How to Position “The BackBone

Turning Wedge

Everything you ever wanted to know about the BackBone but didn’t want to ask


Hello all you hard working Pressure Injury Prevention people!

Thanks for all your great questions!

Here are the answers.


1. What is The BackBone™ Positioning Wedge?

The BackBone is a “Turning cushion”. It has a 30 degree angle designed to support your person on his/her side in a “turned” position while laying in bed so that he/she is does not have any direct pressure on his/her sacrum or coccyx.

2. Why does my person need to be supported at 30 degrees on his/her side while laying in bed?

It’s not that they have to be exactly 30 degree’s, it’s just that we have to turn far enough to be off the lower back, sacrum and coccyx, but not too far as to be on the side hip (trochanter). In other words, positioned so that he/she is resting on the buttocks.

Since there is usually more soft tissue and less pointy bones there, the buttocks can tolerate pressure better than the sacrum and the side of the hip. We need to “offload” the sacrum and hips because the skin is thinner there and tends to breakdown under prolonged pressure.

(For detailed information about pressure ulcers and where any how they develop, see our guide “Pressure injury prevention 101 – How the nurses do it”)

3. Why is The BackBone™ curved like that?

The BackBone™ is the only back wedge cushion that is curved so that the patented “lift tips” can provide lift while conforming to the natural curvature of the back. It makes it possible to support under the scapula and buttocks without touching the sensitive bones of the spinal column, especially the sacrum/coccyx.

4. How do I position the BackBone™ correctly?

The BackBone™ is easy to place so that your person is comfortable. The sacrum offloading positioning technology lifts them off the bony prominences of the lower back, sacrum and coccyx.

First: Have your person turn all the way on his/her side for a second. (If your person cannot turn all the way over, see our “How nurses turn patients” section for more detailed instructions)





Next: place the “tips” of the cushion under the buttocks so that it supports the buttocks, but curves away from the lower back, sacrum and coccyx. You may move the cushion any way you need to so to avoid a particular spot because the top part of the cushion lifts also!



Then: The upper “tip” will fit naturally under the scapula area and curve away from the spine.


Trick: The further you put the “tip’ under the scapula, the higher your person will be lifted




Now you can have your person roll back comfortably onto The BackBone.

Notice how she is comfortably on top of the cushion.


The BackBone allows her to rest with a gentle tilt, just enough to offload the sacrum without forcing her onto her trochanter (hip).


5. Can I use the BackBone™ cushion to support other body parts?

Yes! The curvatures and bilateral angles make it possible for The BackBone™ to be used as a support many other body parts.

Try it to float the heels under the head, between the knees, on both sides, under the arms. You can even use it as a your breakfast in bed table. The curvatures of The BackBone fit the curvatures of your persons body!

6. Is the BackBone™ Guaranteed?

Yes! If you are not 100% satisfied that The BackBone™ is the best lateral turning sacrum positioning wedge your money can buy, we will give your money back.

Pressure Injury is a complex health condition and there are many reasons it happens. So there are many things we have to do to get them to heal. We would never try to claim that The BackBone™ itself can heal a bedsore (If a cushion company tries to claim that, don’t believe them!). But what we can say is that reducing pressure is a critical thing to do, and that you will find that the BackBone is more comfortable and effective than anything else out there!

8. Does the BackBone™ have a warranty?

Yes! The BackBone has a 6 month warranty on materials and cover construction under normal use. The BackBone cover cannot hold up to sharp objects like scissors or needles. Although the BackBone meets fire code, if you tried really hard, you could burn it. And we would not warranty that.

9. What are the dimensions of The BackBone™ ?

Standard Size: The BackBone is 27″ long by 12″ wide. The back side is 5″ thick and the “tips” are 2″ thick. It is a triangle shaped wedge: 75 x 75 x 30 degrees angle.

Bariatric Size: The Bariatric BackBone is 28″ long x 13.5″ wide. The back side is 5.5″ and the “tips” are 2.5″ thick. It has the same angles: 75 x 75 x 30 degree angle


               Standard Size                                                                                                                           Bariatric Size
BackBone pictorial dimensions
The BackBone pictorial dimensions bariatric

10. How much weight will The BackBone™ support ?

The BackBone standard size is ideal for persons between 90 pounds and 200 pounds. The BackBone Bariatric size can also be used for lighter weight people, but it will support persons up to 500 pounds as well. Stay tuned for xtra-large Backbone, pediatric, infant and preemie BackBones, coming soon!


11. What is The BackBone™ made of? Does The BackBone™ contain latex?

The BackBone is a latex free positioning wedge. We took care to construct our BackBone positioning wedge to be able to provide the most superior lift, support and efficient pressure distribution properties.

The BackBone is better at supporting because of the dual layer design. The thick foam core is our top grade therapeutic poly “just right” density foam (a patent pending secret !) It is firm enough to provide lift and support but flexible enough to conform to the contours of your persons back without feeling like a rock. The top is layered with a high density memory foam for the “fine tune and soft touch” pressure distribution and less impedance of circulation. **

** (For detailed information about how support surface density affects circulation, see our guide “Pressure injury prevention 101 – How the nurses do it”)

12. What kind of cover does The BackBone™ have?

The BackBone is covered with a high grade “gurney pad” stretchable nylon. The cover is water proof and antimicrobial treated, so it is perfect for any setting, from the hospital operating room, to the ICU and the acute care setting, Skilled Nursing and the home care world.

13. How do I clean and disinfect The BackBone™?

The Backbone is waterproof and stain resistant, so you may use any institutional disinfectant wipes to clean. You can even use soap and water. Do NOT try to put it in the washing machine.

14. Can I put a pillowcase over The BackBone™?

The special nylon cover is “skin friendly” because it allows air exchange, so a pillow case is not necessary. Actually using a pillowcase is not recommended because it makes it harder to keep in place and can possibly wrinkle, which can damage sensitive skin.

However, some people may find the special cover a bit too “cool”.  If this is the case, here is what we suggest:

  • 1. “Warm up” the cushion by putting it under the blankets for a little while before positioning it.
  • 2. If there’s no getting around it, try this nurses trick: put the wedge under a “boosting sheet” **. By using a boosting sheet between The BackBone and your person (instead of a pillowcase) there is less slipping and it is easier to prevent wrinkles.
  • 3. If you just have to use a pillowcase, use cotton (or if you have it, silk pillowcases are the best for sensitive skin). Make sure its smooth without wrinkles where it touches skin.

** (For detailed information about boosting and how to use boosting sheets, see our guide “Pressure injury prevention 101 – How the nurses do it”)

15. Is The BackBone™ single patient use or re-usable?

Because it is covered with a high grade “gurney pad” nylon cover that is both water proof and antimicrobial treated, The BackBone is re-usable.  Why? Because re-usable wedges just make more sense. Here’s why;

  1. The BackBone costs less because it is re-usable; Why on earth would you pay again and again for a disposable back wedge when you can just pay once for the BackBone? Do the math: pay again and again, vs use again and again. Math is fun!
  2. Another good reason is environment. Less waste = more eco-friendly.
  3. But perhaps the best reason is what all us nurses have known for years; The best equipment to use is the equipment that is effective and available. Caregiver engagement is directly proportional to expediency and reliability. Meaning nurses use what works the best with the least amount of time and effort.**** That is why care facilities that stock pressure injury prevention equipment in each room have lower pressure ulcer incidence scores.

** (For detailed information about pressure ulcer injury incidence, prevalence and prevention, see our guide “Pressure injury prevention 101 – How the nurses do it”)

16. My Healthcare Facility will need a BackBone™ for every room. May I get a sample first to make sure it will suit our needs?

Of course you can get a sample! We suggest you put a few “testers” in patients’ room and give it a few weeks just to see how usage evolves. You will be amazed at how your caregivers will start to seek it out to use for many different offloading needs once they discover how handy it is and how well it works. If you are not completely satisfied that that The BackBone honestly works better for everyone, we will give you your money back!