title: Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial.
abstract: 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.
authors: Scientific Department, Kovacs Foundation, Palma de Mallorca, Spain. kovacs@kovacs.org
authors: Francisco M
authors: FM
authors: Kovacs
authors: Víctor
authors: V
authors: Abraira
authors: Andrés
authors: A
authors: Peña
authors: José Gerardo
authors: JG
authors: Martín-Rodríguez
authors: Manuel
authors: M
authors: Sánchez-Vera
authors: Enrique
authors: E
authors: Ferrer
authors: Domingo
authors: D
authors: Ruano
authors: Pedro
authors: P
authors: Guillén
authors: Mario
authors: M
authors: Gestoso
authors: Alfonso
authors: A
authors: Muriel
authors: Javier
authors: J
authors: Zamora
authors: María Teresa
authors: MT
authors: Gil del Real
authors: Nicole
authors: N
authors: Mufraggi
mesh_terms: 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