At a glance
Sitting with a perianal abscess is one of the most immediately miserable aspects of the condition. The abscess is in exactly the area that bears weight when you sit. Until it is drained, sitting may be nearly impossible. After drainage, sitting gradually becomes more comfortable, but strategies for the interim period are essential.
Before drainage
Before an abscess is drained, sitting is often the most painful position. People describe:
- Being unable to sit on a normal chair at all
- Standing, lying, or side-sitting as the only tolerable positions
- Car journeys being excruciating
- Work being impossible if it requires sitting
Strategies before drainage
- Stand or lie down whenever possible
- If you must sit, lean to one side — keeping pressure off the abscess
- A cushion helps slightly but may not be enough when the abscess is at its worst
- Ice packs wrapped in cloth on the area can reduce swelling temporarily
- Seek drainage as soon as possible — this is the only real solution to the sitting pain
After drainage
Sitting comfort improves significantly once the abscess is drained. The pressure is released, and although the wound is tender, the constant throbbing is gone.
The first week after drainage
- A coccyx cushion (U-shaped) is the most commonly recommended option — takes pressure off the wound area
- Avoid hard surfaces — add a cushion to every chair you use
- Limit sitting duration — stand up every 20 to 30 minutes
- Choose a position that minimises pressure on the wound — slightly forward lean works for some people
- Car journeys — use a cushion and plan regular stops
The first two to four weeks
- Sitting becomes progressively more comfortable
- The cushion remains helpful for longer periods
- Most people can sit normally for short periods by week two
- Full comfort returns as the wound heals — typically two to four weeks for smaller abscesses, longer for larger ones
Cushion options
Coccyx cushion (U-shaped)
- The most commonly recommended type
- Has a cutout at the back that takes pressure off the coccyx and perineum
- Distributes weight to the thighs
- Available in memory foam or standard foam
- Portable versions available for travel and work
Ring (donut) cushion
- An alternative for some people
- Takes pressure off the central area
- Some people find it less stable to sit on
- Can increase pressure on the sides of the perineum if not positioned correctly
Folded towel
- A simple option when a cushion is not available
- Fold a towel into a thick pad and sit on it
- Less effective than a purpose-made cushion but better than a hard surface
At work
- Bring your cushion — there is no getting around this
- Request a standing desk option if available
- Take regular breaks to stand and move
- If your job requires driving, keep a cushion in the car
- If the abscess has not been drained yet, you may need to take sick leave — sitting through a work day is often not possible
At home
- Keep cushions on your most-used chairs
- Lying on your side is often the most comfortable position for extended rest
- When watching television or reading, a side-lying position with cushions for support is commonly described as the best option
- Avoid sitting on the toilet longer than necessary — the toilet seat shape can put pressure on the area