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 For example, if you have chronic back pain or need extra support for a larger frame, an extra firm mattress might be an ideal choice. An extra firm mattress is a type of mattress that is designed to provide the user with an extremely firm sleeping surface. Potential Benefits of an Extra Firm Mattress for Back Pain ReliefAn extra firm mattress can provide the support your back needs to stay aligned while you sleep. Other extra firm mattress benefits include increased support for your neck, shoulders and back, extra cushioning to reduce motion transfer, improved spine alignment and extra edge support. Final SayIn conclusion, an extra firm mattress may be beneficial for those who are experiencing mild to moderate back pain.