I use mainly for leg elevation - you can put the cushion vertically at end of bed. This has greatly improved my circulation which I was worried about due to lack of mobility/housebound. Prefer it for use as leg cushion but ok for back too - I feel I would just need another foot cushion to support me so my weight isn't being pushed onto my legs and off my back as that hurts. Very sturdy but soft, just right. Would like to see slightly narrower width cushions like this for foot use. 5 stars as foot/leg cushion, 4 stars as back cushion for above reasons.