How We Test Mattress Support and Spinal Alignment

I am Chris Miller, and I lead the Dweva mattress testing team. When I talk about support, I mean how well a mattress holds your body in a steady, healthy position through a full night. That includes how your spine lines up, how your hips sit in the surface, and how your shoulders and ribcage rest on the layers underneath.

Support is not just about feeling firm. Clinical research and systematic reviews now link proper spinal alignment and medium-firm support with better comfort and less back pain for many people. Spine and pain experts also stress that poor mattress support can disrupt alignment, irritate muscles, and worsen low back symptoms over time.

We studied how major labs and review sites test support and alignment. Many of them use pressure mapping, edge support tests, long-term firmness checks, and visual alignment assessments in real sleep positions. Then we built our own process. We added week-long in-home trials, multi-body testing, and structured reviews from our clinical advisor, Dr. Adrian Walker.

This page explains, in detail, how we test mattress support and spinal alignment on every model we review. I walk through every step, from lab-style bench tests to real-night diaries, and I show exactly how our team uses their different bodies to stress each bed.

What “Support” and “Spinal Alignment” Mean in Our Testing

When I use the word support, I am talking about how the mattress handles load over time. Your body presses into the surface. The mattress can either keep your spine close to neutral, or it can let parts of you sag or tilt.

From the perspective of spinal health, a supportive mattress should:

• Keep the natural curves of the spine in a healthy range.
• Hold the pelvis and ribcage in line, without big tilts.
• Avoid deep hammocking under the hips or mid-back.
• Prevent sharp peaks under shoulders or lower back.

Spine-health organizations and clinical sources describe clear links between alignment during sleep and next-morning pain or stiffness. Studies using imaging or posture tools show that different mattresses can change lumbar angles and spinal curves, even with small yet meaningful differences.

For us, spinal alignment means how straight and balanced the spine looks in your natural sleep positions. That includes side, back, and stomach sleeping. We look from the side, from behind, and sometimes from overhead. We combine simple camera views with body awareness from our testers and, at times, reference tools that resemble alignment gauges used in clinics and some consumer apps.

Support is not just a number on a tag. It is how the entire mattress structure behaves under real bodies across many nights.

Our Testing Philosophy and Support Score

We built our support testing protocol around three pillars.

I treat them as non-negotiable:

• Real alignment on real bodies in natural sleep positions.
• Objective patterns from tools and structured tests.
• Clinical framing from Dr. Walker on what this behavior means for pain and function.

Our 0–10 Support and Spinal Alignment Score

We rate support on a 0–10 scale. We use half steps when needed. The number reflects how well a mattress keeps different bodies in healthy alignment over time.

Score band	What we experience in testing
9.0–10.0	Strong, consistent support and neutral alignment in most positions.
8.0–8.5	Good support with mild drift in certain positions or body types.
7.0–7.5	Adequate support; some sag or tilt for specific sleepers.
5.5–6.5	Noticeable sag or push in common positions; risk for many users.
4.0–5.0	Clear alignment problems for several testers.
Below 4	Poor support; we warn strongly for long-term nightly use.

As far as our team is concerned, 8.0 and above usually fits most sleepers well, when you also choose the right firmness for your position. Many clinical sources now point toward medium-firm profiles as a good balance between support and comfort for common back-pain patterns.

We do not adjust the score for price. A high-end mattress and a budget one share the same support scale.

Step 1: Bench Tests for Load, Sag, and Edge Behavior

Before we sleep on a mattress, we put it through a set of bench tests. These tests do not tell the whole story. They build a baseline.

1.1 Standard Setup for Support Testing

We start by standardizing the setup.

Every mattress gets:

• A flat, rigid platform base or the required foundation.
• No topper or pad, only a thin fitted sheet.
• At least 48 hours to expand and settle after unboxing.

Under these circumstances, we know that any sag or tilt comes from the mattress, not a flexing frame. Marcus always checks the base, because his 230-pound frame will expose weak spots quickly.

1.2 Static Load and Sag Depth

Support starts with how the mattress handles static load. We mimic body weight using distributed loads. Many labs and furniture testing groups use weights and controlled loading to see how surfaces compress.

Our static test uses:

• A set of flat plates with known weight ranges.
• Placement zones at head, shoulders, lumbar area, and hips.
• Depth measurements from the top of the plate to a fixed reference.

I log how far each zone compresses under the standard loads. This gives us a profile of where the mattress is softer or firmer under a simple, repeatable setup.

We then compare this pattern to what we expect from the design. Zoned coil systems or varied foam densities should show clearer support beneath the hips and lumbar region. If the static map shows the opposite, we already know the mattress may struggle with long-term alignment.

1.3 Edge Support Under Sit, Slide, and Sleep

Edge behavior is crucial for support. Many sleepers use the outer third of the mattress for sleeping and sitting. Leading test labs sit testers along the perimeter and also use weights to measure edge compression.

We adapted this into a three-part edge protocol.

1. Seated edge testI sit near the edge with knees at a right angle.Marcus repeats this, then Jamal does the same.We note sink depth, forward roll, and whether we feel the base.
2. Slide and stand testFrom the seated position, we slide slightly forward and stand repeatedly.We pay attention to how much the edge helps or fights the move.
3. Edge sleep testEach tester lies near the edge in their usual sleep position.We slowly shift closer until the edge feels unstable.

This routine shows how well the mattress supports real use around the perimeter. Weak edges do more than cause a roll-off feeling. They can tilt the spine, especially when people sleep close to the side or share a smaller size.

1.4 Early Firmness and Zoning Check

Many modern mattresses use zoned support or multi-layer builds. We want to see if those zones actually deliver targeted support. Pressure mapping and industry guidance show that well-tuned zoning can help keep the spine straighter, especially under the hips and lower back.

To check this, we:

• Press along the surface by hand, moving from head to toe.
• Note where resistance increases or decreases.
• Compare this to the brand’s zoning claims.

Carlos focuses on the lumbar and mid-back region. In his view, this kind of zoning should feel supportive here, not just firmer near the shoulders.

We do not score support solely from these checks. They prepare us for what we might feel during full-night testing.

Step 2: Real-Spine Alignment Testing With Human Sleepers

Bench tests show raw behavior under load. They do not replace real alignment checks. For that, we use cameras, body awareness, and structured routines while we actually lie on the mattress.

2.1 Side-Sleep Alignment Photos and “Straight Line” Checks

Side sleeping creates clear alignment pictures. The spine should form a mostly straight line from neck through tailbone when viewed from behind, with natural curves preserved but not exaggerated. Clinical and expert guides use similar visual tests, often with photos or a helper checking form.

Here is how we run our side-sleep alignment test:

1. The tester lies on the mattress in their true side position.
2. They stay still for several minutes, long enough for full settling.
3. Another team member takes level photos from behind and from head level.
4. We review lines and angles on-screen with a simple overlay.

We check:

• Whether the neck lines up with the mid-back and hips.
• Whether the hips sag relative to the shoulders.
• Whether the waist collapses into a side bend.

Mia plays a big role here. Her petite frame tests how the mattress supports lighter side sleepers. On some beds, her hips barely sink while her shoulders press in. That pattern can twist her spine and create side-bend stress.

Marcus, by contrast, loads the mattress heavily under the hips and shoulders. Poorly supported mattresses let his pelvis sink, creating a clear “U” shape in side view.

2.2 Back-Sleep Alignment and Lumbar Gap

Back sleepers need support under the lumbar curve. Too much gap and the lower back hangs. Too much fill and the spine flattens unnaturally. Spine-health sources describe this balance as key for comfort and reduced back pain.

Our back-sleep alignment check follows a similar pattern:

• The tester lies on their back in a normal, relaxed posture.
• Another tester looks from the side, at hip, lumbar, and chest level.
• We note whether the stomach sinks far below the ribcage.
• We slide a flat hand under the lower back to feel the gap.

Carlos pays special attention to this test. He tracks mid-back fatigue during long sessions. When a mattress supports well, he feels the curve of his lower back, yet he does not feel a huge empty space or a sharp ridge.

In my own back-sleep tests, I focus on my mild lower-back tightness. If I wake from a session with more stiffness than I started with, that matters for the support score.

2.3 Stomach-Sleep Checks for Hip Drop and Neck Angle

We do not promote stomach sleeping as ideal posture, and neither do most spine experts, yet many people sleep this way. For them, mattress support is even more critical. Excessive hip drop can strain the lower back and twist the neck.

Marcus and Jamal run most of our stomach-sleep checks, since they sometimes fall into that position during naps.

We watch for:

• Hips sinking much deeper than the ribcage.
• Lower back bowing downward in a clear arc.
• Neck angles that become extreme as the head turns to the side.

On overly soft beds, their hips dive and the spine bows. On overly hard ones, the chest and thighs float while the pelvis struggles for contact. Mattresses that hit our higher support scores usually keep this stomach curve closer to neutral, especially in medium-firm ranges.

2.4 “Feel” Checks During Long Holds

Static photos and quick positions matter, yet support problems often show up after longer holds. For that reason, each tester spends extended periods in their main sleep positions.

During those holds, we track:

• Onset of low back fatigue.
• Shoulder or hip soreness tied to sinking or pushing.
• Sense of sliding or rolling toward the center.

I run this test on every mattress. I stay in side and back positions long enough to mimic reading, then early-night sleep. Carlos does the same from an alignment-focused viewpoint. Mia remains in her curled side position and waits to see where pressure and support fail.

We log how long it takes for discomfort to appear, if it appears at all.

Step 3: Pressure Mapping and Objective Support Patterns

We layer pressure mapping on top of our visual and feel-based checks. Expert labs commonly use pressure mats to see where load concentrates across the body.

3.1 How Pressure Mapping Fits Into Support Testing

Pressure mapping tools track interface pressure between the body and the mattress. A flexible mat with many sensors sits on the mattress, usually under a thin cover. The mat sends data to software that displays a color-coded map.

In support terms, we care about:

• Excess pressure under shoulders and hips.
• Collapse under the lower back or waist.
• Whether weight spreads evenly or pools in one zone.

Carlos and I lie on the mat in different positions. We capture maps for side, back, and stomach where relevant. We then compare maps across mattresses of similar type and firmness.

3.2 Reading the Maps for Alignment Clues

High-pressure hot spots can mean poor pressure relief. Large low-pressure zones under key areas might reveal sag or lack of support. I look at these patterns alongside our photos.

For example:

• A mattress might show even color under the hips and shoulders for Marcus, yet the side photo still shows hip sag. That pattern suggests the top feels comfortable, yet the core is letting his pelvis dip too far.
• Another mattress might show modest pressure under Mia’s shoulders with consistent support under her waist. Side photos then show a straighter spine.

Dr. Walker reviews selected maps with us. From his perspective, pressure mapping gives clues about tissue load and possible pain points, yet it does not replace actual alignment or comfort feedback.

We use the maps to confirm or question what we feel on the bed.

Step 4: Time, Firmness, and Long-Term Support

Support changes as a mattress breaks in. It also changes with firmness choices. Clinical research and consumer data now show that firmness level, and how it evolves, matters a lot for back pain and sleep quality.

4.1 Week-by-Week Sag and Feel Tracking

We track support across time points:

• Early impressions in the first nights.
• End of the first focused test week.
• Later follow-up sessions when we rotate mattresses back into use.

Marcus is sensitive to gradual hip sink. He often notices when a mattress that felt firm at first starts to cradle his pelvis more after a few weeks. If that change bends his lower back into a deeper curve, we treat it as a real support decline.

Mia sometimes notices the opposite pattern. Some firmer mattresses soften just enough after a week to support her joints better without losing alignment. In those cases, the support score may improve slightly from initial estimates.

We also re-check edge support for mattresses that stay in our environment for longer periods. Sagging edges can show up later, especially on softer builds.

4.2 Firmness and Alignment for Different Sleep Positions

Many sources now highlight medium-firm mattresses as a good starting point for relieving common low back pain and improving sleep quality. From the perspective of a sleeper, this kind of firmness often combines enough contour for pressure relief with enough pushback for alignment.

In our testing:

• Back sleepers like Carlos often favor medium-firm profiles that keep their spine straight without feeling rock-hard.
• Side sleepers like Mia usually need a little more surface give, yet still rely on a supportive core.
• Stomach and heavier sleepers like Marcus often lean toward the firmer end of medium-firm, so their hips do not dive.

We never assign a blanket “best firmness.” Instead, we show how each mattress supports specific body types and positions, then we use the research on medium-firm balances as background, not as a strict rule.

4.3 Durability and Support Retention

Support also lives in durability. Studies have linked longer mattress use with worse back pain, especially when support has degraded.

We cannot simulate years inside a single test. We can track early signs:

• Body impressions that form quickly.
• Noticeable softening under key zones.
• Edges that lose height and stability.

Jamal and Marcus expose weak durability. Their weight and movements reveal early breakdown. When we see pronounced changes in support during our testing window, we mention that clearly. It influences long-term support expectations, even if the short-term alignment looked acceptable.

Step 5: How Materials and Design Affect Support

Different constructions lead to different support behaviors. Industry guides, expert reviews, and clinical summaries all describe recurring patterns. Our own testing confirms many of them.

5.1 All-Foam Mattresses

All-foam mattresses rely on foam densities and layer design for support. High-density foam cores tend to hold alignment better than low-density cores.

In our tests, supportive foam beds usually show:

• Good contour under shoulders and hips.
• Stable lumbar support, as long as the core is dense enough.
• More risk of deep impressions over time if densities are low.

On strong foam builds, Carlos and I see straight spines in back and side photos. Marcus may still need firmer options because his hips press more deeply. On weaker foam builds, he almost always sees hip sag.

The research on medium-firm foam surfaces and chronic back pain fits many of our experiences. Well-designed medium-firm foam beds often strike a good support balance for average-weight back and side sleepers.

5.2 Hybrid Mattresses

Hybrids use a coil core with foam or latex layers above. Properly tuned hybrids can give strong core support with tailored contour. Many expert lists of top mattresses for back pain now feature these builds, often with zoned coils and reinforced lumbar areas.

In our testing, good hybrids often show:

• Clear support under hips and lower back.
• Controlled sink for shoulders.
• Stronger edge stability from perimeter coils.

Marcus often prefers this kind of build. His hips get firm support from the coil system, while foam layers still cushion his shoulders. Jamal likes the combination of support and bounce. Carlos frequently rates these mattresses highly for alignment, especially when zones support the lumbar area without creating weird ridges.

We pay attention to coil gauge, coil count ranges, and foam densities when brands share those details. That data, plus our results, helps predict support performance over time.

5.3 Latex and Latex Hybrid Mattresses

Latex has a buoyant, elastic feel. It tends to push back more quickly than memory foam, while still offering contour. Many guides describe latex beds as supportive, yet a bit firmer or bouncier for some sleepers.

Latex and latex hybrids in our lab usually show:

• Strong support under heavy bodies, with limited deep sag.
• Good spinal alignment for back and combination sleepers.
• Potential pressure challenges for very petite side sleepers if comfort layers are thin.

Mia sometimes finds latex surfaces a bit firm at the shoulder. In those cases, her spine alignment can still look straight, yet her pressure points complain. Marcus and Jamal often enjoy the support level, especially in zoned latex hybrids that target the lumbar region.

5.4 Traditional Innerspring Mattresses

Classic innerspring mattresses rely heavily on coil networks with thinner comfort layers. Some modern models add zones, thicker foams, or pillow-tops, yet support still comes from the coil geometry.

In our tests, traditional innerspring builds show mixed support results:

• Firm, simple innersprings can hold alignment for some back and stomach sleepers.
• Softer pillow-tops on these cores often sag under the hips for heavier bodies.
• Thin comfort layers may create pressure points for side sleepers, even if alignment looks okay at first glance.

Dr. Walker often comments on this category. He notes that firm, unsophisticated innersprings may feel supportive in a store, yet over time they can worsen pain if they do not distribute pressure or support curves properly. Medium-firm or more advanced hybrids usually give a better balance in his experience.

Step 6: How Each Team Member Stresses Mattress Support

Our team exists for a reason. Different bodies, habits, and sensitivities reveal different weaknesses in mattress support.

6.1 Marcus: Heavy Frame and Hammock Risk

Marcus weighs about 230 pounds and splits his time between back and stomach sleeping. He reacts badly to hammock sag under his hips.

On weakly supportive beds, he reports:

• Hips sinking far below his shoulders.
• Lower back ache after a night of back or stomach sleep.
• Edges collapsing when he sits or ties shoes.

On supportive hybrids and firmer foam beds, Marcus feels his hips held up while his shoulders still get some give. Side photos of his spine show less curve, and he wakes with fewer complaints.

His feedback dominates our support score for heavier sleepers.

6.2 Carlos: Alignment and Mid-Back Fatigue

Carlos weighs around 175 pounds and sleeps mostly on his back. He notices mid-back fatigue before anyone else.

When a mattress supports him well, he describes his spine as “straight and quiet” after long holds. When support misses the mark, he feels either a sag under his lumbar curve or a hard ridge pushing into his mid-back.

Carlos also pays attention to transitions between layers. In his view, a mattress should let his spine travel smoothly as he shifts, without sudden drops or stiff zones. That behavior matters for support during real movements, not just static photos.

6.3 Mia: Petite Side Sleeper and Joint Protection

Mia’s 125-pound frame and side-sleep style test support for lighter bodies. She quickly spots mattresses that ignore smaller sleepers.

On some beds, she floats almost on top. Her shoulders do not sink enough, so her neck bends. Her waist falls toward the mattress, creating a side bend. On others, she drops too deep around her hips while the rest of her body stays high. That tilt strains her lower back and outer hip.

When a mattress supports her properly, she feels a “soft pocket” under her shoulder and hip, with her waist gently held instead of hanging. Side-view photos show her spine in a clean, level line.

Her notes weigh heavily when we rate support for petite side sleepers.

6.4 Jenna and Ethan: Shared Surface Support

Jenna and Ethan share a bed. Their feedback tells us how well a mattress supports two bodies at once.

They track:

• Whether the middle of the bed sags when they both sleep near the center.
• How the edges behave when each person uses an outer third.
• Whether rolling toward each other feels like sliding into a trench.

On weak beds, they feel a ridge or dip where their weight meets. This kind of contour shifts their spines toward the center. On stronger support systems, the bed holds them in neutral positions even when they sleep close together.

Jenna is also sensitive to any tilt when Ethan gets out of bed. If the mattress loses support under his side, her alignment can change suddenly, even if she stays still.

6.5 Jamal: Active Body and Functional Support

Jamal uses the bed as functional support, not just a place to lie down. After sports or workouts, he stretches, kneels, and leans on the surface.

He checks:

• How the bed holds his knees and hips during stretches.
• Whether his spine feels supported when he leans on his forearms.
• How the surface behaves when he sits at the edge to lace shoes.

Support that works for Jamal needs to combine solid structure with controlled resilience. Too much deep sink makes his knees and hips ache when he kneels. Too little give makes his back complain as he stretches.

His experiences help us frame support for active users, not just sleeping bodies.

Step 7: Dr. Walker’s Clinical Review of Our Support Findings

After we gather our test data, we send a structured summary to Dr. Adrian Walker. He views our notes through the lens of sleep medicine and ergonomics.

7.1 What He Looks For

Dr. Walker focuses on issues that show up repeatedly in his clinic:

• Chronic low back pain.
• Neck strain and shoulder discomfort.
• Sleep-disordered breathing that worsens with poor posture.

He reads:

• Our alignment descriptions for each body type and position.
• Our notes on morning pain changes during test weeks.
• Pressure and sag patterns for models marketed for back pain relief.

Studies and expert reviews now support the idea that mattress firmness and support design can influence low back pain outcomes, with medium-firm options often performing best. He compares those findings with what our team reports.

7.2 How His Comments Shape Our Scores

When he sees clear patterns, he adds short notes, such as:

• From a sleep-medicine perspective, this level of hip sag on our heavier testers could strain the lower back over time.
• This kind of medium-firm hybrid, with zoned lumbar support, matches what many of his patients tolerate best.

We do not raise or lower scores solely because of his remarks. We use them to check our interpretations. If our team notices mild sag and he views that sag as clinically risky for common conditions, I may cap the support score even when overall comfort looked okay.

7.3 Support and Long-Term Health Risk

Dr. Walker also reminds us that people do not sleep on a mattress for a week. They sleep on it for years. Clinical studies link long-term use of poor or worn-out mattresses with increased pain and worse sleep quality.

He urges us to flag mattresses that show early signs of sag or unstable support, especially if they target people with existing back issues. I factor that advice into our durability and support retention notes.

Step 8: Combining All Data Into One Support Score

With all this information in hand, I still have to assign a single support and alignment score for each mattress. That score needs to stay consistent and meaningful from mattress to mattress.

8.1 Our Internal Weighting

Here is how I roughly weight the different pieces:

• Visual and feel alignment checks across positions: about thirty percent.
• Multi-body feedback from Marcus, Mia, and others: about twenty-five percent.
• Bench tests, sag depth, and edge support: around twenty percent.
• Pressure mapping and time-based changes: about fifteen percent.
• Clinical framing from Dr. Walker: roughly ten percent.

These numbers are guidelines, not rigid formulas. If a mattress shows extreme behavior in one area, I may place more emphasis there.

For example, if the bench tests and pressure maps look acceptable, yet side photos show obvious hip sag for several testers, I lean more heavily on the photos and lived experience.

8.2 Typical Support Patterns by Mattress Type

Across many models, we see recurring patterns that match broader research and reviewer consensus.

Mattress type	Support and alignment tendencies in our testing
Quality hybrids with zoned coils	Often very strong support and alignment across sizes.
High-density all-foam beds	Usually solid support for average-weight sleepers; heavier bodies vary.
Latex and latex hybrids	Very strong core support; surface comfort depends on layers.
Basic innersprings with thin tops	Firm feel but mixed alignment, especially over time.
Soft, low-density foam beds	Often weak support and early sag, especially under hips.

We still judge each mattress on its own data. These patterns help readers set expectations.

How Different Sleepers Can Use Our Support Results

Our support score and notes matter only if you can apply them to your life. I always picture specific people when I write up results.

People With Low Back Pain

For people with low back pain, spine alignment is central. Clinical studies and expert guides consistently point toward supportive, medium-firm surfaces for many of these cases, as long as individual comfort is respected.

When you read our reviews, you can look at:

• Carlos’s and my back-sleep notes.
• Marcus’s reports when he sleeps on his back or stomach.
• Dr. Walker’s comments on lumbar sag or over-firmness.

If we call a mattress supportive and aligned for these testers, and Dr. Walker backs that up with a positive comment, that bed may fit many people with back issues, assuming the firmness feels right to you.

Side Sleepers With Shoulder or Hip Pain

Side sleepers like Mia need support and pressure relief at the same time. Their shoulders and hips must sink enough for comfort while the spine stays level.

If you are a side sleeper, focus on:

• Mia’s alignment notes in side position.
• Our pressure map comments for side-sleep scenarios.
• Any mention of waist collapse or hip tilt.

Beds that support Mia well usually suit many average or light side sleepers, when paired with the right pillow height.

Heavier Sleepers and Taller Bodies

Heavier sleepers like Marcus and Jamal need stronger cores and stable edges. Under those circumstances, support performance can differ a lot from lighter testers.

If you are larger or taller, check:

• Marcus’s reports on hip and midsection support.
• Jamal’s feedback on supportive feel during stretches and kneeling.
• Our notes on edge stability under sitting and sleeping.

Hybrids with robust coils and denser foams often shine here. Weak foam cores and very soft builds usually fail.

Couples With Different Body Types

Couples need support that works for two bodies at once. This includes center support, edge strength, and alignment stability when weight shifts.

If you share a bed, read:

• Jenna and Ethan’s shared-surface notes.
• Our comments on center sag and edge behavior with two people.
• Any mention of a trench or ridge between partners.

Mattresses that earn high support scores and positive couple notes usually keep both spines in better alignment across the whole surface.

Older Adults and People With Limited Mobility

For older adults, or people with mobility challenges, edge support and functional support matter as much as sleeping support. Sitting, swiveling, and standing safely depend on stable mattress edges and predictable surface behavior.

If this describes you, focus on:

• Our seated edge and slide-and-stand test notes.
• Jamal’s and Marcus’s comments when they stand from the edge.
• Dr. Walker’s remarks on mobility and transfers.

Beds that offer firm yet not harsh edges, plus balanced support in the center, usually work better for this group.

Frequently Asked Questions About Our Support Testing

How Is Support Different From Firmness in Our Reviews?

Firmness describes how hard or soft a mattress feels at the surface. Support describes how well the mattress holds your body in healthy alignment over time.

A mattress can feel soft yet still support well if it uses strong underlying layers and correct zoning. A mattress can feel firm and still support poorly if it pushes certain areas up and lets others sink too far.

We score firmness separately and then evaluate support using the methods described above.

Do We Use Medical Imaging or Only Visual Checks?

We do not run X-rays or MRIs in our home-based lab. Those methods appear in research studies that compare spinal angles on different mattresses, and they show real alignment differences between designs and firmness levels.

We base our testing on visual alignment, pressure mapping, and subjective reports, then compare our patterns to what those studies describe. Dr. Walker helps us interpret where our results line up with that literature.

Do Pillows Affect Support Scores?

Pillows affect neck and upper spine alignment. A bad pillow can ruin a great mattress for side or back sleepers.

We test mattresses with appropriate pillows for each tester and position, yet our support score focuses on what the mattress does. When a mattress needs a very specific pillow height to look aligned at all, we mention that in the review.

How Long Do We Sleep on Each Mattress Before Finalizing Support Scores?

For a full review, we dedicate at least one focused week to each mattress and then continue to use it in rotation for longer.

I usually set a provisional score after the first week of heavy testing. Then I adjust it if break-in changes support levels in clear ways during follow-up nights.

Can a Topper Fix Poor Support?

A topper can change comfort and pressure relief. It rarely fixes a weak support core.

We sometimes test a mattress with a topper when readers ask, and we may describe how the combination feels. Our main support score still reflects the mattress itself, because that is the part that drives spinal alignment over years.