Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial.
BACKGROUND
A firm mattress is commonly believed to be beneficial for low-back pain, although evidence supporting this recommendation is lacking. We assessed the effect of different firmnesses of mattresses on the clinical course of patients with chronic non-specific low-back pain.


METHODS
In a randomised, double-blind, controlled, multicentre trial, we assessed 313 adults who had chronic non-specific low-back pain, but no referred pain, who complained of backache while lying in bed and on rising. Mattress firmness is rated on a scale developed by the European Committee for Standardisation. The H(s) scale starts at 1.0 (firmest) and stops at 10.0 (softest). We randomly assigned participants firm mattresses (H(s)=2.3) or medium-firm mattresses (H(s)=5.6). We did clinical assessments at baseline and at 90 days. Primary endpoints were improvements in pain while lying in bed, pain on rising, and disability.


RESULTS
At 90 days, patients with medium-firm mattresses had better outcomes for pain in bed (odds ratio 2.36 [95% CI 1.13-4.93]), pain on rising (1.93 [0.97-3.86]), and disability (2.10 [1.24-3.56]) than did patients with firm mattresses. Throughout the study period, patients with medium-firm mattresses also had less daytime low-back pain (p=0.059), pain while lying in bed (p=0.064), and pain on rising (p=0.008) than did patients with firm mattresses.


CONCLUSIONS
A mattress of medium firmness improves pain and disability among patients with chronic non-specific low-back pain.
Kovacs
Francisco M
FM
Scientific Department, Kovacs Foundation, Palma de Mallorca, Spain. kovacs@kovacs.org
Abraira
Víctor
V
Peña
Andrés
A
Martín-Rodríguez
José Gerardo
JG
Sánchez-Vera
Manuel
M
Ferrer
Enrique
E
Ruano
Domingo
D
Guillén
Pedro
P
Gestoso
Mario
M
Muriel
Alfonso
A
Zamora
Javier
J
Gil del Real
María Teresa
MT
Mufraggi
Nicole
N
D000328:Adult; D001513:Beds; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D010147:Pain Measurement