Hi Jrogers,
While the most common cause of lower back pain is a mattress that is too soft … as you read in the posts I linked it’s certainly not the only reason and in this case I would also have guessed that with the combination of a thinner mattress and a firmer sleeping surface that you would have needed some additional thickness and softness on top of your mattress.
This would seem to confirm that additional thickness and softness seemed to be moving you in the right direction (your back symptoms and side pressure points were better) although it still wasn’t ideal for you.
Greater thickness and lower ILD’s both have a softening effect on a mattress so a 9" mattress that uses all 32 ILD latex would feel softer than a mattress that only has 6" of 32 ILD latex (assuming that all the layers are the same type and blend of latex because this will also have an effect on firmness/softness). There is more about the effects of thickness in post #14 here.
It’s possible that your symptoms are coming from both thickness and softness issues. Your 19 ILD top layer may be too soft to isolate you from the firmer support core (although this would be unusual at your weight range because 32 ILD isn’t particularly firm) so this may be contributing to the pressure issues you are experiencing and you may also need some additional thickness to provide better secondary support to fill in the gaps in your sleeping profile. It’s also possible that any shoulder issues are connected to the firmness and thickness of your pillow so it may be worth trying a different pillow to see how your upper body symptoms change as well.
It may be worth considering a layer in the medium range (around 28 ILD or so) to use as the top layer of your mattress and then it could act as a transition layer if you use the softer 19 ILD layer as a topper and then you also wouldn’t have to change the thickness of the cover. This would provide additional pressure relief for your shoulders and would it would also be less risky than having two softer top layers on top of your mattress which would increase the chance of experiencing alignment issues and back pain from a mattress that was too soft.
Since you have the option available it may also be worth trying your mattress with the softer layer under the firmer support core just to see how your body reacts to this configuration so you can “learn” as much as possible from any changes in your symptoms with the layering options that you currently have available before deciding on any other changes.
Phoenix