Welcome to Reader’s Request Fridays! This week’s question comes from Tory*, who writes, “I was in a car accident a few months ago and am suffering from ongoing back pain. My sexual relationship with my boyfriend has suffered significantly as a result. I’m too embarrassed to talk about this with my physical therapist, so can you suggest activities or positions we can try to keep my pain to a minimum?”

Hi Tory,

First of all, I’m so sorry to hear about your accident. I’ve worked with clients with chronic pain conditions, and I know it’s no walk in the park. I’m not a medical doctor, but I’ve got a couple of suggestions for you.
 

Communicate

It’s also important to talk to your partner about the impact your back pain is having on your sex life. Some couples are reluctant to discuss this openly, for fear of making the partner in pain feel guilty, or making it seem more “real”.

But the pain is the reality for the two of you right now, and acknowledging it will be much better than trying to pretend it doesn’t exist.

This is especially important around sexual initiation; your boyfriend is far less likely to take a rejection personally if he knows it’s because you’re in too much pain for intimacy.

Always tell your partner when you’re in pain. Don’t be afraid of “ruining the moment” by bringing up the fact that something feels amiss. I’m sure your PT would tell you that trying to push through the pain can make your injury worse.

 

Warm up

Treat sexual activity like any other form of exercise and take a little time preparing your body. Take a hot shower, or use heating packs on your muscles. Ask your PT for a short stretching routine you can try.

 

Experiment with positions

Has your PT given you recommendations (non-sexual) positions to avoid, or ways to support your body? You can incorporate this advice into your quest for comfortable sexual positions. For example, if you’ve been told not to spend a lot of time sitting, don’t have sex in positions that require you to be upright. If you’ve been instructed to put bolsters under your knees, lower back, or neck, try doing that during sex.

In general, two good sexual positions are missionary and spooning. In missionary, prop your head up with a pillow, and keep your knees bent or pulled in towards your chest. On your side is another wonderful position to try. Have your boyfriend lay behind you, with both of you on your sides. This position allows you the freedom to make little adjustments as you go.

 

Focus on foreplay

I would give you this advice even if you weren’t experiencing back pain!

Take your time with your boyfriend, and try to find the foreplay activities that you really enjoy. You may have an easier time finding comfortable positions for foreplay than for intercourse. For example, if your back pain is minimized when you’re standing up, try making out with your boyfriend in the shower or up against the wall.

The goal is to maximize your pleasurable experiences instead of focusing on what you can’t do.

 

Try to relax

Chronic pain can be unbelievably stressful and frustrating. It’s hard to enjoy sex when your body is hurting, but the mental strain that often accompanies pain conditions can make things even worse.

Try to focus on relaxing as much as you can, both in and outside of the bedroom. See if you and your boyfriend can create a soothing atmosphere around intimacy. Do you like taking baths? Lighting candles? Having him give you a light massage?

 

Good luck!

*Names changed for privacy