A woman may rest on her arms and knees while her partner is positioned posteriorly. While kneeling, the partners' knees should be padded for appropriate height and comfort. A woman with back pain should assume a more passive but protective posture.

With certain spine problems (usually non-disc related), sitting may be more comfortable during sex. Sitting may allow more sensuous caressing; however, careful coordination by the partners is important.

Sex and Back Pain

When you or your significant other is suffering from back or neck pain, sex is one of the first activities to be put at the bottom of the list.   But it need not be that way.

To oversimplify the problem, there are basically three components of sexual functioning. All three must be in working order for things to function normally. First and foremost are the emotional and psychological aspects of sexuality. If you are depressed, angry, frustrated, preoccupied or uninterested, you are unlikely to enjoy a sexual experience. The second key components of sexuality are the physiological and anatomical ones. These refer to your equipment and wiring. If they are not working normally, you will not be unable to function normally. Thirdly, many people have the desire, and the equipment and wiring are fine, but are unable to enjoy sex because they are not able to get into a comfortable position due to neck or back pain. This is usually easily overcome with some thought and experimentation. The general rule is "If it hurts do not do it". Positions that are not comfortable in your day-to-day activities will not be comfortable during sex either. Do not be afraid to experiment, there is no right or wrong, normal or abnormal.


The female with back problem lies supine and comfortably on the floor or bed with hips and knees bent. Pillows or towels may be used for support. Her partner without back pain is on top being more active, but cautious and gentle.

The woman with back problem lies supine in a comfortable position supported by pillows or towels. Her hips and knees are bent and relaxed over her partner. He enters her while facing her, with minimal stress to his or her back.

The patient with back pain can lie supine on the floor or bed with pillows or towels for comfort. The patient should be relatively passive and reduce stress to his back. His partner without back problem is on top and is taking a more active role.

The patient with the back problem lies in the supine position on the floor or bed with appropriate supports, pillows or towels for comfort. His back is protected and immobile. His partner without back problem is on top and is taking a more active role.

A woman with a back problem, especially disc related, may be more comfortable in the prone position. In the prone position, the lumbar spine is in extension, which puts less stress on her discs. The degree of back extension can be adjusted using pillows or cushions under the chest or abdomen.

The following is a general outline of some of the more common back diagnoses and their symptoms. Along with the position diagrams, try to use these examples as a 'starting point' to guide you through an evaluation of what works and what does not.
Your back or legs hurts when you sit, bend or stoop and you feel better standing, walking, sitting in a recliner or lying with your back supported. These symptoms are usually caused by disc disease such as internal disc disruption, annular tears, central disc herniations or sprains and strains. Acute disc herniations and 'sciatica' will some times act similarly. When the symptoms are relieved by straightening or by arching the spine backwards use this as a basis of your positioning. Alternatively, your back or legs hurt when you stand, walk or reach over head and you feel better sitting, reclining and in certain positions lying down. Spinal stenosis, spinal arthritis, facet joint disease, sprains and strains, deconditioning and soft tissue diseases, may cause these symptoms. Acute disc herniations and 'sciatica' will some times act similarly. These conditions tend to be worsened by an arched back position and relieved by bending forward or sitting.

As you and your partner embark on this adventure to make sex more enjoyable, remember that this can be emotionally charged and potentially frustrating. Take your time and start slowly. If your partner is the one in pain, offer to start with a hot bath or shower together. Most conditions respond favourably to gentle massage with some warm oil. The massage works to decrease pain, relax the muscles and mind, and can be stimulating. Share your feelings and enjoy.