Sex position from back


3 of the best sex positions if you have lower back pain

  • To alleviate lower back pain during sex, there are certain positions that are better than others.
  • Try missionary, “doggy-style,” or “spooning” to ensure you have minimal pain.
  • Try using pillows for extra support and communicate with your partner about what feels good and what doesn’t.

Lower back pain affects eight out of 10 people at some point in their lives, according to the American Chiropractic Association. Chronic back pain can include a dull ache or a stabbing or shooting sensation and can impact a person’s lifestyle, work, and sex life negatively, according to WebMD.

But just because you have back pain doesn’t mean you shouldn’t enjoy sex. Using a study conducted at the University of Waterloo, INSIDER was able to find the best sex positions for lower back pain.

This study was conducted with heterosexual couples, but this article is aimed to be as gender inclusive as possible.

If in severe pain, please consult a physician, chiropractor, or physical therapist.

“Spooning” is the most common position for those in pain

Widely deemed as the least distressing position for those in pain, spooning can be a relief. Lying side-by-side facing the same direction is especially recommended for women. According to the study, this applies to those with “flexion-motion intolerance” — a pain when they bend over to touch their toes or sit for long periods of time.

Classic missionary style is great for those who have trouble arching their backs

Simple missionary can be valuable to anyone. For this position to be comfortable, Natalie Sidokewicz at the University of Waterloo said the hips and knees, rather than the spine, should be the real controllers of movement. A cushion can also be placed under the curvature of the spine of the person face-up.

“Doggy-style” intercourse can be helpful because there’s no bending or weight supporting

Men suffering from the same sort of stiffness that spooning reduces will benefit from having sex while standing up and approaching their partner from behind. This does not crunch the back in any way, according to the same study. The partner supporting themselves in a tabletop position on an elevated surface like a bed may benefit from using their hands. This squared position does not cause any arching in the back. Sliding down to the elbows could have a painful effect.

Using pillows and cushions is widely recommended

For any position where there is discomfort, adding a pillow or cushion might be the answer. Just as it can be helpful to sleep with pillows, it can be just as helpful to use them to make sex more comfortable. WebMD suggests sleeping with a pillow between or underneath your legs for extra support. The same can be done during sex.

You shouldn’t discount other intimate activities, such as taking a bath together, as a way to lessen back pain. Communication during sex is the number one way to make it a comfortable and enjoyable experience for all parties involved.

Visit INSIDER’s homepage for more.

Best and Worst Sex Positions for Back Pain

Back pain isn’t just one of the most common reasons for skipping work. It can also affect your sex life. But new guidelines based on how the spine moves during intercourse could help.

Back pain affects 8 out of 10 people at some point in their lives, and low back pain is the leading cause of disability globally. Regarding sex, doctors used to recommend the spooning position for people with back pain, despite a lack of scientific evidence to support it. Also, a sex position that’s appropriate for one type of pain, might not work for another type of pain.

Now researchers from the University of Waterloo in Canada have developed guidelines to avoid back pain during sex for men who don’t have a preexisting back or hip condition.

“Our analysis of spine motion during intercourse shows that, in fact, the recommended positions for men depend on what movements trigger their pain,” says Natalie Sidorkewicz, a PhD candidate at the University of Waterloo and lead author on the paper published today in the journal Spine.

RELATED: 4 Proven Ways to Stop Low Back Pain

The researchers tracked how 10 couples’ spines moved in five common sex positions. Using both infrared and electromagnetic motion capture systems, they measured how the men’s spine moved during sex, and created guidelines for best positions and techniques based on what movements cause pain.

Based on range of motion, researchers identified the best and worst sex positions for men. Here’s what they found:

• Sexual Position: mQUAD1, a variation of doggy style. In this variation, the woman is supporting her upper body with her elbows.

Sidorkewicz says flexion-intolerant men – meaning men whose back pain becomes worse when they touch their toes or sit for a long period of time – will likely be much more comfortable using this position.

• Sexual Position: mQUAD2, a variation of doggy style. In this variation, the woman is supporting her upper body with her hands.

The study showed that this position, in addition to the mQUAD1 variation, is considered to be easier on the spine for flexion-intolerant men.

• Sexual Position: mMISS1, a variation of missionary style. In this variation, the man is supporting his upper body with his hands and the woman has her hips and knees slightly flexed.

Along with mQUAD1 and mQUAD2, this position is considered a “spine-sparing” approach, meaning it won’t exacerbate pain caused by motion and/or posture.

• Sexual Position: mMISS2, a variation of missionary style. In this variation, the male is supporting his elbows and the woman is more flexed at the hips and the knees.

This may not be the best position for men experiencing flexion-intolerant pain. However, for extension-intolerant men – meaning men who feel pain when they arch their back – this may be a comfortable position.

• Sexual Position: mSIDE, also known as spooning or sidelying. In this position, the woman and man are both lying on their left sides, and the man is behind her. Both people have their hips and knees flexed.

Researchers found that this position isn’t very easy on the spine, and is the least recommended position for men experiencing flexion-intolerant pain. However, it’s a comfortable option for extension-intolerant men.

“Men who are extension-intolerant, or those who experience pain when arching their backs, will find sex in the spooning or missionary position more comfortable, especially when supporting his upper body with his elbows in missionary,” says Sidorkewicz.

Future Research for Women With Pain

Although this study focuses on sex positions for men with back pain, the researchers said results for female pain patients should be published in the next few months.

“The findings revealed that if women have back pain when they touch their toes or sit for long periods of time, they should use positions that use minimal spine flexion, like spooning and doggy-style while propping themselves up at the hands,” says Sidorkewicz. “If women have back pain when they arch their backs, they should use positions that use minimal spine extension, like missionary.”

The researchers will look to include patients with hip pain and other types of back pain to further develop the guidelines.

Low back pain can make sex a challenge. Motions like thrusting or supporting one’s weight can trigger pain that makes it difficult to continue intimacy. Many couples have sex less frequently, which can lead to anxiety, depression, and strained relationships.

Considering sexual positions in light of back pain may help, however. In 2015, a team of Canadian researchers from the University of Waterloo published a study that identified which sex positions might be more comfortable for people with back pain.

Their results are based on data from ten heterosexual couples who had intercourse in a laboratory while wearing special devices that tracked their spine movements.

The researchers found that comfortable positions depended on the type of back pain and gender.

• Flexion-motion intolerant people have pain when they try to touch their toes or sit for long periods.

For men in this group, the researchers recommended “doggy-style” sex, in which one partner is on hands and knees while the other penetrates from behind. This position may be comfortable for flexion-motion intolerant women as well, as long as they support their body with their hands, not their elbows.

“Spooning” – lying side-by-side facing in the same direction – may also be less painful for women in this group.

• Extension-motion intolerant people feel pain when arching their backs.

Doggy-style and missionary (man-on-top, using elbows to support the body) positions seem to be best for men in this group, the researchers suggested. The missionary position may be better for extension-motion intolerant women as well.

Other ways to make sex more comfortable include:

• Taking a hot bath or shower before sexual activity.
• Taking a pain reliever beforehand.
• Moving with the hips and knees, not the spine.
• Placing a cushion, like a rolled-up towel or a pillow, under the back.
• Putting an ice pack on the back after sex.

Good communication between partners is also important. If a particular position or activity hurts one partner, the other should know. Couples should also be open to trying new techniques. A physician or sex therapist can suggest helpful strategies.

Sex – it does the body good.

Yet most of us are quicker to hit the gym before hitting the sheets when it comes to taking care of ourselves. Believe it or not, huffing and puffing your way through a hot, sweat-inducing sex session may be far more beneficial to your overall health than the time you spend on the treadmill.

As research confirms time and time again, good sex in a healthy, stable, monogamous relationship can only better our physical, mental, emotional and spiritual well being. Sex, in this context, offers us tons of benefits, most of which aren’t touted nearly enough.

Here are just a few benefits:

— Weight loss and weight control. Forget torturing yourself with the latest fad diet or hours on the elliptical machine when you can burn about 200 calories in 30 minutes of sex! Lovemaking lends itself to improved strength, flexibility, muscle tone, and cardiovascular conditioning. Plus, there’s something super sexy about getting to sleep with your very own “personal trainer.”

— Pain management. Forgo popping a pain killer and opt for something a bit more “au naturel.” Sex has been shown to offer migraine and menstrual cramp relief, as well as alleviate chronic back pain thanks to the endorphins and corticosteroids released during sexual arousal and orgasm.

— Stress relief. Sex, even if only with ourselves, impacts the way we respond to stress, increasing levels of oxytocin and stimulating feelings of warmth and relaxation. What better way to unwind from a tough day than sharing its most climactic moment with your special someone?

— Immune booster. Stop spending late nights at the office. Sex wards off colds and the flu. And sexually active people take fewer sick days, giving the phrase “working late” an entirely new meaning. Bosses, take note.

— Better heart health. A little bit of heart and soul in the sack should be part of every doctor’s orders when it comes to cardiovascular care. Sex may help lower cholesterol and the risk of heart attack.

— Increased self-esteem and intimacy. When sex is consistent and involves mutual pleasure, it can increase bonding since the surge in oxytocin at orgasm stimulates feelings of affection, intimacy, and closeness. When spiritual in nature, sex can lead to an even better quality of life and stronger relationship. Is it any wonder that good sexual energy in a positive relationship can make you feel better about yourself, your partner, and life in general?

— Sleep enhancement. There’s no need to count sheep when sex, including masturbation, helps insomnia. Plus, making love sure beats tossing and turning your way to zzzz’s.

— A better, younger looking you. Sex keeps you looking and feeling younger and, according to some research, may lead to shiny hair, a glowing complexion and bright eyes. This is because it increases the youth-promoting hormone DHEA (dehydroepiandrostone). And feeling more attractive charges your sex life even more.

— Mood lifter. Sex releases pleasure-inducing endorphins during arousal and climax that can relieve depression and anxiety, and increase vibrancy.

— Longevity. There is a significant relationship between frequency of orgasm and risk of death, especially with men. Men who orgasm two times a week have a 50 percent lower chance of mortality than those who climax one time per month. The bonus: Living longer also gives you and your honey the opportunity for even more lovin’!

— Decreased risk of breast cancer. One study of women who had never given birth found that an increased frequency of sexual intercourse was correlated with a decrease in the incidence of breast cancer.

— Reproductive health benefits. According to at least one study, sex appears to decrease a man’s risk of prostate cancer, and the prevention of endometriosis in women. It also promotes fertility in women by regulating menstrual patterns.

In a nutshell, the health benefits of sex in a good, solid relationship are practically endless. Yet, in planning our New Year’s resolutions, how many of us are declaring, “I think I’ll have more sex with my lover” in fulfilling any 2008 health and self-improvement goals?

While exercise on a regular basis is important to your health, sex can do so much more for you and your relationship. So before signing any dotted line for a new gym membership, consider how time allotted to an athletic club could be far more effective in your boudoir.

You can get a lot more bang for your buck in the bedroom, double your “membership” benefits, and, with sex breeding the desire for more sex, thanks to a boost in testosterone, it’s a workout plan you’re likelier to stick to.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Does sex give you a backache? When to choose missionary position or doggy style to avoid back pain

Science based recommendations and how therapy can help you

Does sex give you a backache?
Do you avoid sex due to your low back pain?

If you are thinking “YES,” you are not alone. In a study by Bahouq et al. in 2013, 81% of clients with low back pain reported sexual problems and 66% of those clients reported never bringing the subject up with their doctor. As we all know, sex is an important activity for many. Today’s post will shine a light on the latest science based recommendations sex positions for those with low back pain and how the therapists at Femina PT can help.

Science Based Sex Positions

In the 2014 study “Male Spine Motion During Coitus, Implications for the Low Back Pain Patient” and the 2015 study “Documenting Female Spine Motion During Coitus With Commentary on the Implications for the Low Back Pain Patient” Sidorkewicz and McGill used infrared cameras and electrodes to biomechanically test five common sex positions to analyze the strain they put on the spine. This was the first investigation of its kind.

Their investigation revealed that sex positions are not one size fit all – it depends on the type of back pain you have. Some people get backaches with spinal flexion (like the position bending over to tie your shoe or bending forward), while others become more aggravated with spinal extension (leaning backward or arching). Layered on top of this, some people experience more back pain with excessive movement, while others do not. Various sex positions can decrease or increase these types of movements, aggravating or allowing pain-free movement.

The study suggests that when receiving penetration, extension-intolerant people (pain made worse with arching) try the missionary position. Adding a low-back support, such as a pillow, can also help keep the spine in a more neutral position. For those receiving penetration who are flexion-intolerant (bending forward), the findings suggest trying spooning or doggy-style with the receiver supporting their upper body with their hands.

For those giving penetration, the atlas recommends that those who are extension-intolerant try missionary on elbows or spooning. For those giving penetration who are flexion-intolerant, try doggy style with the receiver supporting their upper body on their hands. Additionally, the study recommends a hip-hinging motion rather than thrusting when penetrating, to conserve spinal movement.

Some examples of recommended sex positions based on types of low back pain are highlighted in the figure at the bottom of this article:

Is this too much information? Not sure what kind of back pain you have? Have other issues like wrist, pelvic, or shoulder girdle pain that would make these positions difficult? The therapists at Fusion Wellness and Femina PT are trained and ready to help you.

How Can Therapy Help?

A pelvic health occupational or physical therapist with the skills to help you troubleshoot the mechanics of your favorite activities (including sex) can provide great insight into your pain, with a thorough assessment and evaluation of your current range of motion, muscle strength, posture, and body movement. We also welcome partners to sessions to make therapy client centered and tailored to your needs.

In the treatment of low back pain, you can expect a variety of modalities such as manual therapy, therapeutic exercise to gain muscular strength and length, and functional movement training to help you get back to your beloved activities (including sex) without pain!

The physical and occupational therapists at Femina PT are well equipped and ready to help, contact us today.

***This information is for educational purposes only and is not intended to replace the advice of your doctor.***


The mouth-opening, screaming, and kicking some people experience during sex are sadly not tell-tale signs of a body-shaking and bed-rattling orgasm, but of excruciating back pain. The bouts of this physically debilitating pain may cause their sex life to take a back seat to their health, often forcing couples to remain celibate to prevent months of back agony. Luckily, science has got your back and suggests doggy style and missionary, not spooning, are the best spine-sparing sex positions, according to a study forthcoming in the journal Spine.

Spooning has been the popular go-to sex position for back pain patients who wish to avoid added pressure to the spine. “pooning was often recommended by physicians as the one position that fit all. But as we’ve discovered, that is not the case,” said Natalie Sidorkewicz, lead author of the study, and a Ph.D. candidate at the University of Waterloo, in the press release. “Sex positions that are suitable for one type of back pain aren’t appropriate for another kind of pain.”

Before this study, physicians and chiropractors recommended spooning as the one sex position to alleviate back pain. However, this had no hard science base, and failed to recognize the other triggers for back pain. While someone may find relief in one position, the other person with back pain may not.

In an effort to document the way the spine moves during sex and discover what and why certain positions are better than others when it comes to back pain, Sidorkewicz and her colleagues recruited 10 heterosexual couples, with an average age of 30, to have sexual intercourse in a controled laboratory setting. The couples were given pictures of five different sex positions, including spooning and variations on missionary and doggy style positions, to perform. The participants were outfitted with infrared and electromagnetic motion capture systems, similar to those used in the creation of video games, to model the spine angles used during the five different sexual positions. The researchers also observed how hard muscles worked during sex, and which muscles were affected by orgasm.

The findings revealed there is a solid science that exists to guide clinicians on their recommendations for patients who suffer from back pain but still want to be sexually active. Since both men and women use a lot of spinal motion during sex, the researchers recommend the individual who’s controling the movement to use more of their hips and knees, rather than their spine. Missionary, and rear entry quadrupled, more commonly known as doggy style, are found to be the ideal spine-sparing positions.

“A great example of both of these recommendations is the missionary (position),” said Sidorkewicz, advising that a woman lying on her back place a cushion or other support under the curvature of her spine, CBC reported. The kneeling behind one’s partner during intercourse can also help alleviate back pain caused by flexion in both partners. Those who are flexion-intolerant, meaning those whose back pain is made worse by touching their toes or sitting for long periods of time, should also replace spooning with doggy style sex.

The findings of this study help provide a resource for a chiropractor, physiotherapist, or a physician, to refer to for lower back patients. Currently, any recommendations that are out there are not based on scientific data. “So we are now providing that to help guide those clinicians to make better recommendations for those patients. So the idea is to improve the quality of life of these couples by helping them maintain more of a healthy sexual relationship,” Sidorkewicz said.

Although this study solely focused on how a man’s spine and muscles move during intercourse and orgasm, the researchers also gathered data on female participants, which is set to publish later this year, or earlier next year, The Independent reported. The researchers plan to expand on this research and also focus on people with existing back and/or hip pain to test the effectiveness of their initial recommendations. This will not only help patients but also get a doctor-patient dialogue going, which “has the potential to improve quality of life — and love-life — for many couples.”

Doctors now have scientific evidence to make recommendations related to back pain for their patients. According to the American Chiropractic Association, 31 million people in the U.S. experience lower back pain. This is the single leading cause of disability worldwide.

Source: Sidorkewicz N. Male Spine Motion during Coitus: Implications for the low back pain patient. Spine. 2014.

Back Pain and Sex: Safe Sex Positions for Your Back Pain

For lots of people, “sex” is an uncomfortable subject. Add back pain into the mix and it can feel like a totally off-limits discussion to have with a partner or your care team. It’s not uncommon for those with chronic pain to feel ashamed, have a lower sex drive, and fear making their pain worse or triggering a flare-up by engaging in sex.

However, it’s important to know that with a little patience, education, and some minor adjusting, a healthy sex life with back pain is possible.

In this article, we want to help build a bridge between “sex” and “back pain”. Read on as we share tips on how to have safer and better sex, and reveal the best sex positions for your back pain type.

During orgasm, your body releases oxytocin. Oxytocin is a hormone and neurotransmitter that is proven to alleviate pain, anxiety, depression and more. The best part: oxytocin is 100% natural and 100% free!

Back Pain and Sex: A Brief Q&A

Ah, don’t you just love the internet? With the anonymity of the interwebs, you can learn a little bit and hopefully regain enough confidence to engage in sex or at least talk to your physician. Before we breakdown specific back pain types and favourable sex positions, let’s answer three common questions about ‘back pain and sex’.

Q: Is having sex with back pain dangerous?

As you know, back pain is very complicated. Of course, like any activity that involves physical exertion, if you’re not engaging in sex positions that are safe for your back pain type or injury, you can cause more pain. Causing more pain or adding strain can be dangerous.

Above following the “rules” for your back pain type and pre-sex tips for safer sex, it’s really a matter of letting your pain levels be your guide. If certain positions hurt, don’t do them. If you are experiencing pain during sex, stop while you’re ahead. Overdoing it by pushing through pain will likely lead to a longer recovery, spasms, a flare-up etc.

Q: Are there sex positions that I should avoid?

Yes. Again, let pain and common sense be your guide. In saying this, we will detail positions that are generally safe for men and women with different pain types. For example, if you are a woman who is extension-intolerant, spooning or side sex may be unsafe. If you are a man who is extension-intolerant, doggy style may not be comfortable or safe for you.

Continue reading as we detail tips on making positions more comfortable and safe positions for you.

Q: Will my sex life improve if I have back surgery?

Great question! First off, there are pros and cons and varying degrees of effectiveness when it comes to spine surgery. Some spine surgery types, like a decompression surgery with a visible structural issue (like a herniated disc or scoliosis) are highly successful for treating chronic pain. Other back surgeries, where a structural issue is not visible may be less successful at treating pain.

Curious about back/ spine surgery? We asked a top orthopedic spine surgeon, who will back surgery help the most?

Some studies show a positive correlation between back surgery, like a spinal decompression or spinal fusion, and pain relief during sex. An study published in Spine, looked at patients undergoing surgery and non-operative treatments for spinal stenosis and degenerative spondylolisthesis. The study found that 71% of patients interviewed said that “sex life was relevant” to them. 39% of all patients interviewed reported having pain associated with their sex life. Four years after surgery, “the three operative groups had a lower percentage of patients reporting pain with their sex life compared to the non-operative group.” In short, in this study, those that had surgery to help with back pain also had improved sex after surgery.

The study concluded that, “sexual function is generally improved postoperatively when compared to preoperative function”.

Tips to Having Safer, Better, Less Painful Sex

Although it may seem less romantic and lack some spontaneity, the more you get ready for sex and follow these tips, the better.

Tips Before/ After Sex to Reduce Back Pain:
  1. Take a pain reliever: Take a non-narcotic pain reliever if you’re feeling back pain prior to sex. Avoid narcotic painkillers like opioids. Take the recommended dose of NSAIDs like Aspirin, Aleve, Advil, Motrin, or your preferred over-the-counter nonsteroidal anti-inflammatory drugs.

  2. Take a warm bath/ shower: A hot water soak will loosen up muscles and actually reduce your likelihood for muscle spasm and tightness.

  3. Stretch: This might seem a little over-the-top, but just like you’d stretch before a game of tennis or a run, you want to loosen up your muscles and encourage flexibility before sex. Here are some exercises for back pain that you can run through at home to treat and prevent a flare-up.

  4. Ice, ice, baby! If you feel some tension in your back after sex, be sure to ice the affected area. Icing reduces inflammation (which is a leading cause of pain). Ice for just 15-20 minutes at a time and do not apply the ice directly (wrap in a tea towel, t-shirt etc.).

  5. Talk to your partner! There needn’t be any shame in your game. By being open and honest about your back pain, you will both have a more fun and relaxing encounter.

  6. Avoid Morning Sex? If you have disc problems, your back will stretch out throughout the day and alleviate some of your disc compression. Having sex after you’ve moved around a bit may be less painful for those with some back conditions.

Tips During Sex to Support Your Back:
  • Let your partner do the work! If your partner does not have back pain, let them assume the “top” position. For men with pain, let your partner go into the reverse missionary position. For women with pain, standard missionary may be best. The more that you can lay with a neutral back, the better.

  • Small posture corrections for the win! By flexing your abs, neutralizing your spine, and making slight adjustments, you will notice that you’re less susceptible to pain during “the act”.

  • Keep your back locked/ neutral. Avoid flexing or extending your back too much. This is especially true if you are motion intolerant.

  • Use pillows for support. For certain positions, like laying down in missionary, towels or pillows under your lower back or under the knees will reduce pressure on your back.

  • Play it safe. Stick to positions that do not over-extend or over-flex you back. Relieve pressure from your back by using your hips and stop immediately if your pain increases.

Sex Positions for Your Back Pain Type

For many obvious reasons, it’s important to know what triggers your back pain or causes your flare-ups. Knowing your back pain type is also important for comfortable sex. In a nutshell, when it comes to sex, you’ll want to know if you are flexion-intolerant or extension-intolerant.

  • Flexion Intolerant: This type of pain commonly affects those that lean forward too much (whether in front of computer for work or caused by jobs that require a lot of bending forward. This means that pain is worsened with forward bending (like picking something up, prolonged sitting etc.).

  • Extension Intolerant: This type of pain is brought on by too much arch in the back. As a result, pain is worsened with backward bending (like lying on stomach and pushing up).

  • Motion Intolerant: This type of pain is harder to pin down, but essentially, pain is triggered when the spine moves away from its neutral position. In this case, laying down can hurt, standing up straight etc.

Safe Sex Positions

Flexion Intolerant Extension Intolerant Motion Intolerant
Women Side/ SpooningKneeling/ Doggy Style Missionary Missionary
Men Doggy style (partner on knees) Side/ Spooning Squating
Missionary (with elbows for support) Reverse Missionary (partner on top) Reverse Missionary (partner on top)
Reverse Missionary (partner on top)

Unsafe Sex Positions

Flexion Intolerant Extension Intolerant Motion Intolerant
Women Missionary Doggy style Doggy style
Side/ Spooning Missionary (knees up)
Men Side/spooning Doggy

Our hope is that you’re feeling more confident about regaining control over your sex life. There are many health benefits to having fulfilling sex and back pain shouldn’t have to stop you!

Are you experiencing back pain? Join now, and be the first to get helpful articles to your inbox. While you’re at it, join our supportive FB group for back pain!

I Had Surgery: Is It Too Soon for Sex?

Question: I recently had spinal surgery to relieve pain from sciatica. How long should I wait to have sex? When I am able, are there any special precautions I should take?
— Gardiner, MESexual relations following back surgery can present physical and emotional challenges. Photo Source: Both of your questions are important because a lot of people share your concerns. In fact, a 2008 SpineUniverse survey about sex and back pain found that 72% of sexually active adults had sex less frequently than before their back pain began.

Sex is a vital component to the health of any romantic relationship. And back pain certainly has the ability to make it a less than satisfying experience.

Besides the obvious physical hurdles, back pain takes a psychological toll that can erase the desire for sex. Those two obstacles often place sex at the very bottom of many back pain sufferers’ to-do lists.

Fortunately for you, it sounds like your recent back surgery hasn’t prevented sex from being a priority. So how long should you wait to have sex after surgery? Well, that depends on the specific type of surgery you had and the recommendations of your doctor. But generally, most doctors will say you can begin having sex again when you feel ready.

Naturally, getting to the point where you feel comfortable is completely unique to the patient. Surgery—even when it’s minimally invasive—is exhausting to go through. Some people may take 3 months before sex is an option, while others might need 6 weeks. It’s completely varied.

But when you do feel comfortable, there are some special considerations you should take into account to protect your back—and your post-surgical sex life.

When it comes to sex after surgery, positioning is essential. You need to find positions that won’t put unnecessary strain on your back muscles. Taking a passive, gentle approach to sex is really the best way to start—this approach will best prevent painful back strains. Sharp movements, such as bending forward or arching your back, can increase your pain, depending on your condition.

To learn more about specific positions that are ideal for back pain sufferers, read this article about sex and back pain.

Placing pillows under your legs or rolling a small towel your low back will also add support. You also might also want to try lying on a firm surface, instead of soft mattress, to support your back. But understand that what’s comfortable for you may be different than what’s comfortable for someone else. If you find firmer surfaces painful, then don’t use them. What’s most important is your comfort.

If you’re ready to begin having sex again after back surgery, you’ve already won part of the psychological battle. Of course, never underestimate the importance of communicating your fears and concerns with your partner. Together, you can start slow and work gradually toward an activity level that you can tolerate. Experiment with positioning that supports your back to discover what works best for you. Keeping your back health in mind may not be the sexiest notion, but it will help you enjoy a happy, healthy post-surgical sex life.

Continue Reading … FAQs About Sciatica, Low Back and Leg Pain

When can I have Sex after back surgery?

By Staff Writer July 10, 2013 Discectomy, endoscopic spine surgery, laser surgery, Pain, Sciatica, Sex, Spinal fusion, Surgery, Treatment Options for Back Pain

Patients often ask when they can safely have sex after back surgery. This is a common concern for the patient and for their significant other.

Often their sex life has already been affected. Back pain may interfere with intimacy, decrease sex drive (libido) and interfere with sexual enjoyment. Patients with pelvic numbness or nerve dysfunction may feel less stimulation and pleasure or have difficulties developing or sustaining an erection or orgasm. Even worse, sex might aggravate the back injury, causing a great deal of pain and ultimately making sex unpleasant and unwanted. Back pain can also lead to depression or be associated with depression, another factor that can affect your sex life.

No wonder people are concerned!

I am happy to tell you that sex is safe after back surgery. For patients undergoing traditional back surgery, doctors commonly recommended waiting 6 to 12 weeks before resuming sexual activity. These operations involved a large midline incision, muscle retraction and bone resection, and patients suffered intense pain from muscle damage. These surgeries are very different from today’s advanced endoscopic spinal surgery. Endoscopic surgery is done through a tiny incision the size of your finger nail, using a little high definition video camera the size of a pen! There is minimal skin, muscle and bone damage. Most people recover in a few weeks and the incision is small and less likely to be torn open.

The great advancements that have been made in minimally invasive back surgery means that patients treated endoscopically can start having sex again after only 2 weeks if their incision is healing well, their pain has resolved or significantly improved, and their sex drive has returned. The healing time will increase for other more invasive surgeries or surgeries involving spinal instrumentation. As with all activity, the patient should approach sex in a safe, gentle manner and take on a passive role. The patient should avoid heavy lifting, bending and twisting. They should stop if pain develops. As an old colleague of mine told his patients, “No shaking the trailer!”

They may benefit from small pillow under their low back, stacked pillows under their knees to bend the hips and support the legs, and taking a well-supported position. They may also benefit from taking pain medication prior to sex. Their partner should avoid putting their full weight on them. The patient may have less pain starting with missionary position, lying down on their side or standing and bending over a chair.

Since all patients and surgeries are different, you should discuss your return to sexual activity with your doctor. Though you might feel awkward bringing it up, don’t worry. It’s a very normal, healthy concern.

8 Reasons You Might Be Feeling Pain After Sex

g-stockstudio/Getty Images

In ~fantasy land~, sex is all orgasmic pleasure (and none of the consequences!) while post-sex is all cuddles and afterglow. But for many people with vaginas, pain after sex and general discomfort are surprisingly (and unfortunately) common.

“More than one-third of people will vulvas will experience pain after penetrative sex at some point in their lifetime,” says Kiana Reeves, a Somatic sex expert and sex and community educator with Foria Awaken, a company that creates products intended to reduce pain and increase pleasure during sex. (Pssst: They make a pretty awesome lube/arousal oil that has weed in it.)

“So, so many many many people come to see me for that reason,” agrees Erin Carey, M.D., a gynecologist who specializes in pelvic pain and sexual health at the UNC School of Medicine.

There’s a surprising variety of possible reasons for having pain after sex. “But while there are many potential causes for painful intercourse, most of them can be remedied with treatment,” says Reeves. Phew.

In order to resolve the pain, first, you have to understand the underlying cause. Here, experts break down the most common reasons you might experience pain after sex. (If any of these symptoms sound familiar, call your doc.)

1. You need a better warm-up routine.

During sex, it should never feel like you’re trying to fit a square peg into a round hole. “Women can fit a 10 cm baby head through the vaginal canal without it tearing; it’s pretty elastic,” says Steven A. Rabin, M.D., FACOG with Advanced Gynecology Solutions, Inc in Burbank, California. For the vagina to become elastic, though, you need to be turned on. “It’s part of the female sexual response,” he explains.

If your body isn’t adequately primed for sex, penetration might not be possible at all, or the over-tightness can lead to too much friction during sex, causing micro-tears in the vaginal wall. In this case, you might feel “a stingy, raw sensation internally” during sex, says Reeves.

Then, if the inside surface of your vagina feels raw or sore and in pain after sex, you may just need more foreplay and/or lube before attempting penetration. Instead of doing trial and error, Reeves suggests touching the labia pre-insertion. The firmer it feels to the touch, the more turned on you are. (Related: What Happens When You’re Really Turned On)

It’s worth noting that some women can only tolerate penetration after an orgasm because then the muscles are more relaxed and your body is more primed for entry, explains Dr. Carey. “Other women could have a high-tone pelvic floor and may need to learn how to relax the vagina before penetration,” she says. Consider seeing a pelvic floor therapist who can give you exercises that will train those muscles to relax enough in order for penetration to 1) happen at all 2) happen without the excessive friction or pain mentioned above, she says.

Another possibility is chronic vaginal dryness, says Dr. Carey. If extra foreplay isn’t helping, check with your doc. (See more: 6 Common Culprits of Vaginal Dryness).

2. You have BV, a yeast infection, or a UTI.

“These three issues can cause sexually active individuals a great deal of pain around sex and often unwarranted worry,” says Rob Huizenga, M.D. an LA-based celebrity physician, sexual health expert, and author of Sex, Lies & STDs. While they’re all super common, the pain that each causes during and after sex is a little bit different.

Bacterial Vaginosis (BV): When BV (an overgrowth of bacteria in the vagina) is symptomatic, it usually comes with a strong, fishy odor and thin, discolored discharge. Again, you may not ever want to have sex when your vagina smells off, but if you do… ouch! “It’s going to cause inflammation to the vaginal mucosa, which is going to get further irritated from sex,” explains Dr. Carey. “Any irritation in the pelvis can also cause the pelvic floor muscles to spasm in response.” These spams can create a throbbing or pulsating sensation that’s uncomfortable and leaves you with pelvic pain after sex. Fortunately, BV can be cleared up with a prescription from your doctor.

Yeast Infection: Caused by the candida fungus, yeast infections often present with “cottage cheese” discharge, itching around the pubic area, and generalized soreness in and around your nether-bits. Basically, sex and yeast infections are about as compatible as Ariana Grande and Pete Davidson. So, if you find yourself doing the dirty when you have one, it’s probably going to be uncomfortable. “Because yeast infections cause the localized tissue in the vagina to become inflamed,” explains Dr. Carey. Combine the friction of penetration with the preexisting inflammation, and it’ll certainly exacerbate any pain or irritation. In fact, Dr. Barnes says the inflammation can be on the inside or the outside, so if your labia look redder after the fact, that’s why. Thank u, next. (Pro tip: follow this Step-By-Step Guide to Curing a Vaginal Yeast Infection before heading South.)

Urinary Tract Infection (UTI): A UTI happens when bacteria gets lodged in your urinary tract (the urethra, bladder, and kidneys). Granted, you’re probably not going to be in the mood if you have a UTI, but if the opportunity comes knocking and you chose to partake, it’s going to feel less than amazing. “The bladder lining gets irritated when you have a UTI, and because the bladder lies on the front wall of the vagina, penetrative intercourse can agitate an already irritated area,” explains Dr. Carey. “As a result, the pelvic floor muscles, (which surround the vagina and bladder), can spasm, resulting in secondary pelvic pain after sex.” Luckily, an antibiotic can clear the infection right up. (Related: Can You Have Sex with a UTI?)

3. You have an STI or PID.

Before you freak out, know that “STI’s are not known for causing pain during or after sex,” according to Heather Bartos, M.D., an ob-gyn in Cross Roads, Texas. Still, some STI’s may lead to pain after sex, especially if they go undetected and untreated for a long time.

Herpes is the STI most classically associated with pain, says Dr. Bartos. “It can present with painful genital or rectal ulcers, sores, or skin breaks that can be extremely painful and uncomfortable not only during and after sex, but also in regular life.” All experts offer the same advice: If you’re in the middle of a herpes outbreak, don’t have sex. Not only do you risk transmitting the infection to your partner, but sex can cause those external sores to open or enlarge and become even more tender until they heal. (Related: Here’s How to Get Rid of a Cold Sore In 24 Hours). Plus, since the herpes virus lives in the nerves, it also results in chronic nerve pain, says Courtney Barnes, M.D., an ob-gyn with University of Missouri Health Care in Columbia, Missouri.

Other STI’s like gonorrhea, chlamydia, mycoplasma, and trichomoniasis can also lead to pain during and after sex if they’ve developed into pelvic inflammatory disease (PID), says Dr. Huizenga. “It’s an infection of the reproductive tract and gut—specifically the uterine, tubal, ovarian, and intra-abdominal lining—that causes them to be inflamed.” A hallmark sign of PID is what doctors call the “chandelier” sign, which is when barely touching the skin above the cervix causes pain.

Sex or not, “people can actually become quite ill from this disease as it progresses; it can cause significant abdominal pain, fever, discharge, nausea/vomiting, etc. until it’s treated,” says Dr. Barnes. The solution? (Bless, there is one!) Antibiotics. (Note: Any vaginal bacteria can ascend and cause PID, not just sexually transmitted infections, so don’t jump to conclusions—unless, of course, you’re experiencing other symptoms of STIs.)

And friendly PSA: Most STI’s are asymptomatic (like these Sleeper STDs You’re at Risk For), so even if you’re not experiencing the symptoms mentioned above, don’t forget to get tested every six months, or between partners, whichever comes first.

4. You’re having an allergic reaction.

If your vagina feels irritated or raw, swollen, or itchy after intercourse (and that goes internally or externally), “it could be an allergy or sensitivity to your partner’s semen, the lubricants, or the condom or dental dam,” says Dr. Carey. Semen allergies are rare (research shows only 40,000 women in the US are allergic to their SO’s semen), but the solution here is to use a barrier to avoid exposure, she says. Makes sense. (Related: Should You Be Using Organic Condoms?).

On the other hand, according to Reeves, latex allergies and sensitivities to your lube or sex toy are pretty common. If you have a latex allergy, there are animal skin condoms or other vegan options, she says.

As for lubes and toys, if there are any ingredients you can’t pronounce, just say no! “Generally, water-based lubricants are less irritating,” says Dr. Carey. “Some women who are particularly sensitive will use natural oils such as olive oil or coconut oil as a lubricant during intercourse.” Just note that the oil in these natural options can break down the latex in condoms and make them ineffective. (Related: How to Tell If Your Sex Toys Are Toxic).

If none of these solutions appeal to you, you can visit an allergist for allergy skin testing to see what the exact allergen is, says Dr. Bartos. (Yes, they can even do this with semen, she says.)

5. You have vaginismus.

For most women and folks with vaginas, when something—be it a tampon, a speculum, finger, penis, dildo, etc.—is about to be inserted into the vagina, the muscles relax to accept the foreign object. (“Alexa, relax vaginal muscles.”) But for people with this little-known condition, the muscles aren’t able to relax. Instead, “the muscles have involuntary contractions which tighten the entry to the point where penetration is either impossible or downright painful,” explains Dr. Rabin.

Even after attempted penetration, the vagina can tighten and clench in anticipation of more pain, explains Dr. Barnes, which in itself can be painful and lead to prevailing muscular soreness, not to mention cause lasting pain after sex. (Related: The Truth About What Happens to Your Vagina if You Haven’t Had Sex in a While).

There isn’t one cause of vaginismus: “It could be caused by a soft tissue injury from sports, sexual trauma, childbirth, inflammation in the pelvic floor, infection, etc.,” explains Reeves.

It’s often thought to part psychological and physical (as most things are!). “It’s like the vagina is trying to ‘protect’ the person from further trauma,” says Dr. Bartos. That’s why she and Reeves recommend seeing a trauma-trained pelvic floor physical therapist who can work with you release these muscles and address the underlying cause, if there is one. “I suggest a hands-on sex and pelvic floor therapist, if you can find one,” says Reeves.

6. Your ovarian cysts are bugging you.

Ready to have your mind blown? Every vulva-owner of reproductive age who’s not on birth control makes an ovarian cyst during ovulation every single month, explains Dr. Carey. Woah. Then, these cysts rupture to release the egg without you ever knowing one was hanging out in there.

However, sometimes these fluid-filled sacs cause pain—specifically in the right or left side of the abdomen, where the ovaries are. (Hellooo, cramps!) According to experts, there are three main reasons why.

First, the actual rupture might cause an uncomfortable ache or abdominal pain. Second, while the fluid from the popped cyst will get reabsorbed by the body within a few days, “it can cause irritation of the pelvic peritoneum (the thin membrane that lines the abdomen and pelvis) making your vaginal canal sensitive, and intercourse painful before it’s fully absorbed,” says Dr. Carey. In both cases, you may have pain before, during, and after sex. But don’t think “well, if it’s going to hurt anyway, I might as well” because, having sex “can cause an inflammatory response in the pelvis which often leads to worse pain after sex,” she explains.

Knowledge is power here: “Every month, you’ll know that there’s a day or two where sex in a certain position might hurt,” says Dr. Rabin. “Make an adjustment and change the angle of attack.” Or, just leave sex for the other 29 days a month. (Related: This Actress Was Hospitalized for a Ruptured Ovarian Cyst).

Sometimes though, these cysts don’t rupture. Instead, “they grow and grow and become painful, especially during penetration,” explains Dr. Rabin. And, yep, they can cause pain after sex, too. “The penetration causes a blunt trauma inside you that hurts even after the fact.”

Your ob-gyn can perform an ultrasound to diagnose whether or not that’s actually what’s causing your pain. From there, “they can be monitored, or you can go on a birth control pill, ring, or patch,” he says. Occasionally, he says, they may require surgical intervention. While this news sucks and nobody likes thinking about going under the knife, think about all the pain-free sex you can have after!

7. You have endometriosis.

Chances are, thanks to Julianne Hough and Lena Dunham sharing their struggles, you’ve probably at least heard of endometriosis—if not know someone who suffers from it. ICYDK, it’s a condition where “menstrual tissue cells implant and thrive elsewhere in the body—typically in your pelvis (such as the ovaries, Fallopian tubes, intestines, bowels, or bladder),” explains Dr. Rabin. “This misplaced menstrual tissue swells and bleeds, causing an inflammatory response and sometimes scar tissue.” (See more: The Endometriosis Symptoms You Need to Know About).

Not everyone with endometriosis will experience pain during sex or pain after sex, but if you do, inflammation and/or scarring are usually the culprits. By now, you know inflammation=pain, so it shouldn’t be surprising that’s why there’s pain during and/or after sex.

But, “in some severe cases, the scarring response is extensive, and penetrative intercourse can create a sensation that the vagina, uterus, and surrounding pelvic organ are being pulled,” says Dr. Barnes. And if that’s the case, she says the pain—which could include anything from slight soreness to an internal stabby sensation or burning—can linger after sex too. Ugh.

For some patients, sex and its aftermath will only be painful around their menstrual cycle, says Dr. Carey, but for some folks, sex is painful every day of the month. “Endometriosis doesn’t currently have a cure, but the next step is to see a physician who understands the pathophysiology of the disease because medication and surgery can help manage symptoms.” (Related: How Much Period Pain Is Normal).

8. You’re going through some ~hormonal changes~.

“During menopause and right after you’ve given birth, there’s a decline in estrogen,” explains Reeves. A decrease in estrogen leads to a decrease in lubrication. ICYDK, when it comes to sex, the wetter the better. So, this lack of lube can result in less pleasant sex and pain after sex, since your vaginal canal may actually feel raw and chafed. Dr. Carey says the best fix here is a combination of lube and vaginal estrogen therapy.

The bottom line: Sex is *not* supposed to be painful, so if you’re experiencing pain after sex, talk to your doctor about it. “Figuring out the exact cause of pain after sex may take a little bit of patience because there are actually so many other possible causes of painful intercourse,” on top of those already discussed says Dr. Barnes. Some less-common reasons include lichens sclerosis (a common genital skin condition in post-menopausal women), vaginal atrophy (the thinning, drying, and inflammation of the vaginal walls that occurs when your body has less estrogen), thinning of the vaginal walls, internal scarring or adhesions, Interstitial Cystitis (a chronic bladder pain condition) or even a disruption of vaginal flora—but your doc should be able to help you figure out what’s up.

Remember though, “in most, cases treatment is available and can help make sex enjoyable again!” says Dr. Barnes.

“So many women experience pain during and after sex, but don’t know that isn’t a normal thing,” adds Reeves. “I wish I could tell everyone that sex should only be pleasurable.” So, now that you know, spread the word. (Oh, and FYI, you also shouldn’t be experiencing pain during sex, either).

  • By Gabrielle Kassel

Tips for Better Sex … even with Back Pain

Besides, doctors have heard it all and they’re ready to help. Your physicians care about all aspects of your physical and emotional well-being; they won’t judge, pity or mock you. So take a deep breath, push past the potential embarrassment, and talk to your doctor about how back pain is affecting your sex life. Often, doctors can give very useful advice. For example, even a modest change in a medication can make a world of difference for your pain.

Because sex is more than…
Sex is more than just the sum of its physical parts—it’s more than a formula of physical steps that lead to the “perfect” experience. A lot of what we see in movies and on TV these days makes sex the pinnacle of a relationship, the one thing that most clearly defines you as a couple (think Grey’s Anatomy).

But for the vast majority of people, sexual satisfaction depends on numerous factors, not just physical performance. Factors such as emotional connectedness, a bouquet of flowers sent for no reason, attentive listening, saying thank you for the little things, or sending the kids to Grandma’s for the night, can all add to sexual satisfaction.

And none of those things are limited by your back pain. You can still have a satisfying, intimate relationship—back pain or not.

WEDNESDAY, Sept. 10, 2014 (HealthDay News) — Guided by movements of couples engaged in sexual intercourse, a new report suggests that alternatives to the traditional missionary-style position can help men who have lower back pain.

The findings report that side-by-side intercourse, known as “spooning” and thought by some to be a cure-all, isn’t recommended for everyone.

Back pain during sex is a major issue for many people and there’s been little, if any, research into the best positions, the Canadian study authors pointed out.

“Up until now, clinicians have only had opinions to go on. Our objective was to set guidelines,” said the study’s lead author, Stuart McGill, director of the Spine Biomechanics Laboratory at the University of Waterloo in Ontario.

The good news is that most men with back pain can avoid triggering their pain during sex, he added.

At least one back pain expert, however, dismissed the findings, because the researchers only looked at healthy couples having intercourse. The methodology specifically excluded participants with back pain or those who had back surgery, according to the study, which was published Sept. 11 in the journal Spine.

For their study, the researchers used a “motion-capture” system to track the spinal movements of 10 men, average age 29, as they had intercourse with their female partner in five variations of three coital positions: facing each other, sideways, and from the back.

After analyzing the results, the researchers then made recommendations about sexual positions for men with back pain.

The study authors suggested that men who get back pain from flexing their spines forward should avoid the side-by-side position, use the back position and also use their hips, not their spine. For men who feel back pain when they extend their spines, it would be exactly the opposite: avoid the back position, use the side position. And men who feel back pain from simple movement of their spine should focus on using their hips, the study suggested.

McGill, who wrote the paper with graduate student Natalie Sidorkewicz, said he hoped this study and future research would produce a kind of atlas of the best and worst sexual positions for men and women with various types of body issues, even hip and knee replacements. A report about women with back pain will be released later, the study noted.

Do You have Backache? These Sex Positions Are The Best For You


  1. 73% women report discomfort while having sex due to lower back pain
  2. Putting too much stress on the spine during sex may trigger backache
  3. Try missionary position with a pillow under your hips for relief

Sex is supposed to be fun but, when your back starts hurting, the fun experience becomes hurtful. Sadly this is becoming a reason for low sex drive in people. 73% women report utter discomfort while having sex due to lower back pain. But that does not mean that you can bring your sex life to an end. A research conducted in the Waterloo University found that the spinal movement was the most important factor when it comes to comfortable sex positions for people with back issues. So, if you are putting too much stress on your back while having sex, there is a good chance that you may end up developing back issues in the future.

Photo Credit: iStock
Also read: Top 5 Sex Positions To Get Pregnant

Listed below are the best sex positions for people dealing with back issues.

1. Missionary position with a pillow under your hip

This one is like regular missionary position, you lie down on the bed with your partner entering you from between your legs but the only difference is that you keep a pillow under your hips. When you lie down and have sex, your body is not completely aligned with the surface due to its structure. This is when the pillow technique will help. It will reduce the amount of stress that goes on your back.

2. Doggy style

In this position, you get down on your hands and knees and your partner enters you from behind. Just keep your spine straight and this position will help you get rid of a backache during sex with the doggy style position.
Also read: Which Is A Safe Sex Position During Pregnancy?

3. Spooning

In this position, you and your partner lie side by side, facing towards the same direction and he enters you from behind. This one is good for women dealing with back issues. It reduces the stress that develops due to sitting for too long or any other activity. Initially, it was considered to be the ideal position for removing stress away from the back but later it was proved that this position proves effective only for certain types of a backache.

To conclude, the best position for minimizing pain and enjoying sex is using hips and knees instead of the spine while controlling motion.


About the author

Leave a Reply

Your email address will not be published. Required fields are marked *