For some lower-back pain sufferers, agony flares up when they bend forward. For others, arching backward is a wince-inducer. Regardless, if either of these sounds like you, sex can seem like a bad idea—an activity sure to cause at least as much pain as pleasure.

But there are work-arounds for almost every back-pain patient. We're talking about sex positions and guidelines that can mitigate or remove the pain, and so allow you to fully enjoy those intimate times with your partner. (Another way to ramp up your pleasure: a couples vibrator.)

“There is no one sex position that will be most comfortable for all [back-pain patients],” says Natalie Sidorkewicz, a doctoral researcher who has coauthored two studies on the spine motions of both male and female back-pain patients during sex. “But we have developed recommendations for women with different categories of back-pain triggers.”

What Type Of Back-Pain Sufferer Are You?

Sidorkewicz says most who suffer from back pain can be sorted into these three groups:

  1. Flexion-intolerant back-pain patients. This person’s pain usually worsens during forward-bending movements like picking up a pen off of the floor, Sidorkewicz says. Tying your shoes, gardening or sitting for long periods could also cause pain, she adds.
  2. Extension-intolerant back-pain patients. For these patients, backward-bending movements or activities are pain triggers, Sidorkewicz says. Many yoga positions that arch the back are trouble, and so is lying on your stomach and trying to push yourself up.
  3. Motion-intolerant back-pain patients. “Any movement of the spine away from a neutral, upright-standing, or laying-down position may bother their back,” Sidorkewicz explains.

The Best Sex Positions For Pain-Free Sex

The right position varies depending on which type of movement causes you pain.

For women who feel pain when bending forward, the missionary position is likely to make things worse, Sidorkewicz says. Meanwhile, side-lying and kneeling positions—yes, that means “doggy style”— are likely to be most comfortable, she says. Just be sure to support yourself using your hands, not your elbows, in order to keep your back from painful downward-bending positions, she adds. 

For women who have pain when arching backward, flip that advice around, she says. Side-lying or doggy-style positions will likely increase back pain, while the missionary position—especially with your knees bent up—is likely be most comfortable, she explains.

Knees-up missionary is also a great position for motion-intolerant back-pain patients, she says. Stay away from doggy-style, which causes the most amount of lower-back movement.

Sidorkewicz’s research didn’t examine women-on-top positions, unfortunately. But if those are your jam, her research on men suggests trying different methods of supporting yourself while on top—leaning forward on your forearms, instead of on your hands, say—may provide relief.

More Helpful Sex Tips

If you’re in any kind of laying-down position, like missionary, it can help to put a pillow or rolled-up towel under your lower back for extra spine stabilisation and support, Sidorkewicz says. Also, if you’re on your hands and knees, try to maintain the natural curve in your lower back, she says. (If vaginal dryness is what's causing you pain during sex, try a safe lube.)

If your back pain is related to any kind of disc issue, “avoiding morning sex would be a good idea,” she says.

Why? “Our discs are highly pressurised, and expand first thing in the morning,” she explains. “But getting up and moving around for an hour relieves about 90% of that extra pressure and expansion, making sex more comfortable.”

Finally, keep in mind that very small tweaks in posture or positioning can make a big difference. If your current position causes ache, arching forward or backward, or changing the way you’re supporting yourself, could relieve your pain.