Does sex give you a backache in missionary position or doggy style?

Details: Written by: Staff; Published: 01 February 2018; Last Updated: 01 February 2022; 158872 Views

Science based recommendations and how therapy can help

Does sex give you a backache? Do you avoid sex due to your low back pain?

If you are thinking “YES,” you are not alone. In a study by Bahouq et al. in 2013, 81% of clients with low back pain reported sexual problems and 66% of those clients reported never bringing the subject up with their doctor. As we all know, sex is an important activity for many. Today’s post will shine a light on the latest science based recommendations sex positions for those with low back pain and how the therapists at Femina PT can help.

Science Based Sex Positions

In the 2014 study "Male Spine Motion During Coitus, Implications for the Low Back Pain Patient" and the 2015 study "Documenting Female Spine Motion During Coitus With Commentary on the Implications for the Low Back Pain Patient" Sidorkewicz and McGill used infrared cameras and electrodes to biomechanically test five common sex positions to analyze the strain they put on the spine. This was the first investigation of its kind.

Their investigation revealed that sex positions are not one size fit all - it depends on the type of back pain you have. Some people get backaches with spinal flexion (like the position bending over to tie your shoe or bending forward), while others become more aggravated with spinal extension (leaning backward or arching). Layered on top of this, some people experience more back pain with excessive movement, while others do not. Various sex positions can decrease or increase these types of movements, aggravating or allowing pain-free movement.

The study suggests that when receiving penetration, extension-intolerant people (pain made worse with arching) try the missionary position. Adding a low-back support, such as a pillow, can also help keep the spine in a more neutral position. For those receiving penetration who are flexion-intolerant (bending forward), the findings suggest trying spooning or doggy-style with the receiver supporting their upper body with their hands.

For those giving penetration, the atlas recommends that those who are extension-intolerant try missionary on elbows or spooning. For those giving penetration who are flexion-intolerant, try doggy style with the receiver supporting their upper body on their hands. Additionally, the study recommends a hip-hinging motion rather than thrusting when penetrating, to conserve spinal movement.

Some examples of recommended sex positions based on types of low back pain are highlighted in the figure at the bottom of this article:
https://www.practicalpainmanagement.com/treatments/psychological/improving-sex-lives-patients-chronic-pain

Is this too much information? Not sure what kind of back pain you have? Have other issues like wrist, pelvic, or shoulder girdle pain that would make these positions difficult? The therapists at Fusion Wellness and Femina PT are trained and ready to help you.

How Can Therapy Help?

A pelvic health physical therapist with the skills to help you troubleshoot the mechanics of your favorite activities (including sex) can provide great insight into your pain, with a thorough assessment and evaluation of your current range of motion, muscle strength, posture, and body movement. We also welcome partners to sessions to make therapy client centered and tailored to your needs.

In the treatment of low back pain, you can expect a variety of modalities such as manual therapy, therapeutic exercise to gain muscular strength and length, and functional movement training to help you get back to your beloved activities (including sex) without pain!

The physical therapists at Femina PT are well equipped and ready to help, contact us today.

***This information is for educational purposes only and is not intended to replace the advice of your doctor.***

Resources

Bahouq H, Allali F, Rkain H, Hajjaj-Hassouni N. (2013). Discussing sexual concerns with chronic low back pain patients: barriers and patients' expectations. Clin Rheumatol. 32(10):1487-92

Volpe, K. (2015). Improving the Sex Lives of Patients With Chronic Pain. Practical Pain Management. https://www.practicalpainmanagement.com/treatments/psychological/improving-sex-lives-patients-chronic-pain

Sidorkewicz, N., McGill, SM. (2014). Male spine motion during coitus: implications for the low back pain patient. Spine (Phila Pa 1976). 39(20):1633-9
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381984/

Sidorkewicz N., McGill SM. (2015). Documenting female spine motion during coitus with a commentary on the implications for the low back pain patient. Eur Spine J. 24(3):513-20
https://www.ncbi.nlm.nih.gov/pubmed/25341806

Image source: https://www.practicalpainmanagement.com/treatments/psychological/improving-sex-lives-patients-chronic-pain

What Our Patients Have to Say

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.
Read more: Testimonial by M.N., age 28

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by Y.L. (mom of 2)

After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

Y.L. (mom of 2)

Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

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Does Sex Give You a Backache? When to Choose Missionary Position or Doggy Style to Avoid Back Pain