Most people choose extra firm mattresses because they've constantly been proven to be the best thing around for back pain. In 2003, a Spanish study took a group of people with lower back pain and studied how their pain level changed based on getting into, out of and sleeping on different mattresses.
90% of participants who were on a medium firm mattress or harder had less pain overall and experienced less disability during the day from back issues.
It's a tough call though, subsequent studies have shown that medium firm is better because it allows the body to have greater contact with the mattress, thereby providing better support. Most health professionals still recommend firmer mattresses even though they're likely to cause pressure points.
It's rather a trade off since the extra firm mattress induces a deeper sleep and proper weight distribution. There's no such thing as too much support, and especially as you age more support is better for joint issues.
In the last two decades memory foam has become a key player in mattresses, while it's known for being a soft and cushioned option they've branched out into a firmer design as well as gel filled and different constructions which still provide excellent support without sacrificing that memory foam cushioning.
If you're finding an extra firm mattress is just a little too hard, consider adding a memory foam topper to get a little cushion without sacrificing support or look for one which already has foam encasement.
Top 10 Extra Firm Mattress Reviews
Sealy Posturepedia Drakesboro Firm
While the Drakesboro has been discontinued by the company, it's still widely available. The mattress is 10.5” and has pocketed Embrace Coils with a cushioned foam outside to prevent motion transfer. It also has a reinforced border and edge to increase the sleeping area and give you a seating edge.
The foundation layer has beams and supports to prevent sagging over time and there's also a 10 year warranty. It has a gel foam band across the lower third to provide extra comfort for the lower back and hip area, though this means the mattress can't be flipped.
- Pocketed Coils
- Boxspring included
- Edge to Edge support
The foundation is designed to absorb weight and motion which can help heavier sleepers with extra support. The “firm tight top” design is exactly that, it's quite hard and does not have a lot of give which some sleepers may not like, while others will appreciate the extra support.
You can always add a pillow top or memory layer above it. The edge support is impressive and even at the far edges it still provides support without sagging so you don't feel like you're going to fall off. There's very little motion transfer which is great.
There are no handles on the mattress and it's pretty heavy which makes it awkward to maneuver since it arrives full sized. The top is very hard and it's not comfortable unless you really want a hard surface. The design is also extra firm, and there's a good chance this may be too hard for most sleepers.
You can't really feel the gel band in the middle so it seems rather pointless. Since the design has also been discontinued it's also going to get harder and harder to find over time.
Zinus Responsive Memory Foam 10” Firm
A thick memory foam mattress that has 5 different layers so that it's much denser than traditional memory foam alone. The mattress is also infused with charcoal, green tea, and other oils to help with the gassing off.
This has a slight bounce to it from the viscolatex foam and 5” of high density support foam for extra support. This means that it retains its shape better and has a soft and responsive feel. It's very firm, though not suited to heavier sleepers as it will compress significantly, lowering it's firm factor.
This is best for a side or back sleeper, though the 13” version is better for stomach sleeping. The removable cover is also nice so that it can be washed for allergies and mites.
- Washable Cover
- Memory Foam
This is a firm mattress for people who don't like firm mattresses. It provides lots of support but the memory foam also provides a cushioning comfort much like a pillow top would, only with better support.
Despite being memory foam this does not have a particularly bad gassing off at all. The memory foam design means there's no springs so you won't feel pressure points even at this firmness, this also isn't a “hot” mattress so you won't have to worry about sweating badly like some other foams because the 5 layer construction is not solid foam. It expands fast and is conveniently packed so you can move it in.
It can take some getting used to if you're not used to sleeping on foam rather than coils. Surprisingly this can be too firm for some people.
Over time the foam does get compressed and softer spots can form as it breaks in. This is to do with the foam design not being solid and will happen over time regardless but how fast depends on your weight on the mattress.
Sleep Inc 13” Body Comfort Select 2000 Extra Firm
This is a traditional innerspring mattress with a twist. It has a gel infused lumbar band for added lower back support, and it also has 360 degree foam encasement that adds edge to edge memory foam for a cushioned layer that doesn't compromise support.
This also means you can flip the mattress without losing the memory foam layer. It's covered in Tencel which helps to wick away moisture if you get sweaty and has a silky finish to prevent skin irritation. There's a 10 year warranty and it's incredibly cheap.
- 360-degree memory foam
- Tencel cover
- 10-year warranty
This is a really tall and thick mattress but it weighs a scant 35lb so it's amazingly easy to move in. It ships full sized so you don't have to worry about it taking time to reshape.
The memory foam doesn't reflect heat because it's quite a thin layer so you don't have to worry about getting hot with it and it's thin so there's no gassing off like a full memory foam would have.
The design is comfortably plush and ideal for anyone who wants a firm mattress with a little give to it.
This is like an extra firm mattress with a memory foam topper. The foam adds a softness that isn't necessarily welcome and the band across the hip area means you'll sink down so that your butt is lower than your body, something that only works if you're a back sleeper.
This is a noticeable sag, and unless you're sleeping in the “perfect” position for it the band is not only useless but uncomfortable. It's not good for stomach sleepers at all despite being the thicker height.
Sealy Hybrid 10.5” Extra Firm
Sealy has a well-known name in the mattress industry and they're known for producing quality mattresses in the USA. This is no different and comes with a 10-year warranty as well.
It has Active Support Technology that includes a memory foam layer to relieve pressure spots and fabric encased coils for support as well as memory foam to adjust to the body's shape and position.
The coils provide superior air flow so you'll never get hot and the outer ring are Quantum Edge coils to provide extra support even at the edge of the bed. It also has a base foam layer for stability and can be rolled up for shipping and storage.
- Spring/foam hybrid design
- Edge Coils for extra support
- Separate Foam base layer
- Can be Rolled
The encased coil and foam design gives you many of the benefits of memory foam without the bad. The foam layer means you can get out of bed without disturbing your partner, and it feels soft and cloud like despite having maximum support.
It's ideal for stomach sleepers and is part of the Posturepedic line designs to provide extra back support. It doesn't need flipping but can be turned if needed.
The design means the mattress can't be flipped and while it does have foam on top it's not quilted. There's an additional 5-9” foundation base foam layer, but the problem is it has to be purchased separately which significantly increases the cost and is somewhat misleading since it's shown as being part of the mattress system.
Zinus 12” Performance Plus Extra Firm
Another hybrid design that combines foam and spring coils to give you a softer feel without sacrificing support. This also has individually wrapped coils like the Sealy Hybrid as well as a 10-year limited warranty.
It uses CertiPUR foam which is better quality than memory foam in both a high density support layer and a thinner comfort layer. It has a Tight top that isn't pillowed and 10% more coils than their firm version for extra support. The foam layer helps prevent motion transfer and pressure spots.
- Foam layer
- 10 year warranty
- Edge Coil support
- 10% more coils
This is firm right the way to the edge of the mattress since all the coils are the same. It's deep enough to work for stomach sleepers and while it's a little more plush than the 10” version it's still firm and solid.
This is ideal for larger sleepers and also has an extra support bottom available for Big & Tall which makes it much more versatile than the average mattress.
The iCoil designs are independent so you don't disturb your partner when moving since only the coils on your side move. It ships compressed so it's convenient to set up.
This takes up to three days to reshape into it's expected thickness which can be awkward since you can't use it in that time. This also has some gassing off of the foam layer which means there's a significant chemical smell that can take days to go away and irritate allergies.
The sizes are also not quite standard so there is often an inch or two different from frames. The foam layer is also only on top so it can't be flipped.
Dream Solutions ComfortPedic Extra Firm Orthotic
This is a mattress and box spring set, it's foam encased and has a 10-year warranty. The big issue with this is that unless you have prime it's not free shipping and the cost is almost as much as the mattress itself since it can't be folded!
It weighs a sturdy 145lb and is an innerspring design. The outer material is polyester rather than cotton which isn't as plush, though the fabric can vary. It has 490 innnersprings inside and an orthotic design.
- Made in the USA
- Box Spring Included
With a simple and basic design, this mattress provides decently firm support without a lot of frills. There's no fancy foam layers and no extras just a basic mattress that's supportive.
It does provide good support and is fairly comfortable if you like a lot of bounce since the springs are not protected.
With such expensive shipping it's debatable if this is worth it (shipping is only cheaper in NYC or just outside).
The company doesn't have a lot of information and there's not a lot of reviews on the product so it's hard to really tell if it's as good as the company says. There's a lot of motion transfer and the coils will sag over time since they're not reinforced.
Simmons BeautyRest Silver Extra Firm 800
As one of the most expensive choices this is a nice 13” deep and has a 10 year warranty. It has AirCool memory foam gel which helps regulate temperature and keep you cool as well as a ventilated foam layer and DualCool memory foam on the top to provide softness without compromising support.
The design is encased in foam 360 degrees but has an Energy Foam base which provides extra stability and durability. The coils are individually pocketed to help protect from motion transfer and to provide more support.
- Pillow Top
- Pocketed Coils
- Foam layer
With a thicker mattress, this is ideal for stomach sleepers. The amount of foam in this means there's almost no motion transfer which is great for couples. It also has a pillow top which makes this feel a lot less firm than it is.
The memory foam doesn't get hot and the gel and cooling layers do keep you feeling comfortable. It's got more give than most extra firm mattresses and feels more like a true coil than a hybrid even with the foam.
The coil design and the thin foam means that there's still pressure points because this mattress is very very firm. This does not come with the box spring and is not flippable.
The coils don't feel like they're pocketed and while there's not a lot of motion transfer it still feels like they start to poke over time.
Beautyrest Black Alexia Extra Firm
As one of the most expensive mattress on the list, you would expect something more. This does come with the box spring but has a wait time of several months before shipping because of its popularity.
It has advanced pocket coil technology for pressure relief and memory foam layers to create a pillowed top that disperses body heat.
The mattress is finished with luxury fabric and Phase Change material to regulate body heat as you sleep. The foam stops you feeling pressure points and increases air flow to keep you comfortable.
- Hybrid design
- 850 coils
- Phase change and foam for heat regulation
- Tight top
This is an especially firm mattress and it has the hybrid design that includes a memory foam and pillow top for softness. It can also be flipped. It's pretty comfortable and has independent support technology which helps prevent motion transfer.
There are two types of coils in an alternating design to give better back support and to provide a tighter amount of coils (850). It has a cotton blend cover for softness and also has a ten-year warranty. Beautyrest is known for quality and this is no exception as it's a well-made design.
This is a pricey mattress and it can vary over several thousand depending on where you shop. It's fairly heavy at 116lb and comes full sized.
This is very firm and can be too firm for some sleepers despite there not being pressure points thanks to the foam hybrid design.
Dream Sleep Highlight Luxury Firm Set
An orthopaedic design that is flippable and has a ten-year warranty. There's also an option for a low profile with the included boxspring if you want less than 8”.
There are 490 coils inside with a smaller coil border for extra support. The entire design is encased in 2.5” foam and there's also extra padding on the sides.
It's a very high mattress at 14” which is great for stomach sleepers. This is about mid-level in price and it's manufactured in the USA. The outside coating is polyester and it comes fully sized.
- Edge to Edge Coils
- Optional low profile Boxspring
- Side Padding
This provides plenty of support but isn't as firm as some of the others. It's a pillow top design that's much more a traditional mattress than any others on the list.
Having two different options for box springs adds the ability not to have a super tall bed. It's comfortable and the quilting is nice but it doesn't provide a lot of give.
The stitching quality is quite poor and they often arrive with several runs and loose threads. This isn't great quality considering the price. It's a pretty basic design that isn't as firm as expected because it's got far fewer springs.
The springs are also not pocketed which means there's plenty of motion transfer. There's also a huge shipping charge on top of the fact that the set is expensive.
Beautyrest Black Mariela Extra Firm
The most expensive mattress on the list has the same Black technology as the Alexia but with some extras. It has black ice memory foam latex to relieve pressure points from the pocketed coils and keep you cool by dissipating body heat.
It's 14” high and has a 10-year warranty. It has large coils for a firmer feel. The foam has a micro-diamond construction that adds ventilation and keeps the surface cool.
- Multiple memory foam layers
- Diamond ventilation
- Pocketed Coils
- Hybrid Design
- 14” high
With a lot of fancy technology, this has very firm comfort and a plush, luxury feel. The foam adds cloud-like comfort without sacrificing support.
This is arguably a very overinflated mattress as it's got a ridiculous price tag that's many times any of the others without really providing any difference in technology.
It's essentially a hybrid mattress with some fancy names thrown in and costs as much as a car! This isn't really worth the massive price tag at all.
Choosing a mattress is all about comfort. It doesn't matter what technology the mattress uses as long as it provides comfortable support. The biggest decision when choosing an extra firm mattress is whether you want the pillowy hybrids which have additional memory foam, or tight tops which provide no give at all.
This is going to make a huge difference in what you feel is the best extra firm mattress for you. The Beautyrest Black are undoubtedly overpriced without giving you a lot of extra so a more reasonable choice like the Drakesboro (if you can find it) is going to give you similar technology at a tenth of the price.