Having sex when you have mild to chronic back pain can be uncomfortable for some—and discouraging for others. In a study
performed by the World Health Organization, 84% of people with low back pain reported increased pain during sex. Conversely, the study also provided results that shed light on the best positions for couples to engage in sexual intercourse when one partner has back pain (more on those findings shortly).
Protecting your sexual self-esteem
Because of the intimate nature of sex, when you have back pain and cannot perform, a new set of issues arises—the psychological aspects. Back pain not only decreases pleasure and frequency in which you have sex but can lower your libido entirely. For men and women, back pain that affects sexual performance can cause you to feel less masculine or feminine. It can saddle you with the guilt of being an unpleasing partner and leave you feeling depressed
. For the benefit of the relationship, it’s important that you openly communicate to your partner about the times in which your back pain is present, problematic, and sex is off the table for the evening.
Communicating with your partner
Communication is mission critical. Talk through your feelings (and explain your pain) to your partner. As someone who loves and cares for you, help them understand what reservations you may have about sex at that moment as it relates to your back pain. While you may think that simply stating your back hurts should be enough, thinking your partner knows how you feel can lead to feelings of resentment in your partner (“Are you blowing me off”) and feeling dismissed by you (“I can’t believe he/she is so insensitive”).
How to have sex when you have back pain
If after talking with your partner you wish to pursue sex, talk through the positions you feel you can safely and painlessly perform without aggravating your back. Before sex, do light stretches to warm your back muscles and take a hot shower to relax. In bed, ask your partner to massage the tender areas of your back. This can serve as foreplay for you both. Engage sexually once you’re comfortable choosing the pain-free position you have expressed to your partner.
For most men who are flexion-intolerant
, which is characterized by back pain triggered when in seated or inwardly bent positions (think child’s pose
), the WHO study states they should avoid the side-lying or spooning position featuring both partners outward-facing. This position involves a lot of lower back movement that can make back pain worse. The position best suited for flexion-intolerant men is the quadruped position with the receiving partner on their knees, posterior elevated, and their weight supported by their elbows (commonly called doggy style). Missionary position, with the male pain partner supporting himself with his hands, chest off the lower partner, is also recommended.
For those men who are extension-intolerant, characterized by back pain triggered in standing or outwardly bent positions (think baby cobra pose
), the study recommended the spooning position and the missionary position in which the partner on top is lying flat (not with an arched back) on the partner beneath them (see Figure 4).
Women with back pain
may discover that lying flat on their back can create too much pressure and produce more back pain during missionary sex. Similarly, lying flat on your stomach or seated atop your partner with him below on his back can also trigger spinal pain. For women who are extension-intolerant, lying on your back with your knees up into your chest can reduce pressure on your back and spine, as can straddling your partner on a chair. Another alternative is to use sex furniture
to provide additional cushioning to support your back and spine during sex. Pillows and wedges can be positioned to support your back while placing your hips in a comfortable position to receive from your partner.
Nonintercourse sexual gratification
Sex doesn’t have to be strictly intercourse. If your back pain prevents you from having sex with your partner, or you find every position you’ve tried to be too painful, choosing oral sex or mutual manual stimulation is another option. Talk to your partner and experiment together to find the right combination of pleasurable activities you can enjoy to meet one another’s needs.
Back pain can complicate sex and leave one or both partners disgruntled and frustrated. The best strategy for a good sex life when you have back pain is communication. Talking to your partner about how sex affects your back pain and coming up with a game plan to have sex gratifying for you both takes time. Experimenting with positions and touch can go a long way to keeping things copesetic between the sheets. In the end, you can overcome some of the physical limitations you feel and ease the mental drawbacks as you work together to create a more fulfilling bedroom.
Updated: July 30, 2021