Some people with back pain find that sex can cause or make their pain worse. Fortunately, there are ways to have sex without making your back hurt.
It is important to communicate with your partner about your back pain during sex. By doing this you can find a position that is comfortable for both of you.
Causes
For women and men with lower back pain, sex positions that cause strain can lead to worsening pain. If your back pain is mild, you might be able to solve it with exercise and a good diet. But if you have a bad case, it might be time to consult a movement professional–chiropractor, physical therapist, massage therapist, Rolfer, Feldenkrais or Alexander Technique practitioner–to see what you can do about your posture and the way you use yourself during sex.
For example, a man with herniated discs in the lumbar spine might find it painful to bend forward. In that case, he might try replacing spooning with doggy-style sex. Or he might consider using a sex position that puts less pressure on his spine, such as hip-hinging.
A woman with a weak spot between her lower abdomen and thigh, called the transverse abdominis, might develop pain during sex in a sexual position that involves pulling on this muscle. A groin hernia, which happens when tissue pushes through a spot that should have closed at birth, might also cause pain during sex.
Sometimes sex-related back problems can lead to moodiness and depression, and that can have a negative effect on a relationship. It’s important that people bring their back pain into the open, with their partners and with an understanding doctor who can help, Marks says. Otherwise, a couple may start avoiding bedroom encounters out of fear that the pain will return.
Symptoms
Whether or not pain during or after sex is a sexually transmitted infection (STI) or something else entirely, it can be stressful for the couple involved. Couples with good communication can help reduce the stress and prevent back pain from affecting their relationship.
Many women experience pain during sex because of a condition called endometriosis. It causes uterine tissue — normally found on the inside of the womb — to grow outside the uterus. This tissue may then irritate the fallopian tubes that carry eggs from the ovaries to the uterus. The discomfort may be either primary (present all the time) or situational (only during or after sex).
A woman’s pain may also be caused by a pelvic inflammatory disease, or PID. This condition occurs when bacteria enter the urethra and cause a urinary tract infection. Symptoms include pain when passing urine, back pain and vaginal discharge.
Groin hernias are another condition that can cause pain during sex. These are bulges that protrude through a weak spot in your muscle wall that should have closed at birth. The pain can be worse during straining activities, such as sex or exercise.
A few ways to help ease back pain during sex include a heating pad or warm bath, and using OTC NSAID painkillers like ibuprofen (Advil, Motrin) or naproxen (Aleve). For some women, position changes during sex and the use of lube can also relieve pain.
Diagnosis
In some cases, the cause of pain is clear, but in others a patient may need to visit a doctor for a diagnosis. Often back pain is a warning sign of herniated discs or sciatica, but it can also be caused by conditions like pelvic inflammatory disease and arthritis of the spine. During a physical exam, the doctor will perform a thorough examination and will run tests if needed.
Women who are experiencing pain during sexual activity can help their doctors identify the cause by describing their symptoms and providing their medical history. They should also discuss any changes they’ve noticed in their sex life, including a decrease in intimacy or avoiding certain sexual positions.
Some sexual problems can be fixed with at-home treatments, such as using a water-soluble lubricant and increasing foreplay. But the best way to deal with pain during sex is to talk about it openly with a partner and an understanding doctor, Marks says.
He has found that patients who don’t broach the topic with their partners may feel embarrassed or guilty, leading to resentment and stress in their relationship. And if a patient is afraid to tell her doctor about the problem, she may miss out on helpful treatment options. A doctor can provide effective, individualized care by performing diagnostic tests and coming up with a plan to address the problem.
Treatment
If back pain is associated with sexual dysfunction, it’s important to let your doctor know. He or she can evaluate your symptoms and do a physical exam. If a herniated disc is the cause, he or she may do an MRI to see if a nerve root is compressed. If the problem is not a spinal problem, your physician can prescribe medication to relieve pain, swelling and irritation and recommend that you limit activities until it subsides.
Many patients avoid having sex as often because of their back pain, and their partners are sometimes unaware that their reduced participation is due to discomfort or fear of hurting them. If the problem goes unreported, it can affect the relationship and create mistrust. One of Marks’ patients who didn’t tell her partner that her back pain interfered with intercourse discovered to her dismay that her partner had stopped trusting her and was avoiding the bedroom altogether.
For women who experience sex-related back problems, doctors can suggest alternate ways to have sex and reduce the strain on their spines. For example, a woman can lie on her stomach with a pillow under it to support her lower back and allow her partner to enter her from behind. Trying new positions can be a romantic journey of discovery and lead to increased sensuality.
