Pressure points are the bony parts of the body that carry your weight when you lie or sit, such as the back of the head, shoulder blades, elbows, tailbone, hips and heels, and they are where pressure sores (pressure ulcers) usually start. Care of pressure points means moving the weight off them every 1 to 2 hours in bed, checking the skin over them every day and cushioning them, because skin pressed between bone and a mattress or chair for too long loses its blood supply. Down-Under Wool has helped caregivers protect pressure points since 1988; this guide shows where they are when someone lies on their back, lies on their side or sits, and how to protect each one.
What are pressure points?
Pressure points are areas where bone lies close under the skin and presses into the surface a person is lying or sitting on. The NHS describes pressure ulcers as areas of damage to the skin and the tissue underneath, and says they usually form on bony parts of the body such as the heels, elbows, hips and tailbone. Mayo Clinic gives the same list and adds the ankles.
Which bones carry the weight depends on the position: on the back it is mostly the tailbone and heels; on the side it moves to the hip, shoulder, knee and ankle. That is why bed sores are prevented by moving the weight around the body, not by softening one spot.
Where are the pressure points in each position?
The pressure points are wherever bone meets the bed or chair, so they change with each position. This table brings together the sites listed by Mayo Clinic for people in bed and in a wheelchair and by MedlinePlus (US National Library of Medicine):
| Position | Pressure points | Simple ways to take the weight off |
|---|---|---|
| Lying on the back (supine) | back of the head, shoulder blades, elbows, spine and lower back, tailbone (sacrum), heels | a pillow under the calves so the heels float; keep the head of the bed no higher than 30° |
| Lying on the side | ear and side of the head, shoulder, hip, knees, ankles | a pillow or foam between the knees and ankles; turn to the other side or back at the next change |
| Sitting in a chair or wheelchair | tailbone and buttocks, shoulder blades and spine, backs of the arms and legs where they rest on the chair | shift weight forward, left and right every 15 to 20 minutes; a foam, gel or wool seat cushion, never a donut ring |
The tailbone (sacral) area and the heels are the two sites that come up most often: a 2025 systematic review of 35 studies of surgical patients found the sacral region and the heels were the most common locations for pressure ulcers.
Why do pressure points break down?
Pressure points break down because steady pressure reduces blood flow to the skin and tissue over the bone. Mayo Clinic names three causes: sustained pressure, friction (skin rubbing against bedding or clothing) and shear (two surfaces moving in opposite directions, as when the skin stays put while the body slides down the bed). Wet skin is a further problem, which is why MedlinePlus advises cleaning and drying the skin straight away after any accident with urine or stool. Anyone can get a pressure ulcer, but the NHS says the risk is higher for people who have trouble moving, have had one before, are underweight, or have poor circulation or fragile skin.
Causes, stages and the full prevention plan are covered on our bedsore prevention page.
How do you care for pressure points?
You care for pressure points by relieving the pressure on them often, checking the skin over them every day, cushioning them and keeping the skin clean and dry. These are the everyday steps from MedlinePlus and the NHS; a nurse can tailor them to the person you care for.
1. Change position regularly
In bed, change position every 1 to 2 hours so no single spot carries the weight for long. In a wheelchair, shift the weight (lean forward, then left and right) every 15 to 20 minutes. How the turn is done matters too: in an Irish trial of 213 older people, 3% of those turned every three hours at night using a 30° tilt developed a pressure ulcer, compared with 11% of those turned every six hours with a full 90° turn onto the side.
2. Check the skin every day
Look at each pressure point at least once a day, including the heels, ankles, knees, hips, spine, tailbone, elbows, shoulders, back of the head and ears. The NHS lists the early signs: a discolored patch that does not change color when pressed (usually red on white skin, purple or blue on black or brown skin), a patch that feels warm, spongy or hard, and pain or itching in that area.
3. Cushion the bony spots
Use pillows or foam so bony areas don't press on each other or on the bed: between the knees and ankles when lying on the side, and under the calves when lying on the back so the heels lift clear. MedlinePlus advises against donut-shaped cushions and notes that natural sheepskin pads are also helpful to reduce pressure on the skin.
4. Keep skin clean, dry and nourished
After any accident with urine or stool, clean the area right away and dry it well. Keep sheets and clothing dry and smooth, with no wrinkles under a pressure point, and lift the person or use a draw sheet to move them rather than dragging them across the bed, which causes friction and shear. MedlinePlus also advises enough calories and protein and plenty of water; the NHS adds not smoking.
How to protect each pressure point
Each pressure point needs its own kind of protection. These are the products caregivers most often choose for each area:
- Heels and ankles. Float them on a pillow under the calves, or use a medical sheepskin heel pad (a Velcro-closed cup of Merino wool for either foot) or Merino lambswool wrap booties. All our boots and booties for pressure sores are in one place, and our guide to heel protectors for bed sores compares them.
- Feet at the end of the bed. The Pressure Smart XD1900 Pressure Care Assistant is a 12 x 26 inch strip of dense Merino wool with flaps that wrap around the mattress, so the feet rest on wool and can still move.
- Tailbone, hips and shoulder blades. A full-length wool surface helps here: an Australian Medical Sheepskin overlay (AS4480.1), about 38 x 24-26 inches, or the 30 x 60 inch Superior Overlay XD. Compare surfaces in our guide to the best mattress topper for bed sores.
- Elbows. The medical sheepskin elbow pad fits all elbows; the XD1900 elbow protectors are sold in pairs.
- Ears and shoulders when lying on the side. A soft pillow under the head takes weight off the ear. The Pressure Care Assistant above is also used for localized protection under the shoulders, ears and buttocks.
- Buttocks and the backs of the legs in a chair. The 18 x 22 inch XD1900 Cushion-It fits on a wheelchair, armchair or car seat, and wool armrest supports cushion the forearms. See wheelchair pressure sore prevention and medical sheepskin for recliner chairs for seating.
How do you prevent pressure sores on the buttocks and tailbone?
You prevent pressure sores on the buttocks and tailbone by keeping weight off them, keeping the head of the bed low, breaking up sitting time and keeping the skin clean, dry and checked daily. The tailbone (sacrum and coccyx) takes the weight when lying on the back, and the tailbone and buttocks take it when sitting; Mayo Clinic lists both as common sites. Shear adds to the risk when a person slides down a raised bed (see the causes of pressure sores), and so does wet skin from incontinence, which NICE links to moisture damage.
- Turn off the back. Follow the nurse's turning schedule, tilting the person about 30° onto alternate sides with pillows so the tailbone does not carry the weight.
- Keep the head of the bed low. No higher than 30° when possible; MedlinePlus says being flatter keeps the body from sliding down.
- Break up sitting time. Shift the weight every 15 to 20 minutes and use a pressure-redistributing cushion, as NICE advises for people who sit for long periods. Never use a donut ring.
- Keep skin clean and dry. Clean and dry it straight after any accident with urine or stool, and use a barrier cream if the nurse advises one.
- Check the skin daily. Look at the tailbone and both buttocks for the early signs listed above.
If a sore has already formed, ask a nurse or doctor to look at it; the NHS advises seeing a GP if you think someone has a pressure ulcer. Home remedies are not a substitute, and an open sore needs a professional to assess and treat it. Overlays and seat pads for this area are among our bed sore prevention pads.
Does sheepskin help protect pressure points?
Yes, medical-grade sheepskin is one of the few pressure-point products with trial evidence behind it. A Cochrane review pooled three trials and found that Australian standard medical sheepskins reduce pressure ulcers (risk ratio 0.56). In the largest of the trials, 441 patients at a Melbourne teaching hospital, 9.6% of those lying on a medical sheepskin developed a pressure ulcer, against 16.6% with usual care.
A medical sheepskin works best with the skin lying directly on the wool, and alongside regular turning, not instead of it. Decorative rugs are not made or tested for this; look for a medical sheepskin that carries the AS4480.1 stamp. Placement tips are in how to use sheepskin for bed sores, and our bedsore prevention packages combine a sheepskin with foot protection.
When should you call a nurse or doctor?
Call a nurse or doctor as soon as you notice redness, a sore or any other change in the skin over a pressure point that lasts more than a few days, according to MedlinePlus. The NHS advises urgent help for pus coming from a sore, a high temperature, or pain that is severe or getting worse. If a sore has already formed, ask the nurse or doctor how to care for it rather than treating it yourself.
Pressure points FAQs
What are the pressure points for bed sores?
The pressure points for bed sores are the bony areas that take your weight: the back of the head, ears, shoulder blades, elbows, spine, tailbone, hips, knees, ankles and heels. Which ones are at risk depends on whether the person is lying on their back, on their side or sitting.
What are the pressure points in the supine position?
In the supine position (lying on the back), the pressure points are the back of the head, the shoulder blades, the elbows, the spine, the tailbone (sacrum) and the heels. The tailbone and heels carry the most weight.
Which pressure points should you check after turning someone onto their side?
Check the ear, shoulder, hip, knees and ankles on the side they are lying on. A pillow between the knees and ankles stops the bones of the two legs pressing on each other.
Is the sacrum a pressure point?
Yes. The sacrum, the flat bone at the base of the spine just above the tailbone, takes much of the weight when lying on the back or sitting, and it is one of the most common places for a pressure ulcer to form.
How do you treat a pressure sore on the buttocks at home?
Ask a nurse or doctor to look at it first, because a pressure sore on the buttocks needs a professional plan, not home remedies. Until it is seen, and afterwards as they direct, keep weight off the area by changing position often and keep the skin clean and dry.
What does care of pressure points mean in nursing?
In nursing, care of pressure points is the routine of repositioning, daily skin checks, cushioning bony areas and keeping skin clean and dry, so no area stays under pressure long enough to break down.
How often should pressure points be relieved?
Every 1 to 2 hours in bed and every 15 to 20 minutes in a wheelchair, according to MedlinePlus. The care team may set a different schedule for the person and the mattress.
Can you put sheepskin under pressure points?
Yes. A medical sheepskin placed under the shoulders, hips and buttocks, or a sheepskin heel pad under the heels, cushions the bony area and absorbs moisture. Use it with the skin directly on the wool, and keep turning the person on schedule.
The short version
Pressure points are the bony spots that carry the body's weight, and they change with position. Caring for them comes down to moving the weight often, checking the skin every day, cushioning the bony areas and keeping skin dry. Ask a nurse or doctor about any change in the skin. For help choosing protection, see our bed sore prevention products or contact us; we've been answering these questions since 1988.
