Don't Let Your Bad Back Lead to Bad Sex

I'm 25 going on 50. I wake up each morning, muscles tight, neck sore, groggy and struggling to roll out of bed, all while listening to each of my bones crack in agony. I spend far too long in the shower letting the scalding water loosen the tension in my shoulder blades, and only then do I finally feel like a real, living person.

I'm being a little hyperbolic, but back pain—even minor—is no joke. In fact, the American Chiropractic Association identified that back pain accounts for more than 264 million lost workdays in any given year, twice as many workdays as there are full-time workers.

And then there's the cost. Managing back pain costs Americans $50 billion each year, and that number rises to more than $100 billion if you factor in lost wages and decreased productivity stemming from time recuperating.

This isn't just an issue that affects your grandparents, either. Research from Georgetown University found that 41 percent of adults with back pain are 18 to 44 years old, spanning across a wide range of lifestyles and income levels.

And, at no surprise to anyone, most people with back pain—more than 72 percent—noted that it directly interfered with their everyday lives.

Put your back into it

Calling off work due to back pain is one thing—hopefully, you get to spend the day doing as few things as possible that could exacerbate your condition, and you're back at work tomorrow. However, chronic back pain is something that doesn't go away quickly, and it can get in the way of everything, including things we enjoy—like sex.

This makes sense. After all, we tend to use the muscles in our back in most sex positions. However, back pain affects our sex lives in less obvious ways, too.

Jacob Barlow, chiropractor and owner of Avonworth Chiropractic in Pittsburgh, identified a few of these, explaining that back pain can cause issues from "limping and stiffness up to severe symptoms such as radiating pain, numbness, tingling, loss of bowel or bladder control and even sexual dysfunction."

'[Back pain] makes it difficult to move, specifically hip thrusting, making most sexual positions painful if not impossible.'

There's an old "Saturday Night Live" sketch starring Will Ferrell, Jimmy Fallon, Rachel Dratch and Drew Barrymore in which Ferrell and Dratch play an overly sexual couple of professors on vacation attempting to incept a courtship between Fallon and Barrymore. After the two singles leave to make love on a bed adorned with hibiscus petals, the professors attempt to make love in the hot tub until Ferrell screams out, "My back! My back! Get off me!" and shoves Dratch away, ending the sketch.

While Ferrell's back pain is obviously played for laughs in the sketch, the joke works because this is a real thing that happens to real people.

"When there is back pain, it can severely limit the act of intercourse," Barlow explained. "It makes it difficult to move, specifically hip thrusting, making most sexual positions painful if not impossible. When severe, it can also cause erectile dysfunction in men and vaginal dryness in women due to nerve interference."

The best sex positions

Given how common back pain is in the population, it's likely this will be an issue for many sexual partners at some point. Thankfully, there are things you can do to manage pain and maintain a healthy sex life.

The most important thing, in any sexual situation, is to check in with your partner. It doesn't have to be a difficult conversation either, as Erin Donnelly, Psy.D., a sex therapist based in Kansas City, pointed out.

"A lot of it is just saying, 'Hey, how are you feeling? How can we compromise so our needs are met?'" she said. "But another part of it is asking yourselves why you're having sex in the first place. It might be that you're having sex because it makes the relationship closer or you argue less. Sometimes, it's those other motivations that are more desirable."

In other words, if you're in an excruciating amount of pain, it's okay to forgo sex. Relationships, and life for that matter, are about more than sex, so consider some other possible actions that can fulfill the emotional need.

Of course, there are going to be times where you want to have sex, in which case there are a few positions you can work with to lessen the burden on your back.

Doggy-style, for one, doesn't require much support from the back. Men tend to support themselves with their knees and arms, and the range of motion isn't too extensive. Women in this position also tend to keep a straight spine if they're supporting themselves on their hands and knees, which might help avoid any pain from bending forward.

Missionary, inversely, is great if your back hurts while you're lying on your stomach. Men supporting themselves on their elbows won't put much pressure on their spine, and women on their back can use their hips and knees rather than their back to control their movements.

Avoiding back pain if you can

"The most common reasons I see for back pain are things that cause either overuse or repetitive use," Barlow explained. "That includes sitting too much, standing too much or even bending too much. Beyond that, the second most common reason is usually trauma-related, something like a fall, car accident or lifting mishap."

While we can't control everything that happens in our lives, Barlow identified small actions we can do outside of the bedroom to help ensure and maintain proper spinal health, including stretching, being physically active and making sure to stay at a healthy weight.

And, of course, checking in with a medical professional every now and then is always a good option as well, Barlow pointed out.