The Box arrived and looked pretty much like every other "mattress in a box" mattresses these days. The mattress had been compressed, air removed and sealed in plastic. It only took a couple of minutes to come back to full/regular size once opened.
I kinda wish they had provided some kind of rip cord or something to unseal the plastic though because I was worried about cutting it and accidentally cutting the mattress underneath it. I managed to open it safely though. I didn't notice any terrible smell or anything, but perhaps the one thing I did notice was that it has a cloth top that tends to develop "pills" as friction across the surface rubs small fibers into balls.
The firmness of this mattress doesn't easily cure my back pain unless I focus on sleeping on my back. If I wind up rolling over it doesn't help nearly as much. I think maybe if it was just a little softer at the top it might be better. Like if the bottom 80% was firm foam and the top 20% was a memory foam or something softer than the kind it uses. My back pain has been better since using this but it still depends on how much I toss and turn during the night.