The Best (and Worst) Sex Positions if You Have Back Pain

Thursday May 13, 2021

If you're a millennial or Gen Z, you may be laughing now, but it's no joke if you find yourself wincing in pain every time you hop in the sack. And back pain isn't limited to age, either. In a culture where many LGBTQ people are obsessed with physical appearance, over-exertion at the gym or poor form during your workout can result in back pain.

Body positivity is gaining more attention, as celebrities and influencers like Sam Smith and transgender model and activist Munroe Bergdorf have spoken about the topic. Still, many gay men are obsessed with building muscle, even leading to muscle dysmorphia, which "may develop when a man becomes preoccupied with his appearance, body size, weight, food, or exercise in a way that worsens his quality of life," Dr. Jason Nagata, assistant professor of pediatrics with the University of California, told Queerty.

Whether your back pain stems from an overzealous workout, bending down to put on your shoes, or any other movement, its impact on your sexual health could put a damper on things if you're not careful. Back pain during sex is more common than patients and physicians think. According to a recent study, 72% of sexually active respondents reported they had sex less frequently than before their back pain began.

Dr. Gbolahan Okubadejo, NYC-area orthopedic and spinal surgeon, has offered a few tips for dealing with back pain during sex.

"Missionary or spooning are more comfortable sex positions for extension intolerant men because they allow the back to stay flat," Dr. Okubadejo advised. "The doggy style position will exacerbate back pain for extension intolerant men because it forces them to flex and extend the spine; therefore, this position should be avoided."

Pain that generates in the lower back and buttocks and extends down one side of the leg (sciatica) is often referred to as flexion intolerant pain. Dr. Okubadejo explained, "flexion intolerant men should avoid spooning [or] side sex because these positions worsen back pain by making it more challenging to move the hips. Try replacing these positions with the doggy style position, as this allows men to use more of their hips and knees rather than the spine."

Over-the-counter options may help alleviate some of the symptoms, but it's important to monitor recovery and consider a doctor's visit if things don't improve. "Applying an ointment or topical pain cream on the back before sex can help reduce pain and inflammation; however, it's important to remember to wash your hands after applying and before sex to avoid creams touching more sensitive body parts," said Dr. Okubadejo. Taking an anti-inflammatory may also help with pain and inflammation.

Dr. Okubadejo also suggested considering alternative ways to please your partner — every sexual experience doesn't have to culminate in intercourse. "Talk to your partner about other forms of stimulation," he suggests. "Ways to maintain intimacy beyond sexual intercourse include but are not limited to erotic massages, oral sex, and exploring the entire body."