What it is
Bed sores, also called pressure injuries, pressure ulcers or pressure sores, are areas of damaged skin and underlying tissue. They generally develop when pressure, sometimes combined with friction or shearing, reduces blood flow to an area for too long.
They most often appear over bony areas such as the tailbone, hips, heels and shoulder blades. People who spend long periods in a bed or chair, or who have limited ability to shift position, are commonly described as being at higher risk.
Pressure injuries are often described in stages, from skin that is red and intact to deeper wounds that reach muscle or bone. Because they can progress, early attention to skin changes is a common theme in wound care education.
How it’s traditionally been approached
Prevention has traditionally centered on reducing pressure and protecting skin. Caregivers and clinicians have commonly discussed repositioning, specialized mattresses and cushions, and careful attention to heels and other bony areas.
Skin care is another long-standing focus, including regular skin checks, keeping skin clean and dry, managing moisture, and reducing friction when someone is moved or transferred. Nutrition and hydration are also often considered part of overall skin health.
Facilities and home care teams often use risk assessment tools to identify who may need extra attention. Which approaches are appropriate varies from person to person, and a licensed clinician decides what fits after an evaluation.
How the right wound care specialist may help
A wound care specialist, such as a licensed nurse, physician or other trained clinician, may help by looking at your overall risk, your skin, and your daily routine. A visit often includes questions about mobility, medical conditions, nutrition, continence, and the equipment currently in use.
The specialist may examine areas prone to pressure and talk through what they see. They may also coordinate with other members of a care team, such as primary care providers, physical or occupational therapists, dietitians and home health staff, if appropriate.
Helpful questions to ask a licensed provider include: What is my or my loved one's level of risk and why? What are early warning signs on the skin? What support surfaces or equipment might be worth considering? How would the cause, staging, treatment options, expected healing time and insurance coverage be handled if a sore develops?
The whole-person view
Body, mind and stress affect each other. Pain, fatigue, low mood, anxiety or the strain of caregiving can influence sleep, appetite, movement and how closely someone is able to keep up with skin checks. Long illness or reduced independence can also be emotionally heavy for both the person and their family.
Body-based support, such as the approaches listed through Somatic Experiences, is one way some people explore reconnecting with their bodies during recovery or long-term care. Talk therapy through Therapists.plus may also help people and caregivers process stress and change. These are complements to, not replacements for, care from a licensed clinician.
Somatic Experiences: trauma and emotional healing →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- This page is for education only and does not replace an evaluation by a licensed professional, who should guide any decisions about care.
- Seek medical care promptly for signs of infection, including spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills, or for a sore that is quickly getting worse.
- Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis such as confusion with fever and rapid heartbeat, or a deep or severely contaminated wound.
- If you or someone you care for is in emotional crisis, call or text 988 for the Suicide & Crisis Lifeline.
Not sure where to start? Answer a few gentle questions and choose who you’d like to hear from.
Frequently asked questions
How do you prevent bed sores?
Prevention generally focuses on reducing prolonged pressure, protecting the skin, and checking regularly for early changes. The specific approach depends on the person's health, mobility and setting, so it's best to ask a licensed provider what fits your situation. A wound care specialist may help assess risk and discuss options.
What are the first signs of a bed sore?
Early signs often include skin that looks red or discolored, feels warm, firm or painful, or does not return to its usual color after pressure is relieved. Skin changes can look different on darker skin tones, so a clinician can help you know what to watch for. Any new or changing area should be looked at by a licensed provider.
Who is most at risk for bed sores?
People who have limited mobility, spend long periods in a bed or chair, or have reduced sensation are commonly described as higher risk. Other factors, such as nutrition, moisture and certain medical conditions, may also play a role. A provider can evaluate individual risk.
Where do bed sores usually form?
They most often form over bony areas, such as the tailbone, hips, heels, elbows and shoulder blades. These spots have less cushioning, so pressure may affect the tissue more easily. A caregiver or clinician can show you which areas to check.
Can a wound care specialist help prevent bed sores?
Yes, a wound care specialist may help by assessing risk, examining the skin, and discussing prevention strategies and equipment with you and your care team. Outcomes can't be promised and depend on the individual. Ask about your risk, what to look for, and insurance coverage.
When should I see a doctor about a bed sore?
See a licensed provider any time you notice a new sore, broken skin, or a skin change that isn't improving. Seek care promptly for signs of infection such as spreading redness, pus, foul odor, increasing pain or warmth, fever or chills. For heavy bleeding, exposed bone or tendon, or signs of sepsis, call 911 or go to the ER.
Educational resource. WoundKare shares general information and connects people with independent wound care specialists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.