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Does sex give you a backache?

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

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Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

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