Around one-half of all adults in the United States experience some form of back pain, and for a majority of these Americans their sex life suffers. A “groundbreaking” study conducted at Waterloo University has revealed the best and worst sex positions for women dealing with back pain. Researchers have outlined which sex positions will work for women suffering from a certain type of pain back. They will look to broaden their findings with future studies that include more exhaustive sex positions for participants with other forms of back and hip pain.

“Primary care physicians report it is common for couples to seek their advice regarding how to manage their back pain during and after sex. Many couples will remain celibate because the pain resulting from one night of love-making lasts months,” Professor Stuart McGill, of the Faculty of Applied Health Sciences, said in a statement. “Now doctors have solid science to guide their recommendations.”

McGill and his colleagues observed 10 couples performing five sex positions using infrared and electromagnetic motion capture systems that assessed spinal movement in both participants. The five positions couples were asked to perform included two variations of doggy style, one in which women supported their body with elbows and the other with their hands; two variations of the missionary position, one that required less flexion at the hips and knees and the other more flexion at the hips and knees; and, finally, spooning or “sidelying.”

For women who experience back pain by arching their back or lying on their stomach, known as “extension-intolerant,” the research team recommends the missionary position while using a pillow for lower back support. For women who experience back pain when touching their toes or sitting for long periods of time, known as “flexion-intolerant,” they recommend spooning or the doggy style position where women support their body with their hands, and not their elbows.

“Traditionally, spooning was recommended by physicians to all individuals with back pain because it was thought to reduce nerve tension and load on the tissues,” said Natalie Sidorkewicz, a Ph.D. candidate in Waterloo’s Faculty of Applied Health Sciences. “But when we examined spine motion and muscle activity, we found that spooning can actually be one of the worst positions for certain types of back pain.”

According to the National Institutes of Health, anyone can suffer from back pain, but certain lifestyle factors can increase a person’s risk. Although back pain tends to become more common as a person gets older, it often starts in their 30s or 40s. A lack of physical fitness or being overweight can also increase someone’s risk for lower back pain development. Unfortunately, sometimes there is nothing a person can do to avoid back pain. It could be hereditary or the result of a disease such as arthritis or cancer.

“What we know now is that sex positions that are suitable for one type of back pain are not appropriate for another kind of pain,” Sidorkewicz added. “These guidelines have the potential to improve quality of life — and love life — for many couples.”

Source: Sidorkewicz N, McGill S. Documenting female spine motion during coitus with a commentary on the implications for the low back pain patient. European Spine Journal. 2014.