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Sex Health Blog

Sex and Low Back Pain

Low back pain can interfere with many of our day-to-day activities, like climbing stairs, sitting at a desk, mowing the lawn, or vacuuming the living room.

We can add sex to that list as well.

Think about it. While intercourse does not have to involve strenuous acrobatics, the back can still get quite a workout. Movement during sex, such as thrusting or supporting the weight of the partner on top can all make low back pain flare up.


34% to 84% of men have sex less often due to low back pain. Changing sexual positions may help. (Click to tweet)


Sometimes, the pain is so severe that couples avoid having sex altogether. Indeed, an estimated 34% to 84% of men have sex less often because of low back pain. Women are affected, too. When this continues, couples can become distant and depressed. Relationships may suffer.

Changing sexual positions may be the key to relief. In 2014, researchers from the University of Waterloo in Canada published a pair of studies that investigated the best sex positions for people with low back pain. Let’s take a closer look.


The Study

For this research, the scientists recruited ten heterosexual couples who agreed have sex in the lab. Each partner wore electrodes that allowed the scientists to analyze spine movement during intercourse. The same technology is used by filmmakers and video game producers for animation.

Each couple tested five different sexual positions: spooning (in which the man and woman face the same way, like nested spoons), two versions of the missionary position (“man-on-top”), and two versions of the rear-entry quadruped position (“doggy-style’).

Note: The study included heterosexual couples, but the findings can apply to same-sex couples as well.

Types of Low Back Pain Make a Difference

The scientists found that the type of low back pain can affect comfort during intercourse.

Two distinctions are made. People who are flexion-motion intolerant have pain when they touch their toes or sit for a long time. In contrast, people who are extension-motion intolerant feel pain when arching their back or lying on their stomach. Often, what is comfortable for a flexion-motion intolerant person is painful for an extension-motion tolerant person and vice versa.


Flexion-motion Intolerance

Doggy-style was deemed best for flexion-motion intolerant men, according to the study.

For women in this category, spooning worked well. Doggy-style was also helpful for women, as long as they used their hands – not their elbows – to support their upper body.

Extension-motion Intolerance

Extension-motion intolerant people should avoid arching their backs during sex, the researchers explained. Men in this group may find doggy style or missionary positions more comfortable. If the missionary position is used, the researchers recommended using the elbows to support the upper body instead of the hands.

The missionary position was considered best for extension-motion intolerant women.

Moving with the Hips and Knees

The researchers also noted that moving with the hips and knees instead of the spine could limit pain. For example, it might be more comfortable for a man to thrust using his hips instead of his spine. For women using the missionary position, flexing at the hips and knees could be less painful. Placing a pillow or a rolled up towel under the back can help, too.


Couples Need to Experiment

It’s important to remember that while changing positions can help make sex more comfortable, there is no one-size-fits-all solution. Couples need to experiment and determine what works best for them. Open, honest communication between partners is essential. If something hurts, tell your partner. Stop the activity if you need to. Try something else when you feel ready.

If you and your partner feel nervous talking about sex (as many couples do), don’t hesitate to see a sex therapist. A counselor can help you learn to express what you need. Your doctor can refer you to a qualified sex therapist in your area.

Other Tips

In addition to changing positions, there are other things you can try to reduce back pain during sex, such as taking a pain reliever or a hot shower beforehand. You can also try icing your back afterward.

Don’t Give Up

Having low back pain doesn’t mean the end of your sex life. Many medical conditions require us to make adjustments in the bedroom. And sometimes, a simple change can make a world of difference – for ourselves and our partners!


European Spine Journal

Sidorkewicz, Natalie, MSc and Stuart M. McGill, PhD

“Documenting female spine motion during coitus with a commentary on the implications for the low back pain patient”

(Abstract. First published online: October 24, 2014)

Medscape Orthopedics

Laidman, Jenni

“Is There Sex After Low Back Pain?”

(August 26, 2015)


Sidorkewicz, Natalie, MSc and Stuart M. McGill, PhD

“Male Spine Motion During Coitus: Implications for the Low Back Pain Patient”

(Full-text. Published online: September 11, 2014)

University of Waterloo

“New findings will improve the sex lives of women with back problems”

(News release. October 24, 2014)

University of Waterloo Magazine

Bezruki, Christine

“Less Pain, More Pleasure”

(Fall 2014)

The Washington Post

Phillip, Abby

“Bad back? These are the best sex positions to ease the pain.”

(September 10, 2014)


Kam, Katherine

“Don’t Let Low Back Pain Ruin Sex”

(Last reviewed: June 1, 2011)