Can you get bed sores from sitting too much?

According to the Agency for Healthcare Research and Quality, pressure injuries, commonly called bed sores, can develop in as little as 1 to 2 hours of immobility, and yes, you can get bed sores from sitting too much. When constant pressure restricts blood flow to the skin and underlying tissues, cells become starved of oxygen and nutrients and start to die. This can occur in anyone who sits for long periods without frequently shifting their weight, especially those with limited mobility.

Quick Summary

Prolonged sitting can cause pressure ulcers, also known as bed sores, due to restricted blood flow to weight-bearing areas like the tailbone and buttocks. The risk increases with immobility, moisture, and certain health conditions. Regular repositioning, pressure-relieving cushions, and proper skin care are crucial for prevention.

Key Points

• Causes of Pressure Sores: Prolonged, uninterrupted pressure on bony areas while sitting or lying down restricts blood flow, causing tissue damage and leading to bed sores.

• Key Risk Factors: Individuals with limited mobility, advanced age, poor nutrition, incontinence, or conditions that impair sensation like diabetes or spinal cord injury are at highest risk.

• Prevention in a Wheelchair: Shift weight every 15 to 30 minutes, or have a caregiver reposition you at least every hour, to relieve pressure on the buttocks and tailbone.

• Selecting the Right Cushion: Specialized cushions (air, gel, or high-density foam) redistribute pressure more effectively than standard seating. Avoid donut-shaped cushions, which can worsen the problem.

• Early Detection is Crucial: Daily skin checks for persistent redness or discoloration on bony areas are vital for catching pressure ulcers at their earliest, most treatable stage.

• Early Treatment: If a stage 1 pressure ulcer (persistent redness) is found, the primary step is to remove all pressure from the area immediately and keep the skin clean and dry.

The Mechanism: Why Prolonged Sitting Causes Bed Sores

Pressure ulcers, or bed sores, form when continuous pressure on an area of skin damages the underlying tissue. When you sit, your body weight is concentrated on a small area, especially the buttocks and tailbone where bones are close to the surface with less cushioning. This pressure squeezes the blood vessels, blocking the flow of oxygen and nutrients to the skin and surrounding tissue.

The Role of Pressure, Friction, and Shear

• Pressure: The main culprit. Your body weight, when stationary for too long, compresses the soft tissue between your skeleton and the hard surface you are sitting on, leading to cell death.
• Friction: This occurs when your skin rubs against the seating surface, such as when shifting or being moved. It can rub off the top layers of skin, making it more vulnerable to pressure injuries.
• Shear: This happens when layers of skin slide in opposite directions, putting a strain on blood vessels and tissue. For example, when a person slumps in their chair, their bones might slide down while the skin stays put, causing damage.

Who is at a Higher Risk of Developing Bed Sores from Sitting?

While prolonged sitting can be a risk for anyone, certain individuals are at a significantly higher risk. This includes:

• Wheelchair Users: People who are confined to a wheelchair for extended periods are highly susceptible, with pressure concentrated on their buttocks and tailbone.
• Elderly and Frail Individuals: As people age, their skin becomes thinner and weaker, and they lose the protective fat layer that cushions bones. Many elderly people also have limited mobility, increasing their risk.
• Those with Chronic Conditions: Diseases like diabetes and vascular issues impair blood circulation, making tissue more vulnerable to pressure damage.
• People with Impaired Sensation: Neurological disorders, spinal cord injuries, and some medical conditions can diminish a person's ability to feel pain or discomfort, preventing them from noticing and shifting pressure.
• Malnourished Individuals: Poor nutrition can lead to thinning skin and a weakened immune system, which hinders the body's ability to heal.
• Incontinent Patients: Prolonged exposure of skin to moisture from urine or feces can cause irritation and make the skin more susceptible to breakdown.

A Comparison of Pressure-Relieving Cushions

Choosing the right equipment is a critical preventative strategy. Various cushions are designed to redistribute weight and reduce pressure points. Note: always consult a healthcare provider for the best recommendation based on individual needs.

Cushion Type	How It Works	Best For	What to Avoid
Air Cushions	Uses interconnected air cells that inflate and deflate to constantly change pressure points and promote circulation.	High-risk individuals, those with existing pressure ulcers, or those needing customizable support.	Over-inflating, which can create high-pressure spots.
Gel Cushions	Gel material conforms to the body's shape, distributing weight evenly and reducing pressure on bony areas.	Individuals at moderate to high risk, sensitive skin patients.	Incorrect sizing, which can lead to inadequate support.
Foam Cushions	Made of dense foam designed to support posture and redistribute weight. Different densities offer varying levels of support.	Lower-risk individuals and those needing basic support and comfort.	Donut-shaped foam cushions, as they can restrict blood flow to the center of the opening.
Hybrid Cushions	Combines air and foam or gel elements to offer the benefits of both technologies.	Moderate to high-risk individuals seeking a balance of stability and pressure relief.	Overlooking the manufacturer's specific care instructions.

Preventing Bed Sores from Sitting

Preventing bed sores requires a multi-faceted approach focusing on regular movement, proper support, and good skin care. The following steps can help mitigate the risk, especially for those with limited mobility:

1. Reposition Regularly: Shift weight every 15 to 30 minutes while sitting to relieve pressure. If unable to move independently, caregivers should assist in repositioning every hour.
2. Utilize Proper Support: Use specialized cushions (air, gel, or foam) that redistribute weight and conform to the body's shape. Avoid donut-shaped cushions, as they can actually increase pressure.
3. Maintain Good Hygiene: Keep skin clean and dry, especially in areas prone to moisture from incontinence. Use mild soap and pat dry gently. A moisture barrier cream can provide protection.
4. Inspect Skin Daily: Conduct daily skin checks for warning signs like redness, tenderness, or discoloration. For areas that are difficult to see, such as the tailbone, use a hand mirror or ask for assistance.
5. Lift, Don't Drag: When repositioning, always lift the body to prevent friction and shear damage to the skin. Use a draw sheet or a lifting device if necessary.
6. Eat a Nutritious Diet: Adequate hydration and a diet rich in protein, vitamins, and minerals are essential for maintaining skin health and promoting wound healing.

Conclusion

In conclusion, it is not only possible but common to develop bed sores from sitting too much, especially for individuals with limited mobility or other risk factors. These pressure ulcers are the result of blocked blood flow to the skin, which can happen rapidly. Prevention is the most effective approach and involves diligent repositioning, using appropriate pressure-relieving equipment, maintaining excellent skin hygiene, and ensuring good nutrition. By implementing these strategies, the risk of developing pressure-related injuries can be significantly reduced, leading to better overall health and quality of life. If signs of a pressure ulcer appear, early intervention is critical to prevent the condition from worsening.

Frequently Asked Questions

How fast can a bed sore develop from sitting?

A pressure ulcer can form surprisingly quickly, sometimes in as little as 1 to 2 hours of uninterrupted pressure on a bony area. This makes frequent repositioning and regular skin checks essential for at-risk individuals.

What are the first signs of a bed sore from sitting?

The initial signs of a bed sore (Stage 1) from sitting include persistent redness on the skin over a bony area, such as the tailbone or buttocks. The area may also feel warm, firm, or tender compared to the surrounding skin.

Which areas are most vulnerable to bed sores from sitting?

The most vulnerable areas are typically the bony prominences of the lower body, including the tailbone (coccyx), buttocks (ischial tuberosities), hips, and shoulder blades.

Can I use a regular pillow to prevent bed sores?

While a regular pillow can provide some cushioning, it is not as effective as specialized pressure-relieving cushions. It is critical to use equipment designed to properly redistribute pressure and support vulnerable areas.

Why are donut-shaped cushions not recommended for bed sores?

Donut-shaped cushions are not recommended because they concentrate pressure around the central opening, potentially causing swelling and further restricting blood flow to the compressed tissue.

What should a caregiver do to prevent bed sores for someone in a wheelchair?

Caregivers should help reposition the individual at least once every hour. They should also assist with weight shifts every 15 to 30 minutes, ensure the use of an appropriate pressure-relieving cushion, and conduct daily skin inspections.

Is smoking a risk factor for developing pressure ulcers?

Yes, smoking is a significant risk factor. It reduces blood flow to the skin and can also slow down the healing process if a pressure ulcer does develop.