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This is kind of a long way around, but this has been such a good thing I thought I'd share.
It all started as research for cold weather camping. Looking at alternatives for 12 volt heating.
http://www.electrowarmth.com/fleet.php

I had always slept on a water bed. Warm in the winter. My wifes discomfort with the water bed led to a spring mattress. It was cold. I found those pads and noticed the fitted bedwarmers. VERY NICE!

Those down south may not know the cold of a northern climate. Bed warmers have been around for centuries. Many different things have been used. Slaves, pans filled with coals passed between the sheets, electric blankets ,etc. Slaves are not an option, coals are sooty and messy, not to mention the fire hazards. Electric blankets heat from the top side. That just doesn't make sense. Heating from beneath is the answer. This has been a good bed mod. We covered it with a 3" wool topper. I had to share as this has been one of those things that is so nice and works better than I had imagined. It shuts off so it is not on all day and you don't have to remember to shut it off. The temperature has two controls so each side can be a different temperature. The low setting is just right, however just before bed I bump it to 5-7 for an hour so it is real warm when I crawl in. then shut it off or hit low for the night.

It has been in service for about three months now. I have to give it two thumbs up.

Sounds pretty cool (warm), Brule. I to have been pretty much a wave less water bed guy for several decades. Mrs Hoff (the 3rd) managed to destroy 2 (not very discreetly) water beds in the last few years. She is a RN and they keep trying different jobs and hospitals.

Anyway, she had a gig out of town with all expenses paid. I visited her and although I do not know the proper name of the mattresses but, they were the memory foam type. Now, I have had lower back pain since getting hit by Heep, as a kid, when I jaywalked in front of it. I took a bad landing at Benning (before you start, a few Marines and Seamen go through there) later on, which didn't help. I have never ever had a better nights sleep than I did when on that thing.

It would be worth the money to just rent a room and try one out. I think the cheapest that I have seen is $1300 for a queen size.

Needless to say that I keep reasoning that the next mod is more important but, it is times like this that I think I need to bite the bullet.

Man I ain't tellin the wife about this one!!! She's always freezin and I'm always too hot. During winter she uses a twin size elec blanket on her side and I just throw the extra blankies over on top of her. I sleep best when it's around 60-65 in the bedroom and in the bed. Too warm I just as well get up as I won't be able to sleep at all.

We bought a memory foam mattress. You are right it is a huge investment. Anything to make the misses happy though. Memory foam=big mistake. Sure your body heat and weight make it conform to your body. That can be the problem too. You roll over and it takes time for the holes to fill.
We tried it for a few weeks. I really tried to make it work. No dice. I ended up spending the last week on the air mattress or couch.
Normally a mattress can not be returned as bedding products can not be resold. Fortunately Costco will take anything back , no questions asked.
After that I did lots of research.
The human body gives off moisture. That needs a place to go and dry out. Foam mattresses do not do a good job of breathing. I read reports of really bad mold problems with them. That and my previous "nightmare" with the memory foam, put those off the list.
Next was the "air beds". Sleep by numbers has been around a while and we see lots of raves. Further research revealed parts supply problems. Why would you want a bed that needs to be maintained like a car? Parts to fix. Compressor failures, leaks. Also the same mold horror stories.

Spring matresses have airspace. Mold is usually not an issue. So it came down to the conventional mattresses. Renting a room to sleep on one is not an option, as the mattresses sold to chain are usually not the same as the consumer models. It can give you an idea what to look for, but may not be quite the same.
Every where we shopped had a no return policy. Basically you spend a grand on a mattress and it is yours after you sleep on it. Seems crazy. We must have tried a dozen or better. We were limited in that it had to be Cal-King and fit the waterbed platform.
We decided to go a little firmer and add a topper. The mattress was made not 40 miles from our house at a local builder.

On the recommendation of my father, we went with wool. The oils in the wool are a natural deterrent to mites. It breathes very well and wicks moisture away. The fibers offer excellent support.
This combination worked pretty well, but it was still a cold bed to climb into. Enter the heating pad...this combination works. The wife is happier with the support. I am warm and toasty. I would say a topper is needed. The heating pad is not bad, but if you have the sensitivity of a princess, you might feel a pea? The wires are not bad, but I fear a sensitive person might be annoyed.

I too like to sleep in a cold room ( 60 F or less ), but I want to be warm and cozy in bed.

Add this one to your mods list if she needs to sleep warm and you want it cooler. The dual controls make that easy. My wife always has her side a couple settings above mine. The buttons are as easy to find as the snooze button. If you get too warm, hit the off.

Sure, I would need to do a lot more research and I believe all of your points that you made. All I know is that it was the one night that I didn't wake up with pain and have to curl up into the fetal position to relieve it as recommended by several docs.

Everyone is different. I would recommend Costco if you want to try a memory foam mattress. Returning it after trying it for a few weeks was easy.

If you have a good mattress store around find a premium Latex rubber mattress to try most people never want to go back. My Mother's uncle owns Southard Mattress in Syracuse NY and has been custom building mattresses for over 50 years, the whole family being tall he custom made 7' versions for us they last more then 20 years and are inherently anti-microbial add a wool topper and your good to go for decades. Wish I had the money to have one now.

I've had the sleep number for 4 years I'd never go back.
What maintenance?
I've got 2 of my cleaning staff sleeping on them, they are happier and more productive.

Long term update. This mattress pad it fantastic. Nothing better than crawling into a toasty bed on a cold night.
If we do much winter camping in the new trailer, I am going to consider one of the 12V pads

We did add a fleece topper to the bed. That is pretty nice too.