Having sex with back pain can be challenging for both partners, but it can be done. It just takes a bit of planning.
According to a recent study from the University of Waterloo, men with flexion-intolerant back pain, which increases when they bend forward or arch their spines, may benefit from sex positions that limit spinal movement such as doggy style and reverse missionary.
Doggy Style
The doggy style, also known as the rear-entry quadruped position or mQUAD1, is a good choice for back pain sufferers. In a 2015 study, researchers examined spine movements of heterosexual couples during penetrative intercourse and found that the position is easier on the spine than other common positions, including spooning.
While there is no one-size-fits-all sex position that will work for everyone with back pain, the doggy is an excellent option for those who struggle with spine movement or arching. It’s easy to adjust to different variations of this position, so be sure to take it slow and communicate with your partner if you are experiencing discomfort.
The doggy-style can also be used for anal sex, cunnilingus, or any other type of non-penetrative intimacy. Ultimately, your sexual pleasure should be the primary consideration for all of your activities, not pain or discomfort. If you’re not feeling comfortable, try adjusting your position or attempting another position until you find what feels right. In a recent AskMen poll, doggy style was America’s most Googled sex position—perhaps because it is a classic, easy-to-use sex position that provides many levels of pleasure for the bottom partner. It can also help prevent the bottom partner from straining to reach for anal or vaginal sex, which can put pressure on the lower spine and lead to discomfort.
Missionary
If you suffer from lower back pain (or sciatica) it shouldn’t stop you from enjoying a full sexual life. However, you do need to be mindful of how certain positions affect your back. Fortunately, there are several options for you and your partner to explore during sex that won’t put pressure on your back. If you have any questions, make sure to consult your healthcare provider.
For men who experience back pain when they bend forward or flex their spine, the best position is one that minimizes spinal flexion like spooning or doggy style where they support their weight on their hands or elbows. If you are more prone to back pain in extension, you can try a modified missionary where you support your body weight on your hips and knees.
The simple missionary position was the least distressing for men with flexion-intolerant back pain, according to Natalie Sidorkewicz’s study at University of Waterloo. However, she didn’t test women-on-top positions so you may want to add a pillow underneath your hips.
Another option is the reverse cowgirl or straddle, where you straddle your partner and then face away from them. However, this can aggravate sciatica because it puts additional pressure on the lower back and abdomen. It can also be difficult to achieve deep penetration if the bottom partner has gynecological issues.
Spooning
Traditionally, the spooning position has been a go-to for people with back pain. The position can help reduce pressure on the spine, which may be an issue if you have spinal stenosis or other types of back problems that make it painful to bend forward or crouch. To tweak this classic sex position, try to angle your upper leg over theirs so it sort of encloses theirs. This can make their thrusts shorter and more powerful, and it also makes room for rubbing and grinding with hands and toys to increase pleasure.
A variation of the spooning position is the modified missionary position. This position is a good option for women who are flex-intolerant, meaning that they might experience back pain when arching their backs or sitting for long periods of time. Like the doggy-style position, this position can be made more spine-sparing by having the woman support her upper body with her hands instead of elbows.
Of course, no one sex position is perfect for everyone with back pain, and it might take some experimenting to find the right position for you. The important thing is to communicate with your partner about what you can and cannot do during sex so that you can both come up with a plan for your sexual desires while managing your back injury or back pain.
Straddling
In this sex position, a person lies on their back with their partner sitting behind them. This sex position is ideal for people with back pain because it doesn’t require much movement or body pressure, says Sidorkewicz. It’s also a good option for people with lower back pain who aren’t comfortable with sex from the front.
This sex position involves the woman supporting herself on her elbows with her hands, which can help relieve back pain, says Sidorkewicz. Modified doggy style on the elbows may work well for backs that are flexion-intolerant, meaning their pain worsens with forward-bending movements like touching your toes or sitting for long periods of time. This sex position is also a good choice for people who get back pain from lifting heavy objects or doing yoga positions that involve arching the spine, she says.
For people with extension-intolerant backs, who have pain triggered by bending backward, try the missionary position or spooning, according to research published in 2015 in The Journal of Sexual Medicine. The study looked at the spinal movements of 10 heterosexual couples while they had penetrative intercourse. They found that missionary position and a modified version where the man supports himself with his elbows while the woman’s hips and knees are slightly flexed were spine-sparing positions that didn’t exacerbate back pain caused by motion or posture.
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