The Best Four Sex Positions for Those Who Suffer from Back Pain, by Emma London

The Best Four Sex Positions for Those Who Suffer from Back Pain

Don’t allow your back pain to ruin your sex life.

Last year I had a trapped nerve on my spine; the pain was excruciating. I went through moments of maddening levels of pain. Despite that problem is seemingly solved, I still suffer from back pain, sometimes with severe flares, that can last hours or days. Investigations are still ongoing.

My back pain has affected my life in many ways, including, of course, sexually.

Sometimes, I can’t have sex in the positions I like or I’m in the mood for, because of my back pain. I have to reposition my body in a way that won’t worsen it. When I’m in a flare-up, no sex at all is possible.

I’m one of many who suffers from back pain and have their sex life affected.

Studies showed that back pain sufferers have significantly less sex out of fear it will trigger their pain or make it worse.

Back pain can be something temporary or a chronic situation and besides having several levels of intensity, it presents itself in three different types:

3 types of back pain

Flexion intolerant

For those who suffer from this type of back pain, it’s worse when they bent over (for instance, to pick something from the floor) or when sitting for long periods of time (source).

According to medical professionals, flexion intolerant lower back pain is one of the most common types. This pain can be localised on the lower back or travel down into the buttocks, crotches, thighs and lower legs (source).

Extension intolerant

This is a type of back pain that is worsened by bending backwards, like lying on your stomach and pushing up.

It’s usually a localised intermittent pain, that’s exacerbated by specific movements into extension postures, like extending the torso or standing for long periods of time (source).

Motion intolerant

This back pain type will be worsened when the spine moves away from its neutral position.

This can happen when lying down, standing straight or by some movements (source.)

The best sex positions for those who suffer from back pain

There’s no magical one-fits-all sex position for sufferers of back pain. It has to be a personal adjustment, depending on the type and severity of the pain.

Only by understanding your back pain, you’ll be effective in minimising it or the risk of triggering it.

The most important is to take things carefully and to listen to what your body is telling you — pain always provides relevant information.

It’s also very important to walk your partner through your pain.

If I’m in pain and we’re going to have sex, I always let my partner know that my back hurts and the level of pain I’m in (mild or with the potential to escalate.)

Your partner needs to know that you’re not in your best shape, so they’ll manage your body without risking hurting you. And it’s also a way to tell them that you’ll be the one choosing the sex position.

The penetrative sex positions I’m suggesting in this piece were scientifically proven to be the most comfortable for people with back pain. I’ve tried them when my pain is active and I can attest that they are, in fact, a great help when it comes to having sex with back pain.

The study mentioned concluded that when having sex, the motion of your body should be done by controlling your knees and hips and not using your spine.

Sex positions that involve hip-hinging instead of thrusting (a spine movement) are the best.

Let’s now go through the three sex positions that experts state being the safest and comfortable for sufferers of back pain:

1. Missionary (non-aching partner on the top)

The missionary — with the partner who’s in pain at the bottom — is a very suitable position for those who suffer from any type of back pain.

It will be particularly effective if you put a pillow under your hips or on the lower part of the back. This will help to maintain a neutral spine and ease the pressure that comes with the curvature of being lying down.

I found that sometimes it helps me if I raise my knees or wrap my legs around my partner. But again, my type of pain can differ from yours, so my suggestion is for you to try with your knees up and with your legs stretched.

One thing to consider — and this shows how important is to communicate with your partner — is the top partner not to thrust vigorously as it can pressure the spine of the bottom partner or force their pelvis against the mattress.

Slow sex will be more adequate to engage when one partner has back pain.

2. Doggy style (supported on the hands)

This sex position is more adequate for those who are flexion intolerant (the pain gets worse when they bent over or are sitting down for long periods.)

The doggy style, where you are supported on your hands (and not on your elbows) allows you to keep your spine in a neutral position.

If the person on their fours is the one with back pain, they will benefit from their back being relaxed — they’re supporting their weight on their arms and knees.

If the partner who suffers from back pain is the penetrative partner, this position will also be good for them as they will use their pelvis and hips to thrust, instead of using their spine.

You can use a variation of the doggy style, like bending over the bed or a table and having your partner penetrating you from behind. This will allow you to maintain your spine relatively straight.

An adjustment that helps me when I’m in pain is to bend over my wedge pillow. The sex is still amazing and my spine and muscles (my pain is also muscular) are totally supported by the pillow.

Tip: don’t arch your back during the doggy style sex; keep the spine straight, in a neutral position.

3. Spooning

The spooning sex position is gentle and comfortable for both partners. But it’s not advisable for people who are motion intolerant (their pain is triggered by being lying down or standing straight.)

You can adopt this sex position either facing your partner or having your back to them (being penetrated from behind.)

Being lying on your side will allow you to take the pressure off the spine and transfer it into your arms and elbows.

I love spooning but I’m a bigger fan of the scissors sex position. Because my type of pain allows me, I often go with scissors instead of spooning.

Additional sex position for people with back pain

From my personal experience and talking and reading other writers, there is another sex position that is compatible with back pain:

Chair Lotus

The person with the back problems will sit on top of their partner, that will be comfortable sit on a chair.

This sex position is incredibly sensual and intimate and it won’t put pressure on your back, as your movements will be done by your hips and you’ll have your feet on the floor, which will help you support your weight and buffer your movements.

In the chair lotus position, you’ll have great control over your back, which will be stabilised.

Alternatives to penetrative sex

Having sex with your partner doesn’t have to include penetration. Often, as careful as you and your partner are, the movements and pressure on the back are still risky.

When that’s the case, you can opt with these two alternatives to penetrative sex:

1. Oral sex

Oral sex can take many body positions.

When I’m in pain or I’m afraid to trigger a flare, my go-to sex is having oral. I’ll lay down on the mattress and my partner will go down on me.

Depending on how bad your level of pain is, you might want to stop before orgasm, as the spasms might worsen your pain.

I know which positions I can better control my pain, so I will place my body that way and I’ll have a great orgasm without hurting my back.

Depending on your type of back pain and the levels of it, you can indulge in a pleasurable 69 session. Position your body the safest way and let your partner adjust to you. Then, mutually satisfy each other with oral sex.

2. Mutual Masturbation

Masturbating will be undoubtedly the safest way to have sexual pleasure without risking extra pain in your back.

With mutual masturbation, you will still share a very erotic and pleasurable moment with your partner while safeguarding your back.

Back pain can be a mood killer for sex. This becomes more critical when you have a chronic or ongoing situation — you never know when a flare is due to come and you’re afraid that sex might trigger it.

It’s fundamental to clearly understand your back pain: what triggers it and what smooths it.

It’s important to manage your back pain in a way that has a minimum impact on your life and your relationship.

I get very angry when my back pain stops me from being intimate with my partner. I love sex; I need often close contact with my partner. Not only for the physical aspect but for the emotional too.

So, what I sometimes do if I’m not in pain but I feel it coming (a slight pinch on the spine or an increasing discomfort in my muscles), is to take ibuprofen, to stop the pain from escalating, and preventing me to be with my partner.

This doesn’t mean I won’t let him know that my level of pain is borderline. I always do, and we soften our sex session to prevent the pain to escalate.

Knowing your triggers and how to deal with your back pain is the best way to stop it from running your sex life.


Although knowing your pain triggers and what sex position won’t make the pain worse is crucial, there are other things that also play an important role in maintaining your level of pain to a minimum when having sex:

  • Respect your body and don’t underestimate your symptoms. Stop the sex if it’s hurting your back;
  • Position your body in a safe and comfortable way, don’t arch your back;
  • Place a pillow on your lower back, under your hips or anywhere that makes your spine supported;
  • Instead of thrusting, use a hip-hinging movement;
  • Don’t support your body weight with your spine, transfer it to your arms, elbows or knees.
  • Communicate with your partner how you feel and what you need;
  • Have non-penetrative sex.

Back pain shouldn’t lead to a sexless relationship.

With adjustments and communication, it is possible to be sexually active even when suffering from a back pain condition.

© 2021 Emma London. All Rights Reserved

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