Help w/mattress causing Upper Back Pain below shoulder blades

Hi. I could use some advice, please.

My upper/mid back hurts from my mattress just below the middle of my shoulder blades.
What can cause mid/upper back pain?

I’m 5’11" 250 lbs with most of my weight around my stomach.

Could my mattress, which gives cushioning to my hips for side sleeping, not be firm enough for my back?

My mattress is a Serta Iseries plush,., a hybrid with coils and 1" of gel foam plus 1.5" plush foam.

My options are limited to exchanging this mattress, perhaps a firmer mattress and/or adding a topper.


Hi stevenkabc,

It’s very possible yes and you could be sleeping in a “hunched” position. It’s also possible that it could be a pillow issue.

I’m not sure how long you have been sleeping on the mattress or whether it was working for you initially and then you started developing your “symptoms” or whether they were there from the beginning but it’s also possible that this is part of the initial breakin and adjustment period for any new mattress or that your choice was “right on the edge” of being too soft for your body type and sleeping positions and the lower quality foams in the comfort layers may have softened enough to put you over the edge.

If you do decide you need to exchange your mattress then you may be in a somewhat difficult position (depending on the other mattresses they have available) but the information in post #2 here and the posts it links to should help you to make the best of a difficult situation.


Thanks for your reply.

The mattress is just 1 week old. My upper back began hurting night 1. On my side, it hurts along my rib cage.
One half of the mattress is less painful.

I’ve been trying multiple pillows and found one that gives be good side sleep support while not being too high for back sleeping.

I went with the plush to cushion hip and shoulder for side sleeping. A pillow top version of the same mattress actually felt more comfortable, but I worried that it would flatten out fast.

This mattress replaced a 6yo inspiring that sagged 2" which itself gave me upper back pain.

The old mattress warranty was honored after inspection which gave me it original purchase price to apply towards this replacement. So I’m not heavily invested into this mattress.

Would it be worth trying a topper on this mattress before exchanging for a firm?


Hi stevenabc,

There is more information in post #2 here about “breaking in” a new memory foam mattress that may be helpful and post #2 here has more information about some of the more common “symptoms” that may also help you to identify their underlying cause. Now that you have a “reference point” it may also be worthwhile testing different mattresses using the testing guidelines in the tutorial post to see if you can find a mattress that is more likely to be a better match for you (both in terms of suitability and in terms of the quality/durability of the materials inside it).

I would tend do nothing for the first few weeks if that’s possible so you can see if your symptoms are improving, staying the same, or getting worse and I would rotate the mattress as well so that it breaks in more evenly if one half of the mattress is different from the other.

If after a few weeks you decide that you need some additional softness because the mattress is too firm for you then a topper can certainly be a good possibility. If you decide that the mattress is already too soft (in either the comfort or support layers) then a topper is unlikely to be a good solution (see post #4 here) and exchanging the mattress would likely be a more effective solution.


I exchanged my mattress today for a slightly cushioned extra firm Simmons as my upper back pain had not subsided; I was waking after 4 - 5 hours sleep with pain that wouldn’t subside for hours.

I narrowed my choice between a hard like a rock Stearns and Foster ultra firm that would absolutely need a latex topper for comfort and this Beautyrest. It feels like it will support me while keeping my spine aligned; seems like it contours to my lumbar spine, too. With this mattress there’s a chance I won’t need to add a topper for comfort; Hopefully, this will alleviate my back pain.

This is my 3rd mattress try.

Consumer Reports gave high ratings to a Novaform Serifina at Costco, my 1st try. In hindsight, I should have given it a longer trial as my back didn’t hurt but my hips did. Perhaps it might have softened up over a few weeks.

The 2nd was the Serta Iseries also highly rated by CR; because of the hip pain from the Novaform, I went with a plush, resulting in the upper back pain.

I gave too much weight to CR’s ratings. My body obviously didn’t agree.

Maybe this 3rd time will be the charm and I’ll sleep to 7am, waking rested with no pain.

I couldn’t have imagined finding the goldilocks mattress would be such hard work. (Finding the right pillow has also been challenging.)

Thanks for this site. It’s been helpful.

Hi stevenkabc,

You can see my comments about the consumer reports mattress suggestions in post #2 here and in this topic. IMO … they were written by people who have little understanding of mattresses or the industry.

I hope your exchange works out well and if it’s on the firm side then you would still have the option of adding a topper. I also hope you have the chance to let us know how things are working out after a few weeks when you are through most of the initial break in and adjustment period.


Hi Phoenix.

My new mattress is very firm and hurts worse than the plush mattress I just returned. I woke at 2am to excrusiating upper & mid back pain and it has felt injured all day. My low back, though, feels fine.

My upper back pain does comes from these mattresses as when I sleep on either of two couches at home, my upper back does not hurt. One sofa is very soft it gives me low back pain from obviously having no support. The other sofa feels fine on my back as it has a sleeper under the cushions that I guess acts as some support.

Today, I must either add a topper to this new, firm mattress, to try to relieve this pain or begin again with a web order latex mattress.

I read through your suggestions for mattress toppers.

For my specific pain – mid & upper back, and size – 5’ 11" 250lbs mostly around my stomach I’m unclear as to size and firmness. You wrote that average [quote]
In general … 19 - 24 ILD in latex would be considered to be in the soft range for “average” body types … and heavier body types would probably do better with 28 ILD and above.

Is a 3", 28 ILD right for my size and/or back issues? I woudn’t mind softer if it wouldn’t be engulfing and would ease my back.

I was looking at Sleepez and KTT Enterprises toppers, amognst others.

Thanks again for your thoughts. You’ve been very kind.

Hi stevenkabc,

Unfortunately there is no way for me to know this based on “theory” because there are too many unknowns and variables involved and this is one of those questions where the only reliable answer would be “it depends”. Having said that the topper guidelines can shift the odds of success in your favor but when you are making a purchase that you aren’t certain about then the return or exchange policy of the topper would become a more important part of your purchase so you can use your actual experience on your mattress/topper combination to decide whether the combination is working well for you without taking the risk of having no additional options remaining if it’s not.


I ordered the 3" 28 ILD talalay. Hopefully, this will help.

If not, it’s time for me to move on with the knoweldge gained from your wonderful site to buy a proper mattress.

This all started with my 6yo Sealy giving out; it sagged by 2 1/2"s. The store inspected it and gave me full credit towards a replacement, for which I didn’t have to shell out a lot out of pocket. I didn’t like using this store but didn’t want to walk away with money on the table. Now I know better.

Thanks for your help

Hi stevenkabc,

It sounds like your topper is “in the range” that could work for you and I’m hopeful that it does. I also hope you have the chance to share your feedback when you receive it and have had the chance to sleep on it.


Hi Phoenix. I purchased a Dreamfoam 3" medium (28 ILD) topper as I was able to receive it in 24 hours. I’ve now slept on it for 3 weeks. It reduced by upper back pain; though, not enough to sleep through the night. My pain was at 10, now 6.

I’m thinking of trying some soft comfort foam. Some of the polyfoam suppliers listed on this site have soft, HR foam 21 ILD 2.5-3 lb. Also saw some 1.8 lb soft foam. Not sure of depth, 2 or 3 inches.

Is it possible for a topper to add softness for comfort like a pillowtop that wouldn’t cause poor spinal alignment.
The latex felt firm. I would have liked it to feel softer. Though, I want whatever will help make my back comfortable.
My weight is down to 229, 5’ 11".

Thanks for your help.

Hi stevenkabc,

That’s good news … and at least “one step” in the right direction :).

The density of polyfoam has little to do with it’s firmness/softness and is more related to its quality and durability. Any density of polyfoam can be made in a wide range of firmness levels. There are also several factors that affect how soft a foam feels including the IFD/ILD (which is a measure of how easily a foam compresses), thickness, compression modulus, and point elasticity (see post #4 here). Firmness ratings such as ILD also don’t “translate” well between different types of foam.

You have several options to add some softness and pressure relief to your mattress which includes replacing your current topper with a softer latex topper or adding another layer of foam of the type (either latex, polyfoam, or memory foam), thickness, and firmness/softness that you would.

Post #2 here and the topper guidelines it links to has more information about choosing the type, thickness, and firmness of a topper that may be helpful but there can be so many variables involved in the relative firmness of a material (including everything underneath it) that I would tend to make these choices based on a more detailed conversation on the phone with the supplier of the topper you are considering. Because you won’t really know for certain how well any topper works for you in combination with your mattress or any other toppers you are using it with … the return or exchange policies of the supplier you buy from and the options that you have available after a purchase if a topper you choose turns out to be less than ideal may also be an important part of the “value” of a topper purchase.

Adding thicker/softer layers of foam to your sleeping system by adding one or more toppers can certainly provide additional softness and pressure relief and would be similar to a pillowtop that used the same type and thickness of materials (there are hundreds of different versions of pillowtops) but they would also increase the risk of alignment issues because the heavier parts of your body can “sink down” more before they are “stopped” by the firmer support layers that are deeper inside your mattress. In most cases its best to use “just enough” additional softness to provide the pressure relief you need in your most pressure prone sleeping position so that there is the least possible risk of replacing pressure or comfort issues with alignment issues.