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Most people assume that the firmness of a mattress determines how good it is for your back. The conventional wisdom is that a firm mattress offers the proper support, and an extra firm mattress moreso. The truth is a little more involved. Firmness is not the same as support. The amount of firmness depends on your body type, your weight, how you sleep... in other words, you need whatever degree of firmness or softness is necessary to keep your spine aligned. Consider a bed that will let you adjust a firm mattress if you have special needs.