In the clinic, patients often ask: Doctor, I have severe back pain, is it better to sleep on a hard bed. Many people are convinced of this idea, and even some doctors suggest sleeping on a hard bed to their patients. So what exactly is the answer? To answer this question, we must not rely on our own conjecture or the clinical experience of our doctors, but let the evidence speak for itself. I searched through the literature and found a weighty paper, and there are really serious doctors abroad, so let’s take a look together. Back in 2003 a doctor named Kovacs in Spain designed a prospective randomized controlled trial (RCT trial with the highest evidence-based grade of I and a high level of confidence) specifically to answer this question. The authors included 313 patients with chronic low back pain and no lower extremity radiating pain, and randomized the patients into two groups based on bed firmness: a hard bed group and a medium-soft bed group. Bed hardness was expressed using the H-index, with 0 representing the hardest and 10 representing the softest. The results of this study showed that at 3 months, patients in the medium-soft bed had 2.36 times (1.13-4.93) and 1.93 times (0.97-3.86) the relief of back pain scores at bedrest and rest, respectively, and 2.10 times (1.24-3.56) the relief of functional impairment than those in the hard bed. The authors concluded that sleeping on a medium-soft bed significantly improved the degree of low back pain and dysfunction, and that sleeping on a hard bed not only did not help but had disadvantages for relieving low back pain. This paper was published as a treatise in the top medical journal The Lancet (with an impact factor of 39.207 in 2014) and is a good answer to the question of whether you should sleep on a hard bed for low back pain. Seeing this, you may already know whether you should sleep on a hard bed for low back pain, but just knowing this is still not enough to know what kind of bed is suitable for you, and how to “use foreign for Chinese”, further research is needed. I found that most of the mattresses on the market through the study of soft and hard index is divided into five levels: extra soft, soft and comfortable, soft and hard moderate, hard spine (debatable) and extra hard, roughly corresponding to the foreign hardness index 10, 8, 5, 3, 1. And how to judge the mattress for their own soft and hard moderate? Here is a recognized method: lying flat on the mattress, hand to the neck, waist and hip to the thighs between the three obvious bend in the flat, to see if there is no gap; and then turn over to the side, with the same method to try the body curve recessed parts and the mattress between there is no gap, if not, it proves that the mattress and you in the sleep of the neck, back, waist, hip and leg natural curve fit, such a mattress for You are the right amount of soft and hard. Now we should know how to choose a mattress in the time of low back pain, simply put is good to sleep comfortable, without overemphasizing the role of the mattress. As for how to rehabilitate exercise for low back pain, please look forward to my next popular science article – how to exercise for low back pain.