The Extra-Firm Tush Cush is higher density cushion that is recommended for persons over 200lbs. The Tush-Cush orthopedic seat cushion is scientifically designed to relieve and prevent back pain, numb buttocks and other discomforts associated with sitting. The unique cutout section of the cushion suspends the tailbone providing comfort and relief to areas sensitive to sitting. Wedge shape tilts your pelvis forward to restore your spine's natural lumbar curve. The Tush Cush is the original design of the wedge shaped cushion with cutout. During the 22 years that we have been in business there have been many attempts to replicate our product. Often imitated, NEVER duplicated. Our cushion is made of the highest quality foam to maintain the integrity of the wedge and give you the best support possible every time you sit.