Sex and Back Pain can be a challenge.
Sex and back pain can really suck. Maybe you can relate? It was the height of my pain years; I was in my 30s and had been married for a decade. I wanted to be wanted. I wanted to be sexy and sultry and have those fun evenings, and mornings, that my friends were having with their husbands. However, an orgasm, even a little one, caused me a weeklong flare.
My Personal Story
The hobbling, the Increased pain in my familiar places, down the back of my thigh, my glute max, all on fire and feeling off and like someone had stuck a screwdriver into my rear. All those things made it very hard to prioritize sex, and I am defiantly a fan of it! It also affected my partner, his drive was lower than mine to start with, but the fact it caused me pain lowered the desire even more. It was a terribly sad cycle that would cause much grief, frustration, and shame for me.
I remember it had been years since we had been intimate, and I had a particularly bad flare after an attempt. A 911 call to my PT was made the next morning and as he worked to calm down the angry tissues, he was emphatically telling me to never ever ever do whatever I did to get “this bad”.
I started crying. Never have sex again?! Was my pain going to take this from me too? I felt hollow. Not this too. He noticed the change in my emotional state and asked further questions, ” What happened to gt you like this?” I responded with a whisper….” I had sex with my husband.”
He drew back his chastisement and apologized. We worked in silence for a while, until he started asking questions to assess the issue. Then said, “When you come back in two days. I’ll have some suggestions for you, ok. This isn’t ok.”
It was the first time in 15 years a provider had asked me about sex, anything about sex. or even considered that maybe I needed help having it in a way that didn’t cripple me for a week.
We need to talk about sex & pain with our providers
Somewhere along the line medicine decided to take the sex question out of the back pain disability survey. Why, who knows? In orthopedic settings, providers often feel “embarrassed” to ask, based on my conversations with them. Sigh. So, because it IS an activity a healthy adult should be able to participate in, talk about it with your medical professionals! It may be embarrassing BUT it is a basic need, just ask Maslow!
Women’s health PTs or Pelvic floor PTs, who have additional training in sexual health, are valuable resources. Depending on when and why you experience pain during intercourse, they offer fantastic hints and assistance. They openly discuss anything without embarrassment! Don’t be fooled by the name; they also assist men!
I always advocate for a check-in with a Pelvic Floor PT – can find one here
What can you do to help painful sex?
As I reflect on my experience, as well as the stories of others I want to point out a few things to consider as part of the flare soup.
1. If you haven’t been doing it, it’s a new activity. It’s no different than a new exercise routine. Muscles are used, chemicals are supposed to flow, it’s supposed to be active. So pacing is still part of keeping flares down. ( How unsexy is that?!)
2. Fear heightens our nervous systems – makes us more aware of changes biology. Sooooo fear that it will hurt, you will flare, you won’t be able to work…. these are all factors in the increased experience of pain.
Head into an intimate session with your partner or yourself in a more relaxed state for a better experience.
Here is why fear screws with pain and the body
- The Body anticipates pain: fear/ anxiety may also be contributors
- The body automatically tightens the vaginal muscles
- Tightness makes sex painful, penetration may be impossible
- Pain reinforces/ intensifies reflex response
- The body reacts by bracing more and more
- Avoidance of intimacy and or lack of desire may develop.
Some practical tips that have helped others with painful sex.
First, let’s remember that sex can be a whole lot more than just penis in vagina “sex”. So open up your definition of intimacy and “sex”. Be willing to explore and have some fun. You deserve it!
Second, a ramped-up nervous system is no fun, so making sure you are relaxed headed into your sexy time is helpful. Maybe a bubble bath, meds, a glass of your favorite adult beverage, a loving massage – you do you, whatever helps you to relax and get in the mood will help reduce those nervous system glitches
Foreplay: Never ever underestimate the importance of foreplay. This prepares you emotionally, mentally, and PHYSICALLY. Get those tissues warmed up and all the feel-good hormones flowing. Try new things. Who knows what you will find!
Don’t underestimate “ other forms of sex”: The goal is intimacy and an exchange of good feelings right? Well….. our bodies are designed to do that in lots of ways, get creative and experiment with… well, whatever!
Share fantasy: create intimacy by sharing ideas, fantasy, stories, and erotica. Send sexy texts or emails. Share a thought or fantasy while snuggled on the couch.
Touch: Touch each other, passing in the hall, a butt tap, a hug, hold hands, give kisses and hugs. Non-sexual touch is just as important in building intimacy. Cuddles too!
The most asked question I get about sex is, “What position is best”.
The reality is the answer is different for different couples, so like I said, get creative and experiment!
Start with these ideas.
On the bottom
On your stomach legs straight or one bent
Side by side
Pillows to prop hips or buttocks, and they even sell wedges.
On all 4’s
Cowgirl/ Reverse Cowgirl
Try using a chair
A sex swing to take pressure off different bits
Look up ideas!
Here is a book for further reading, it’s a bit old, but some things don’t change.
I hope these hints help get you back on track with your sexual self and intimacy with your partner. Please feel free to join the Facebook group for more support. I can’t wait to talk with you!
