Which mattresses are endorsed by the American Chiropractic Association for back pain relief?

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Two people sit on top of the Plank Firm flippable double-sided mattress, which is endorsed by the American Chiropractic Association for back pain relief
(Image credit: Future)

The American Chiropractic Association (ACA) is the largest professional chiropractic organization in the US, and mattresses endorsed by them undergo a thorough review, testing, and analysis period, with products regularly retested to ensure they’re still meeting the standards. It can be difficult to know where to start when you’re looking for a mattress that will help with back pain, so an ACA endorsed bed is a good place to start.

ACA endorsement is only given to products deemed to have chiropractic-related benefits which, in layman’s terms, means they’re good for your back. Several of the very best mattresses we have tested for all sleepers this year (including mattresses by Saatva, Helix, Nectar and Puffy) have all been awarded ACA certification.

But what other mattresses have this endorsement? If you’ve been looking at the top-rated options in our best mattresses for back pain buying guide then you'll notice quite a few have ACA endorsement. We'll be listing all them here, as well as detailing which of them are on sale in the now-live Black Friday mattress deals.

Today's top deals on mattresses for back pain

  • Saatva: $400 off the RX Hybrid mattress
  • DreamCloud: Up to 50% off the DreamCloud Hybrid
  • Cocoon by Sealy: 35% off the Chill Mattress
  • Brooklyn Bedding: 30% off the Aurora Luxe mattress
  • Helix: 27% off the Helix Midnight Luxe mattress
  • Purple: Up to $600 off the Purple Plus mattress
  • Winkbed: $300 off the Winkbed mattress

Which mattresses are endorsed by the ACA?

There are a few mattress brands endorsed by the ACA, but an endorsement doesn’t mean that every mattress a brand makes will have certification. Instead, the ACA endorses specific mattresses from a brand that they feel have chiropractic-related benefits which can help sleepers keep their spines aligned and pressure points cushioned. Here is a list of the brands endorsed by the ACA:

  • Casper
  • Brooklyn Bedding
  • Nectar
  • Saatva
  • Puffy
  • Avocado
  • Big Fig

Here's a closer look at some of these mattresses...

Casper

Casper was one of the original mattress in a box companies and in the last year the brand has redesigned its mattress range, earning two endorsements from the ACA for the Casper Dream Max Hybrid and Casper Snow Max Hybrid mattresses.

The Casper mattress

(Image credit: Casper Mattress)

The ACA noted that, ‘Chiropractors regularly talk with patients about the importance of design and quality in selecting the right mattress. ACA is proud to partner with a company like Casper that is committed to research in the development and delivery of high-quality products.”

Both mattresses feature seven targeted support zones, including a three-zone foam layer that’s firmer in the middle, plus a second memory foam layer with narrow channels to cradle the body. This all gives the lumbar region the support it needs to avoid unnecessary strain that can lead to back pain. The Snow Max also includes cooling tech to help hot sleepers stay comfortable at night.

Brooklyn Bedding

Brooklyn Bedding also has two mattresses endorsed by the ACA and, in this case, they’re the ultra-firm Plank and Plank Luxe mattresses. The organization said, "ACA is pleased to endorse Brooklyn Bedding’s mattresses, which feature premium workmanship and comfort. Sleep is an important aspect of overall health, and a comfortable and supportive mattress contributes to better quality sleep."

Both Plank mattresses are flippable, with a firm and extra firm side. When we tested the mattress for the Brooklyn Bedding Plank hands-on review at the brand’s headquarters, we felt that the extra firm side rated at 9-9.5/10 and the firm at 8/10. The targeted coils in the mattress and high-density support foam combine to give excellent lumbar support, with the dense support holding the lower back in alignment.

A person lies in a side sleeping position on the Firm side of the Plank Firm mattress

(Image credit: Future)

Helix

Helix is part of the Brooklyn Bedding family, with three of its mattresses receiving ACA endorsement – the Helix Midnight Luxe, Twilight Luxe and Plus. In our Helix Midnight Luxe mattress review, we rated it as the best mattresses for side sleepers, especially those with back pain, due to its enhanced lumbar support combined with plenty of cushioning comfort.

Side sleepers who prefer a firmer feel should look at the Twilight Luxe, while the Plus is aimed at heavier bodies – we rate it as a good mattresses for heavy people too. Both also have Helix’s enhanced lumbar support, helping to reduce aches and pains and keep the spine aligned. 

You can save 27% when putting the discount code into the checkout TOMS27 during this year's Helix Black Friday sale, plus you'll get $330 worth of free bedding. 

Nectar

One of the best mattresses in a box, the Nectar Classic Memory Foam Mattress, has earned ACA endorsement for its superior support for an all-foam bed.

In our Nectar mattress review, we found it to be medium firm, with particular support for side sleepers (we consider it one of the top-rated mattresses for side sleepers), with plenty of pressure relief foam and supportive foam to keep the spine aligned. It’s also our top pick in our best memory foam mattresses round up.

This month's Nectar mattress sale saves up to 50% off mattresses, with a year's trial, lifetime warranty, and free shipping and returns on all models. 

The Nectar Classic Memory Foam Mattress placed on a white wooden bedframe in a blue bedroom at our testing facility

(Image credit: Future)

Saatva

Satava has a wide selection of mattresses endorsed by the ACA, including the Saatva Classic (our best hybrid mattress of the year), the Saatva RX, Saatva HD, Zenhaven, Latex Hybrid, Memory Foam Hybrid and the Solaire. The ACA also runs a scheme with Saatva whereby any chiropractor who partners with Saatva can offer their patients an extra $100 off their order.

In our Saatva Classic mattress review, Saatva RX review and Saatva Memory Foam Hybrid mattress review we praised all of these mattresses for their enhanced lumbar support thanks to their use of Saatva’s patented lumbar crown. The Saatva RX also contains the brand's Therapeutic Support Core, which enables the RX to adjust to any movement.

You can save $400 on all of these mattresses in the new Saatva mattress sale, and get a year's trial, lifetime warranty, and free mattress installation with old bed removal.

Puffy

Puffy’s entire mattress range has been endorsed by the ACA. The brand uses its own ‘Cloud Comfort’ foams, which are designed to offer outstanding pressure relief, as well as keeping the body and back perfectly aligned.

The brand offers one all-foam mattress – the Puffy Cloud. In our Puffy Cloud mattress review, our testers praised the bed for its pressure relief and support for back sleepers, noting how the medium firm feel helped ease back pain. There are also three hybrids – the Puffy Royal, Puffy Lux and the Puffy Monarch, which add in coils for more adaptive support.

Tester sleeping his side on a Puffy Cloud mattress in a king

(Image credit: Future / Jonathan Knoder)

Big Fig

The Big Fig is designed specifically for bigger bodies and was recently endorsed (September 2024) by the ACA. With its ability to support a combined weight of 1,100lbs, the mattress offers firm support to back and stomach sleepers.

Using a combination of latex, high-density foams and coils, the mattress also has a ThermoGel treated fabric cover to help prevent sleepers overheating – this is important for back pain sufferers, as sleeping cool prevents restless tossing and turning overnight.

It’s the hybrid design that helps larger sleepers with back support, with the large number of individually wrapped springs providing responsive support where your body presses into the mattress.

What does the ACA endorsement process include?

The ACA grants endorsements after thorough review, analysis, testing and evaluation by ACA’s Business Development Advisory Board. When a mattress is presented for evaluation, the ACA spends approximately three months sleeping on the bed and assessing its chiropractic-related benefits.

The process can include consultations with doctors who specialize in any area of practice that relate to the mattress being tested. Chiropractors will sleep on the mattress before filling in a questionnaire to provide feedback.

After this, the advisory board will meet to discuss the results, before making their recommendations to the ACA’s Board of Governors for final approval. Mattresses are regularly retested to ensure they’re still suitable for accreditation.

Should you only buy an ACA-endorsed mattress if you have back pain?

The back of a woman sat on the edge of her bed holding her lower back

(Image credit: Getty Images)

Although many of the mattresses in our guide to the best mattresses for back pain do have ACA endorsement, you shouldn’t rule a mattress out if it hasn’t. For starters, not all mattress brands will have chosen to put their mattresses forward for accreditation. You could miss out on a real gem if you limit yourself to only ACA approved mattresses.

For example, our testers rate the Purple Plus a top mattress for back support, with the unique GelFlex grid adapting under the body to offer firmer support at the lumbar region, with softer support around the arms and legs for cushioning and soothing of pressure points. There are plenty of excellent mattresses on the market without ACA endorsement that will still offer exceptional lumbar support.

Jo Plumridge is an experienced mattress reviewer with several years' experience covering all things mattresses and sleep, and who tests memory foam, hybrid and organic mattresses. What Jo doesn't know about a boxed mattress isn't worth knowing, so naturally we tasked her with producing a series of features for Tom's Guide looking at all aspects of mattresses, from how to pick between latex and memory foam (it's a tricky one), to the seven mistakes people make when buying a mattress for the first time. When testing the DreamCloud Luxury Hybrid for Tom's Guide, Jo said: "I loved the back support and pressure relief it offered. Plus, it looks far more expensive than it is." When she isn’t writing about sleep, Jo also writes extensively on interior design, home products and photography.

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