What to do - bad back AND shoulders

Mattress underground - love it!

I’ve recently joined the ranks of the “mattress obsessed.” Had a back injury last year and slept on a pad on the floor for months. Worked fine until it didn’t. My back is OK, but I now have excruciating pain in shoulders/elbow joints.

Ive been testing beds locally, and what I’ve found is that what feels best lying on my back (firm latex) crunches the shoulders when I turn to my side. And vice versa, what feels best for shoulders (medium-soft Orthogel) does not feel as good when Im on my back - I get that butt-sinking effect which I know will mean trouble over the long haul. Part of the reason I developed a bad back in the first place was sleeping on an old mattress where that was happening

So- what to do? How to bridge those two, very different needs? Ive thought of some sort of soft topper - maybe even gel - over a firm latex, but then get overwhelmed by the question: which topper, which thickness, which firm latex. Im not sure how to translate the ILD information into how it feels.

Do not like memory foam, and prefer a simple single unit that will sit on a platform vs. one of those monsters you need stairs to climb into. About 140 lbs - 5’3" Thank you in advance for any and all input - most appreciated!!!

Hi sleepless in wi,

You are in the same boat as many people trying to balance the needs of spinal alignment with pressure relief which by their very nature are conflicting needs. Support requires firmness while pressure relief requires softness.

The good news though is that the softness part relates more to the upper layers while the firmness relates to the deeper parts of the mattress so while each affects the other, they can also be adjusted independently of the other. The trick with this is to pay attention to the firmness of the support layers and to BOTH the thickness and softness of the comfort layers. Thickness especially is the “neglected” factor. The closer to the support layer you are … the more it can hold up your heavier parts and help with best alignment. The goal is to use the firmest and thinnest comfort layer that adequately relieves pressure on your shoulders. In your case this will likely be in the range of 3" although if 2" worked it would be even better.

An example of this is when you were sleeping on the floor on a pad. This would have been good for support (your pelvic area couldn’t sink down too far) but not to good for shoulders (couldn’t sink in far enough to spread the pressure out to the torso without bottoming out).

So the goal in mattress testing is to test out various mattresses where the thickness and softness of the comfort layers is known so that it is easier to make adjustments (softer/firmer or thicker/thinner) from a known set of specs. For example it would help to know the thickness of the orthogel layer of the mattress you tried and also the support layer underneath it. My tendency (as you also suggested) would be to start with a “firmer” support core (36 ILD or so) and then experiment with various comfort layers over top of this. Without knowing the thickness of a comfort layer you’ve tried it’s difficult to know which direction to go. What you are looking for with each layer you test is first of all pressure relief (laying on your side completely relaxed to sense any pressure points on your shoulders) and if the comfort layer is suitable for pressure relief then to test for alignment on your back (completely relaxed and sensing for any tendency to keep the muscles in your lower back tense). You want the mattress to keep you in alignment rather than your muscles.

Another solution that gives you more flexibility in the choice of comfort layers would be to test zoned support cores where the middle zone is firmer which means that the upper layers can be either slightly thicker or softer without sacrificing support and alignment. Zoned comfort layers can also help with this although they are less common.

So a thinner comfort layer is better … as long as it’s not too thin for optimal pressure relief on your side.

A firmer comfort layer is better … as long as it’s not so firm that even with the optimal thickness you don’t sink into it deeply enough with your shoulders.

A zoned core will allow you to go a little thicker or softer than a core without zoning.

A “standard” starting point would be to try a latex core in an ILD range of about 36 (firm) with a comfort layer in the range of 3" and 19 ILD (your weight is lower so softer 19 may be better than slightly firmer 24 ILD). If that works then trying 2" for pressure relief would be the next step to see if this works. If this is too thin then slightly softening the support core or using a middle transition layer which is slightly softer can “help” the comfort layer and still be firm enough for good alignment. Testing other materials in the same general thickness would also help.

This suggestion isn’t “exact” and it’s more important to have a beginning reference point with specific feedback than it is what that “beginning point” is. Each person has a different weight distribution and even a different natural curvature and flexibility of the spine so actual testing and feedback based on your own experience is the best way to know whether to go thinner/thicker and/or firmer/softer in the various layers.

One further suggestion is that local factory direct manufacturers or sleep shops that carry smaller brands and are more knowledgeable and transparent about the layers in their mattresses (and why a particular layering scheme may work better for you) will almost always give you better advice and help that leads to better choices than chain stores or other outlets that focus more on national brands with so called “proprietary” layering.

If you let me know which city you live in I’ll be happy to take a look if I know of any better options that are near you.


Thanks!!! I appreciate being able to apply some scientific logic to this situation - have been just going around in circles trying to decide.

The orthogel bed I tried was the Solutions Single Gel (with stretch knit ticking, 1" quilting foam, 2" orthogel layer, 8" “plant based” foam which I’m pretty sure they said was acella-flex…) It really was comfy and I almost fell asleep. Came close to buying - but had a nagging doubt about whether the underlying support was firm enough and how durable the gel & foam base would be over time. Do you have any thoughts about the durability of the gel technology?

Im in Madison, Wis - I saw the listing on this website for Beloit and thought I might go check it out - unless there’s anything closer to home?

Went to Verlo but didn’t get the sense that they would do anything custom - but then again I didnt really ask. Just now I called and was told they they have a model that has simiilar configuration as what you suggested . Its 6 inches latex ( 2" layers of 19, 24 & 36 ILD) over 3 inches of acella-flex. Then another one of all latex with same configuration, except with 3" instead of 2" layers. He said this one was softer – I guess because the soft layers are thicker (hey Im catching on!)

Will go test them out!

I’ll offer you a critically important piece of advice in your shopping efforts… Take your time and be sure to lay on your side for a good 10-20 minutes, it will take that long before pressure points in your shoulder might set in. And when you do eventually decide to pull the trigger, make sure the company you are dealing with has some knid of return or exchange policy (or will work with you until you get things right). You cannot really know what a mattress is going to feel like until you actually sleep on it. Far too many variables involved to assume that by simply testing a bed out in a store, or going by numbers (ILD’s, etc) that you will get it right.

Phoenix has put together this incredibly helpful site and it would be wise to utilize some of the referred mattress companies who are Mattress Underground members.

Good luck,


Hi Sonic,

Good advice and I couldn’t agree more about the need to completely relax on a mattress to test for pressure relief.

Hi Sleepless in wi,

We have two sleeplesses now so I have to add the area as well :slight_smile:

The orthogel uses what is called bucking column gel and it’s a very durable material and will last for a long time. It has a unique way of relieving pressure because the columns which are under pressure will collapse while the rest which have less pressure will stay more stiff and continue to hold weight. It can be a very effective pressure relieving material although it has an unusual feel to it when you move and the columns buckle. 1" of quilting polyfoam is thin enough that it would also not be a durability issue and with buckling column gel its a good idea to have some foam on top for a more consistent feel. The Acella-Flex foam usually comes in 2.0 lbs and is a good quality support foam. the only down side to buckling column gel is that it’s an expensive material (even more than latex).

There are also other versions of this material including intelligel which use a different cell structure and use a heavier more pure gel rather than the foamed gel used by Natura and are a little less stiff. Serta used intelligel in several of their mattresses including this one which had 2.5" of the intelligel and had 2" of Talalay latex over it along with a 6" soy polyfoam core.

Both of these are buckling column gels are licensed from Edizone.

Beloit Mattress Company in Beloit, WI or Rockford, IL would be well worth the trip to go there. They are a member of this site which means that I believe they compete well with the best in the country and are also great people to deal with. They have a wide range of mattresses that include gel memory foam, memory foam, latex, and innersprings.

Verlo Has stores in Madison, Janesville, and Fort Atkinson (among others in WI and Northeast IL) and is a regional factory direct manufacturer and has a wide range of mattresses of many types (innerspring, memory foam, latex etc). They also do custom work and can adjust their mattresses to suit an individual. Note: their store in Madison is small and doesn’t carry their full line (see post #4 here).

Denver Mattress is another regional factory direct manufacturer with stores in Madison, Wi and Rockford, IL (among others). They also make a range of mattresses including innersprings and their iChoice which is a mostly latex mattress that has the option of a memory foam or latex comfort layer. They may also be well worth visiting.

http://www.satarahome.com/ Retailer in Madison that carries Savvy Rest (including their component latex mattresses), Sleeptek, Suite Sleep, Royal-Pedic, and Naturepedic. They are all very high quality mattresses but I would also make some careful value comparisons because they tend to be in a more premium price range.

I don’t think you will need much more in the way of options as these represent some good value and/or selection.


Thanks - yes, good idea about longer duration testing. For me though - because Im in pain during the day as well as night ( in shoulders/elbows/hips) it’s been hard to judge what my back was experiencing because Im so focussed on the other joints. I think that’s where the scientific approach helps. If the stats look like they “should” work and be supportive enough for the back then thats good info that helps me make a decision.

Phoenix - could you clarify your comment about the intelligel being “softer” than the orthogel. Would that mean sinking down more - giving more of a memory foam effect? I liked the orthogel surface because it was a nice combination of feeling like floating more on the surface but yet able to “give” pretty deeply in the high pressure places like shoulders, hips It certainly did feel different - can feel the cells go down and come back up - but not unpleasant.

That intelligel topper on their website for $449 looks tempting - 2 1/2 inches of gel - I like the flexibility of having a removeable topper.

Hi Sleepless in wi,

I you go to the Edizone site and click on “available technologies” they provide a brief description of both.

The orthogel is a lighter version with a different foamed material encapsulated inside the gel. This material and the hexagonal shape of the columns seem to make it a slightly stiffer version with a higher buckling pressure.

The gelastic is all gel without a stiffer foamed material inside so because of that and the square columns … it seems to have a lower buckling pressure.

Real life feedback seems to confirm that the intelligel is softer. Both have quite a firm hand feel until they buckle.

Neither have a memory foam feeling and they are both quite different from memory foam in feel. When the columns buckle … that particular part will sink down to the layers underneath (it has almost no resistance after it buckles) while the columns beside it continue to support weight up until they also reach their buckling threshhold. This means that it can very effectively shift pressure away from pressure points with the body parts around the pressure points supporting weight.

When I talked with Intelligel they told me that the topper has a thin cover so as not to interfere with the buckling. I asked him if or how much he could feel the columns underneath and he said that he is used to it and it feels very consistent like foam but I would imagine that the crinkling feeling may be a little more noticeable. I could feel it when I lay on the material under a layer of foam but it wasn’t at all unpleasant.

Overall it is a great pressure relieving material.


Hello! Just got back from a trip from Beloit Mattress factory! Have one on order that’s 6" firm 36 ild latex with 2 " soft 14 ild on top + a wonderful wool/cotton layer on top. Seemed to be the best compromise w/good back support + enough cushioning for the shoulder. In fact I actually laid on the bad shoulder for 15 minutes without pain. Could not do that on most other mattresses.

I ended up asking them to put same cotton/wool layer on the bottom side - in case I wanted to flip it over and go firm after my shoulder heals (IF it does). Which they can do for a reasonable amt of $$.

However, now Im fretting - will this extra layer on the bottom affect the feel when I lay on top? Its not all that thick - maybe an inch at most

An alternative would be - just waiting to see if I do ever want to go firm (may or may not) and then having them or someone replace the soft layer with a firmer one (they had another latex with Nu-form instead of the soft 14 ild that felt great on my back - not so good on shoulder.) Obviously that would be more hassle than just flipping it over.

I think I can change my order back to one-sided before they start work on Monday - but wanted to get a knowledgeable opinion from you first.

Oh BTW- thanks so much for the website and advice - I would never have heard about this place otherwise. It’s great that this old family business is still going and I was able to get a better quality at a lower price. I really wanted wool and no flame retardant so happy to have gotten that. Maybe I wasn’t looking in the right places, but in Madison all I could find in all-latex was 1 that was way too soft, and another that was too hard… both of them were well over $2000.

PS Another question.

Could I get a reality check - is what I ordered (2" 14 ild over 6" 36 ild) something you would consider a “firm” supportive mattress?

Part of my problem all along has been - I’ve been sleeping on a floor and a camping pad with a little bit of memory foam on it - anything that’s not a floor is going to feel soft in comparison! I know I like “firm” but Im just not sure what that means anymore!!!

It does seem to be pretty darn close to the configuration you suggested above except instead of 19 ild Ive got 14.

Hi sleepless in wi,

One reality check coming up :slight_smile:

From the sounds of it your mattress fits you well. No mattress is either soft “or” firm but is always soft “and” firm. Even your camping pad and memory foam on the floor is both soft (the memory foam) and firm (the camping pad and the floor). The top needs to be soft enough for pressure relief and the support layers under it need to be firm enough to keep you in alignment.

From your testing … it’s clear that the top layer (2" of ultra soft Talalay with a wool quilting) is soft and thick enough for the pressure relief you need in your shoulders (or you would have felt the firmer layers underneath more). Even better is that you were able to get this pressure relief with only 2" of soft foam which puts you closer to the firmer support layers for best back alignment (36 ILD for your weight would be considered quite firm). For reference … 14 ILD Talalay is about the same softness as most memory foam (once the memory foam has warmed up a bit and sunk in).

Your mattress testing is always more accurate in “real life” than “theory at a distance” but your construction (2" of soft over a firm core) is in the range of what we discussed in the beginning of this thread. In other words the 2" seems to be “just enough” softness over the firm support and works both for your pressure relief needs on the side and your support needs on your back. This is the balance we are all looking for when we buy a mattress.

I personally doubt that you would be as comfortable sleeping on the bottom of the mattress because you would be sleeping directly on very firm foam. While the wool quilting on the bottom wouldn’t affect your support, I would question if you would actually use it mainly because I doubt it would be comfortable on your side even if your shoulder heals. While of course it’s always possible that it would work for you … if it did you would certainly be the exception for a side sleeper.

The NuForm is a slow recovery latex (part way between latex and memory foam) but I wouldn’t mess with what is already successful for you …especially because it isn’t as pressure relieving for you as the talalay.

So there isn’t any harm in adding the wool on the bottom … but I doubt it is necessary.

Overall I think you did very well both in terms of the mattress you bought and the outlet you bought it from.

Congratulations on your successful mattress shopping journey :slight_smile: