The Best Sex Positions for People With Bad Backs

The best sex position for sciatic pain depends on what kind of back pain you have. For example, if you have more pain when you bend forward, you might want to try a sex position where you can be on your side. If you have back pain when sitting, doggy style might be more comfortable for you because it takes the pressure off your back during sex.

Studies have suggested that around 37% of adults with low back pain have difficulty during sex. Up to 7% of those adults said that low back pain has significantly limited their sex lives.

This article covers some of the best sex positions for back pain as well as some general tips on how to make sex more comfortable if you have back pain.

First, Determine What Hurts

Back pain that's caused by disc problems usually gets worse when you bend forward (spinal flexion). Bending the spine in the opposite direction (spinal extension) or arching your back can help relieve the pain.

Sex positions that have either less flexion or more extension can help with pain during sex. To see if these positions could help, first see how much you can arch or flex your spine without pain. For example: 

• If you have significant pain when bending in either direction, stick with positions that keep your back stable during sex.
• If you can flex your spine a little without pain, focus on moving your pelvis while keeping your back straight.
• If you cannot flex at all, you may want to stay still and let your partner do more of the movement during oral, vaginal, or anal sex.

Sex Positions to Help Minimize Back Pain

Research has shown that sexual arousal and orgasm may help relieve physical pain because they give you a rush of endorphins. If you have back pain, finding a comfortable sex position might actually prove to be a pain reliever.

If you're wondering how to have sex with a bad back, it’ll help to understand how different body positions (posture) can contribute to back pain. If you have disc problems, like herniated or slipped discs, improving your posture can often help with back pain. Being aware of the position your back is in while you're having sex can reduce or even prevent pain.

While anyone with back pain can benefit from trying these positions for more comfortable sex, they might be especially useful for older couples and postmenopausal people who are more likely to have low back pain from age-related conditions like arthritis and hormonal changes.

The Missionary Position

When you are in the missionary position as the bottom (receptive) partner, you can support your lower back by placing a rolled towel under it. This cushion helps keep a slight arch in your back.

Maintaining a little arch is generally better than keeping your back flat. When your back is flat, it forces your pelvis slightly forward, causing more flexion in your spine.

Partner on Top

The missionary position might be less comfortable for you if you’re the top (insertive) partner because it forces you to flex and extend your spine.

One way to stabilize your back during missionary sex is to have the receptive partner on top while you are flat on your back. However, be careful that your partner does not bounce too much. The jostling can force your pelvis into the mattress, which will cause spinal flexion.

A trick you can use to avoid this is to place a solid board under your buttocks and lower back to keep your spine straight and let the mattress act as a shock absorber.

Doggy Style

Doggy style—where the receiving partner is on all fours and the insertive partner kneels or stands behind them—can be useful for lower back pain.

If you’re the receiving partner, doggy style can give you more control over movement. In this position, it’s easier for you to support yourself with your hands, knees, and arms. If your back pain is worse when you’re sitting, this position will definitely take some pressure off your back. 

Doggy style can also help if your back pain is worse when you arch or bend forward, as you can keep your back a little more neutral in this position.

Sitting and Kneeling

If you are the receptive partner, sitting on your partner's lap can also help you avoid back pain. This position gives you a little more control over your back's position. 

You can also try kneeling as you support your weight on your elbows. In this position, there is room for you to adjust your back as your partner enters you from behind.

If it doesn’t aggravate your back pain, sitting in a chair can also help when you’re the top partner. Your back is stable when you're seated, so there’s not much spinal flexion. You should be able to keep your back relatively stable in this position, even if your partner is moving around a lot.

Kneeling can be more problematic for the top partner, especially if the mattress is soft. That said, back pain in this position can often be avoided if the partner on all fours does all the movement. 

Facedown Position

Lying on your stomach will automatically put your back in an arch and give you some control over how much your back is moving.

To add more arch, place a pillow under your chest. If that does not provide enough spinal extension, prop yourself up on your elbows. To decrease the amount of arch in your back, place a pillow under your stomach.

If you are the top (insertive) partner and your partner is facedown on the mattress, you can reduce back movement by placing a pillow under your partner's pelvis. This position makes it easier to enter the vagina or anus and won’t force you to flex your back as much when you’re thrusting forward.

Side by Side and Spooning 

Positions like side-by-side or spooning can take some pressure off your lower back and spine since you’ll be lying on one hip or the other.

For this position, you lay on your side with your arms in whatever arrangement is most comfortable. You can try having your arms out in front, wrapped back around your partner, at your sides, or in any other position that works. 

If you’re the insertive partner, you can be on your side behind your partner (called “spooning” because you are nestled up against their back).

If your partner’s lower back is tender, be mindful of this when you’re behind them. Communicate about factors like force, speed, and angle that could become painful at the slightest shift in the wrong direction. 

More Tips to Reduce Pain

Once you’ve settled on a position (or more), there are a few other tips to help reduce back pain with sex:

• Relax: Staying relaxed is key to avoiding back pain. Stress and anxiety almost always cause muscle tightening and contractions that will make back pain worse.
• Consider timing: If you have disc problems in your back, you may want to avoid having morning sex. When you first wake up, your spinal discs are the most compressed that they’ll be all day and at the highest level of pressure. High pressure and compression can make back pain more likely to be a problem for you first thing in the morning.
• Use support: Try using pillows and foam rollers or wedges to take some pressure off your back and hips during sex.
• Prepare and recover: If your provider says it’s OK for you to use over-the-counter (OTC) pain relievers like Aleve for back pain, try taking one before you have sex. You may even want to do some warmup stretches to get your muscles ready. After sex, you and your partner might find that a warm bath or shower helps you both relax. If you’re sore, you may want to ice your back to relieve inflammation and discomfort.

Summary

If you have back pain from sciatica or another cause, trying new sex positions that support your spine can help prevent discomfort. 

If you tend to use the same positions with your partner, trying something new can be awkward at first. Talking through the change can make it easier to put into practice and help you avoid injury.

Finding a position that works best for you and your partner may take some trial and error, but it’ll be worth it once you find one that lets you both enjoy being intimate without back pain getting in the way.