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Cushion Confusion

They can be round, donut shaped, square, or oval. They can be soft, squishy, or firm. They can have cut outs in all kinds of places. Which one do you actually need? Will you need a cushion for your pelvic pain for the rest of your life?

Let's address the cushion confusion today!

Most people require a cushion because they have pain in one or more of these places:

  • Rectum

  • Vagina

  • Perineum (area between the vagina/testes and the rectum)

  • Testicles

  • Penis

  • Tailbone

  • Ischial tuberosities ("sit" bones)

This pictures shows female pelvic anatomy from the bottom: meaning this is what you would see if someone were lying on their stomach, feet facing you. The top of the picture is the sacrum and tailbone. The hole just below that is the rectal opening, the middle hole represents the vagina and the bottom hole is the urethra. Any structure in red is muscle, and these pelvic muscles are often the culprit for our pain in sitting.

Pain in sitting can be caused by a number of things:

  • Pelvic floor muscles that are too tight

  • Nerves in the pelvic being compressed and irritated

  • Referral of pain into the pelvis from our low back

  • Hemorrhoids, anal fissures, or perineal tears following child birth

Cushions can provide short term relief by alleviating pressure on the area of concern, wherever that might be for you. It's actually very important that you know where your pain is located, becuase that will determine what type of cushion you need.

Tail bone pain

With pain specific to the tailbone, you need a cushion that has a cut out where your tail bone would normally sit. The one shown below is an example. The famous donut cushion is not the way to go if you have tail bone pain, as it has the cut out in the middle of the cushion, not in the back. Other people who may benefit from this cushion is someone with rectal pain from fissures or hemorrhoids.

Perineal pain

Remember that the perineum is the area between the vagina/testes and the rectum. People with pudendal neuralgia often benefit from these cushions, along with postpartum moms with vaginal tearing. Unlike the tailbone cushion, these options have a cut out in the middle/front area.

There are so many options out there for cushions. Here are some of our favorites:

  • Has cut out for tailbone AND perineum

  • Can add a removal ice pack insert for extra pain relief

  • Washable fabric cover

  • Perineal cut out in the middle

  • Has a cover and travel handle for a more discreet look

  • Hot/cold reusable pack for extra pain relief

  • Can choose which cut out design you need

  • Different options for different weight classes

  • Cover and travel handle for discreet use

  • Less expensive compared to other options

  • No option for perineal/middle cut out

A cushion is not the answer to your pelvic pain, but can help reduce pain while you and your provider figure out the root cause. If you have pain with sitting, that is a sign something within the pelvic girdle is struggling. See a pelvic health PT/OT for guidance!

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