Sex and Back Pain

Millions of people suffer with back pain. One thing that is often not discussed is the effect it has on sex lives. Every person’s condition is different. In the long run, creativity and the right positions could make your sex life easier. Back conditions can be sometimes categorized into those that do better with flexion or those that do better with extension.
Flexion (bending the spine forward) pulls on the ligaments and muscles and puts posterior pressure on the disc. Ligaments and muscles may hurt more if they are strained, bulging discs may also be injured or damaged further by flexion.
In these cases, you may do better with extension positions. Extension (bending backwards) will ease tension on the ligaments and muscle. It reduces disc stress. Missionary position would work best for a man as long as his back is extended or bent backwards more. He could sit upright in a chair, or put a pillow on his low back and lay down on his back. For a woman the facing forward position in a chair movement works well for the extension, or lying on her stomach.
Other spinal conditions find relief from flexion (especially if you have a bony lumbar stenosis, or any other conditions).
Positions incorporating flexion for a man would be “spooning” or “entering from behind” which allows him to bend his spine forward. A woman who would like to incorporate flexion into intercourse may opt for the missionary position with her knees bent up or straddling her partner bending her spine forward.
Overall, use the flexion and extension principle during sex/ sexual positions. It is important to use a firm surface with pillows or rolled up towels for support of your back. Certain positions can be avoided all together while others can be more comfortable over time with exercise.
The next thing is to communicate with your partner, which really is overall the most important. Communication is crucial; you don’t want your stress from your back pain to make your partner feel rejected leading to hurt feelings furthering each other away. Tell your partner what is going on, let them know that you have a plan and get them involved with your plan. If intercourse is too painful on the back, try something else intimate, don’t ever lose that spark!
For more information a good resource is the book, Sex and Back Pain by Lauren Andrew Hebert, P.T.

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