If there ever was a more long-lasting debate over which firmness makes for the best mattress it would have to be the one between doctors and chiropractors; as if there weren’t enough debates between the two fields in the first place. In the end, it all really comes down to the sleeper. Depending on what type of conditions the sleeper has, back conditions, injuries, or things of that nature, a particular firmness gets recommended to the patient.

In order to better judge which is the best mattress for each individual person, they must first decide what they are comfortable with and what they’re looking for in the mattress long-term. However, many people also want to know what medical professionals recommend, as they may have found that their own mattress choices have let them down in terms of comfort and support.

Plush mattresses are designed to be as soft and contouring as possible, and the idea of sleeping on a cloud can sound great. However this same design makes most mattresses like this buckle or “bottom-out” underneath the weight of the sleeper. Plush mattresses can also lack the necessary spinal support to keep sleepers pain-free. After about five years so, most plush mattress owners end up with a concave shape  and compacted pillow top which makes for a highly uncomfortable sleep. Certain types of beds will also lose support faster than others; specifically, pillow tops made of fibre fill tend to compress within a couple of years, as do lower density foams.

Medium and firm mattresses are meant to offer support, and tend have less “fluff” or padding. They can often be cheaper than plush counterparts, and the components may take longer wear out. While there is no guarantee that medium and medium firm beds will prove more comfortable for everyone, professionals and sleep studies almost always end recommending one or the other. Here are the results we found.


When it comes to mattresses, one of the most debated subjects is the one between doctors and chiropractors over which is the best mattress for their patients. The issue here is that for many years, orthopaedic doctors had been prescribing firm mattresses for their patients who suffered from certain back ailments.

On the other hand those patients who went to chiropractors were recommended a medium to firm mattress instead of a extra firm. And thus began the debate of decades. Before we can come to the conclusion over which of the two is best for individuals who suffer from back problems and injuries, let’s first go into the reasons why each recommended either or.

Orthopaedic doctors claimed that firm mattresses aligned the back better, in other words the vertebrae were more inclined to heal if they were in a straight position. However chiropractors came up with the idea that, the only thing that was in the straight position in this composition was the mattress itself. An individual sleeping on a firm mattress lacking the ability to contour to the body could not possibly align the vertebrae. Instead of the sleeper would be sleeping in a crooked position, resulting in tense muscles and achy joints. Thus the chiropractor set tends to recommend medium to medium-firm mattresses, which could still provide support but also prove soft enough to contour somewhat so as not to distort alignment.

Spanish study from 2003 found that people with lower back pain reported greater relief over 90 days on medium firm as opposed to firm mattresses. The overall study interpretation was, “A mattress of medium firmness improves pain and disability among patients with chronic non-specific low-back pain.”

According to Mark Mandell DC, MBA, “Mattresses are health care products that can retain the natural position of the spine and reduce subluxations when properly fitted. A prescribed bedding system can reduce back pain by 57%; decrease back stiffness by 59%; and improve the quality of sleep by 61%.3 Patients ask their doctors for assistance with mattress selection, but few doctors were ever trained in sleep systems.” In his article, makes recommendations for several concerns, included in the list below.

  • Lower Back Pain- Firm Mattresses
  • Upper Back and Neck Pain-  Medium to Plush Mattresses
  • Arthritis and Fibromyalgia- Plush but Supportive Mattresses
  • Seniors- Medium to Plush Mattresses
  • Stomach Sleepers- Firm Mattresses
  • Side Sleepers- Medium to Plush Mattresses with higher conformity
  • Back Sleepers- Firm Mattresses


It remains a toss up. Most doctors still say firm is the way to go, while some chiropractors stick to their, medium-firm ideals. What most professionals agree on is that the majority of people will not benefit from plush mattresses. In the end it depends on the consumer, and what they find to be the best mattress for them. If you feel perfectly happy on your firm or plush bed, then there is no reason to switch. However, if you own a plush or extra firm bed and have pain, it may be worthwhile to consider beds of medium firmness in order to get the best mattress for comfort.