Sexual Health Q&A

Which sex positions are best for people with low back pain?

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.