Don’t let back pain ruin your sex life

Couple in Bed

Hello, all, Dr. Lell here. This blog is specifically geared towards women. If you’ve ever had low back pain, you know how hard it can be to live your normal life. Sometimes it works out to your advantage, “sorry I wish I could help you move this Saturday but my back is killing me.” Most of the time though it just keeps you on the couch and from doing what you want to do. By the way, waiting it out on the couch is the LAST thing I’d suggest for low back pain (LBP) but that’s another blog post. Even small things like shaving your legs and tying your shoes can seem like heroic feats. Clinically, you can always tell how bad the pain is and how long it’s been going on if a female patient arrives to the office with slip-ons and hairy ankles. LBP can seep in and affect almost every aspect of your life, even sex. Ever have back pain so bad that it hurt to drive in the car? Imagine how much worse a bumpier ride would have felt like. But like I tell my patients, “I’ll never tell  you stop doing something you love, we just need to find a different way of doing it for the time being.”

Luckily in 2015, a couple of very smart people designed a small study to look at which sex positions caused the most motion in your low back. The authors, Sidorkewics and McGill published the work in the European Spine Journal. Positions studied were the quadruped position (all fours) with the weight being rested on both the hands and elbows, the missionary position with the hips are flexed up a little and a lot, and the side lying (spooning) position.

Looking at the lumbar spine’s motion during these activities are very important because several different conditions can cause LBP and each has their own characteristics. Some conditions and types of LBP hurt more when you bend over and others when you bend back. The different sex positions caused different motions in the lumbar spine.

So what’s the best sex position?


They found that the best position was the quadruped position (on all fours) with the weight resting on the hands (not the elbows). This caused the least amount of lumbar flexion which is exactly what you want to avoid in back pain caused by disc herniations (“slipped disc”) or discogenic pain just to name a few. This flexion intolerant back pain in the most common kind of back pain that we typically see in patients under 50 years of age. The worse position was missionary with the hips flexed up.

positionHere’s the best safe for work image that I found. It was originally on (one must give credit where credit is due)

Don’t let back pain stop you from living your life. Get out there and keep doing what you love.

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You can see the abstract here: