Sex and Back Pain

gender-312411This post is gonna be a quickie (yes – the pun is totally intended).

A recent research paper (1) was published examining which sexual positions are best (in other words most pain free) for people suffering from back pain.

I can tell you that this topic is not one that many of my physical therapy patients bring up independently. In fact, in my over 17 years practicing as a Physical Therapist I can only recall a handful of times that it did.

But I’m sure it’s an issue that many of my patients would like answers to – even if they are uncomfortable mentioning it.

Years ago when I worked for a company in Alabama we were instructed to hand out a booklet on the topic when it was brought up by patients. You read that right… A booklet. Welcome to the 1950s.

But I digress… Back to the study and it’s findings…

The research basically suggests that if you have pain when you flex (or extend) your back that you should simply use your hips. And it give suggestions on positions that are best depending upon the type of spinal dysfunction you have.

Sounds simple (sort of)…

But I can tell you that for most people it’s not.

When you have back pain it’s challenging to isolate specific motions (i.e. differentiate between using your hips and performing spinal flexion).

This research sounds to me like a case of creating complexity out of something much more simple.

In other words – if it hurts (i.e. moving a certain way or trying a certain position) don’t do it.

In fact according to “Dr. Eeric Truumees, an orthopedic surgeon in Austin, Texas, who’s familiar with the study findings” “the Canadian study is based on an understanding of the mechanics of back pain that’s not universally accepted.”(2)

So what’s the solution??

Here are my suggestions:

1. If your back pain is affecting your ability to do “normal things” (i.e. having sex) then perhaps you should seek care from a qualified specialist. About half of the patients that come to my Arvada clinic suffer from back pain and we have had consistently excellent outcomes decreasing and often eliminating low back pain with several weeks of treatment.

2. Learn self-management techniques like proper use of moist heat (to relax muscles) and cold (to decrease pain), use over the counter pain and anti-inflammatory medicines.

3. Be open and creative with your partner. First let them know that you are suffering from back pain and that certain positions are a problem. Then get some pillows, share some ideas, and have some fun.


1. Stuart McGill, Ph.D., professor and director, Spine Biomechanics Laboratory, faculty of applied health sciences, University of Waterloo, Ontario, Canada; Eeric Truumees, M.D., orthopedic surgeon, Austin, Texas; Chris Maher, Ph.D., professor and director, musculoskeletal division, Sydney Medical School, University of Sydney, Australia; Sept. 11, 2014, Spine


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