in New York City and India.
• David Rubin, Certified Sleep Science Coach and product expert at TheSleepDoctor.com.
• Robert Hayden, DC, PhD, spokesperson for the American Chiropractic Association.

What to Know About Mattress Toppers for Back Pain

Let’s break down some of the key considerations while choosing a mattress topper.

• Materials: All of the top-rating mattress toppers we tested are constructed from foam (polyurethane or latex), with variations in cooling gels, perforations and layering. Rubin notes that while memory foam is most popular, there are benefits (and drawbacks) to other materials. “Mattress toppers are usually made from memory foam, which offers great contouring and the feeling of sinking into your mattress,” he says. “Latex gives the same contouring without the sinking-in feeling. Wool offers excellent breathability, and feathers/down are very soft, but not always supportive enough to keep the spine aligned.” 
• Firmness: When considering firmness, think about the mattress you’ll be topping, your sleep position, and your overall objective of the exercise. If you’re looking to soften-up a firm mattress, look for softer and thicker toppers. To add rigidity to a too-soft mattress, go for something firmer. Dr. Hayden notes, “A mattress should be firm enough to support your skeleton for the 25–30% of your life that you spend resting. That support is critical in maintaining your posture while your muscles are relaxed so that there is less wear and tear on your skeleton.”
• Temperature Regulation: Most manufacturers claim their product has a cooling effect, but the proof is in the testing (see reviews above). For hot sleepers, Rubin suggests avoiding memory foam toppers, unless they have bona fide cooling properties, because they have a tendency to heat up as you sleep. He also recommends latex toppers as they tend to sleep cooler. 
• Your Sleeping Position: In Rubin’s experience, side sleepers who experience hip or shoulder pain sometimes find that their mattresses are too firm, but can remedy the problem with a softer topper. Stomach and back sleepers, however, usually do better with a firmer surface, so he recommends not defaulting to the softest, thickest topper. 
• Price and Value: The price range for the mattress toppers we tested is $58 to $649, with a median price of $189. Given the price of a new mattress is significantly higher, and a topper can increase the lifespan of your old mattress by two or more years, a minimal outlay can bring significant benefits.

Your Questions, Answered

Are mattress toppers good for lower back pain?

Yes. All our experts agree mattress toppers can help better align your spine and alleviate back pain. As Dr. Hayden notes, “A good mattress topper can give you extra support that can help ease low back pain. It can also help with bony prominences, such as the hips and shoulders that touch the mattress in a side-lying position.”

What type of mattress topper do doctors recommend for back pain? 

Dr. Wu recommends memory foam toppers, because of their conforming and contouring abilities to support the spine. Dr. Hayden recommends latex for its lack of motion transfer, but cautions that it can hold body heat, and that some people may have latex allergies. He also rates memory foam highly in terms of comfort and support, but says that if they’re too thick they can cause difficulty moving around the bed. 

What is the best thickness for a mattress topper for back pain?  

Dr. Hayden cautions that if a mattress topper is too thick, there is a risk of it being too soft and allowing your body to sag. “Somewhere between two and four inches should do the trick,” he says. Dr. Wu suggests the thicker end of that spectrum for heavier individuals, while lighter people can find adequate support with a two-inch thickness. It’s also worth considering your preferred sleep position, as side sleepers generally enjoy a little more give than back or stomach sleepers.

Are memory foam or latex mattress toppers better for back pain?  

Dr. Wu recommends memory foam toppers because they contour to your body slowly and allow for low motion transfer—giving you more of a ‘hugged’ feeling of support. She also recommends latex mattress toppers because of their faster response time to your sleeping position, as well as their durability.

Who We Are

Samson McDougall is a journalist, copywriter, editor, and biology graduate. As a writer for Health, he has covered a range of topics from heart monitors and mattresses to toothbrushes and mosquito repellents. A side sleeper, he has been prone to insomnia, but having children fixed that.