How do you get good spinal alignment with wider shoulders and narrower hips?

I have recently purchased a new mattress. It is a Innomax Medallion. It feels very comfortable but I wake up with back pain. I am attaching a picture showing how my spine is out of alignment. This may be due to the fact that my shoulders are much wider than my hips. Can any mattress compensate for this. What can I do?

FYI, I tried all types of beds including innerspring, latex, memory foam, and air. Innerspring and latex both put pressure on my shoulder and hips whereas memory foam does not (or at least far less). The Medallion has air for support and latex, memory foam, and a pillow top for comfort. I figured this is the best of all worlds combined.

Hi dastur,

One of the most effective ways that can accommodate more difficult body types is different types of zoning. This can allow for the use of firmer support under the heavier parts of the body like the pelvis and still allow for the use of thicker / softer materials under your wider but lighter shoulders that can “allow” them to sink in more deeply while still supporting and “holding up” the heavier pelvis.

The materials and the “feel” of the mattress are more a matter of preference and don’t matter nearly as much as the design of the mattress and how well it can provide for different levels of support or pressure relief under each part of the body. There is more about zoning in this article and in post #11 here.

Other factors such as the changing surface area of each part of the body relative to its weight as you sink in more deeply into the mattress and the compression modulus of different foam materials (how quickly a foam becomes firmer as you sink in more deeply) and the “point elasticity” of different materials can also play a role in the primary support, secondary support, and pressure relief of different mattress designs that can work well for different people in terms of PPP (see post #6 here and post #2 here). In some cases even something as seemingly simple as a mattress pad, mattress protector, or the type of cover or quilting in a mattress can affect how much a mattress can contour to each body shape or how well the shoulders can sink into the mattress.

I would also be cautious with airbeds and using air for support and you can see some of my thoughts about them in this article. At the very least it may be useful to have an airbed with a center zone that can be adjusted for firmness independently but even here they don’t have the same progressive firmness as foams, innersprings, or latex.

Phoenix

Hi Phoenix,

Thanks for the very informative reply. Here is another set of pictures showing how adding support under the hips and torso improve spinal alignment. Adding this extra layer may help alignment for side sleeping. But I wonder how comfortable the mattress would be overall. Only one way to tell.

Hi dastur,

What the pillows have done is add a form of zoning which is why they are improving your alignment. I think that using thicker/softer foam under the shoulders would improve it even more but of course pillows can’t accomplish this.

If a mattress is the most suitable design for you it would be “more comfortable” than what you are currently sleeping on but as you mentioned your own careful and objective testing and experience is the best way to know which mattress is the best “match” for you.

Phoenix

Here is what I have right now from bottom to top:

6" air chamber
1" high resilience zoned convoluted foam
vinyl moisture barrier
1.5" 4lb memory foam
1.5" 19ILd Talalay latex
3" synthetic pillow top

I think the pillow top is lacking support. Removing the pillow top helps to improve alignment and reduce pain. Still feel like it’s too flimsy. Perhaps I should replace the pillow top with another 1"-2" of medium ILD dunlop latax for additional support. That way I’ll be sleeping directly on (except for sheets) 2.5"-3.5" of latex. Is there any health concern (like mold) by eliminating the cover?

Hi dastur,

I wouldn’t have any health concerns no although I would make sure you still had a mattress protector along with your sheets over the bare foam. It would also affect the fire retardancy of the mattress because the fire retardant would be in the cover.

Phoenix

Hi Phoenix,

I am experiencing first hand exactly what you have pointed out about air mattresses. They conform but lack resiliency. This may or may not be a problem depending on your situation. For me, it is a problem. My mid back dips and I need the mattress to push back up, not conform.

The more I sleep on this air mattress, the more I realize I need more support than it can offer. The question is, when switching over to a dunlop latex core, would it better to place the latex over plywood or over an air chamber? Might as well use the air chamber if I have it, but not if it does more harm than good.

Hi dastur,

I’m not quite clear on what you are considering but probably neither one. If you are considering sleeping on a latex core with separate comfort layers on top of it (which would be a completely different mattress) then the new latex core would replace the air chamber. If you put the core and the comfort layers over the air chamber then any dips or sagging in the air chamber could still come through the mattress to the sleeping surface. Both a latex mattress and an airbed generally do best with a firm non flexible support system underneath it. Plywood can certainly be firm and non flexible enough but it doesn’t provide any ventilation under the mattress so I would tend to prefer a more breathable support system unless there was a “compelling reason” to choose otherwise (see post #10 here) although it could still be an improvement .

If you are only considering a new latex comfort layer (vs a support core) to go with the comfort layers you already have then it may be a little thin to be used by itself on plywood (or any other firm non flexible base) and you may “bottom out” so you would probably need to use it on top of your air chamber to see if it helps solve the issue in combination with removing the quilted top (and it would likely be an improvement) although once again any sagging in a support system can still “come through” to the top sleeping surface.

Phoenix

Hi Phoenix,

When I said “latex over plywood or over an air chamber” I was making a comparison between the two extremes. But the question was in general, rigid vs flexible. In reality I may place the latex core on an adjustable base (Leggett and Platt Prodigy) or place the air chamber on the adjustable base and the latex core on top of the air chamber. My thinking was that a flexible base results in less compression and therefore more resiliency to the latex (please see attached picture). Or not?

I am considering whatever possibility that will provide a good night’s sleep. But of course I want to approach it with some common sense and use what I have available if it is feasible. But the priority is getting it right not salvaging components on hand.

One conclusion for sure is that plush pillow tops are not for me. This is a case of you don’t get what you pay for. It costs more and the results are worse (too mushy and not enough support). I would rather remove everything except the sheets and mattress protector in between the latex comfort layer and me in order to get the most benefit from the properties of the latex. Hence, the comfort layer and top of my ideal mattress system is now clear to me. The core and base are still TBD. Thanks.

Hi dastur,

In general terms I would certainly agree with this and plush pillowtops that use lower quality materials are one of the biggest “issues” in the industry IMO.

If you are comparing a latex support core to an air bladder support core I would choose latex because it is more adaptable and has better progressive support than air but it would still depend on choosing the most suitable firmness level and the most suitable comfort layers on top of it. In your case though it may be worth trying a latex transition layer in between your current comfort layers and the air bladder to test and see if it works better for you than the pillowtop layer you have removed with the air bladder at its firmest level underneath before you go to the greater expense of replacing the support core or buying a new mattress completely.

Since you also have access to your comfort layers it may also be worth buying a 1" layer of polyfoam so you can experiment relatively inexpensively with different custom zoning options under your comfort layers (see post #11 here).

More specific than this would really depend on the more detailed specifics of a mattress and on how well it matches you in terms of PPP. It’s not possible to predict this based on “theory at a distance” except in very generic terms and it can involve some trial and error to find the best combination of materials with more challenging body types.

The picture you linked was a comparison between two different types of support base under the mattress and which one was more suitable would depend on the specifics and the thickness of the mattress that was on it and again which one was the best match for you. You can read more about the different types of foundations and how they “match” different types of mattresses in post #2 here and the two links in the second paragraph. If they both provided equally good alignment then it would be a matter of preference between them.

With thinner mattresses a flexible foundation (or a box spring) can add some “give” under the mattress which can be helpful with both alignment and pressure relief. Some flexible foundations can also be adjusted for different firmness levels under different parts of the body to create a softer zone under the shoulder area or a firmer zone under the pelvis which can also be useful both for pressure relief and for alignment. With thicker mattresses though the flexible slats or adjustable zones may have much less effect through the thicker mattress.

The most common approach is to design the PPP into the mattress itself with various support, transition, and comfort layers and then to use a firm non flexing foundation under the mattress.

Phoenix

Hi Datsur, curious as to what ended up working for you?