There's this pained look patients get on their face right before they ask me about this. And it is the same look whether they are men or women, whether they are young or old, and no matter where they are from.
For some reason, people are really uncomfortable discussing the topic of sex with their physician. I'm not really clear why. I'm pretty sure there are a lot of people having sex, including many of my patients, and you would think that as their physician, I would (1) be pretty comfortable discussing normal bodily functions, and (2) probably have already answered questions about EVERYTHING having to do with back pain, including sex, so what's the worry?
The truth is, I am amazed by the things people will share with me while they are being treated on my table. I often feel like a bartender, which makes it stranger that folks get uncomfortable discussing this with me. Hey, that's what I'm here for!
Sex May Actually Help, Not Harm
When pain becomes a regular part of your life, sex is often one of the activities which gets pushed aside. Aside from the physical discomfort, there are psychological reasons for this as well: Back pain makes people feel diminished and damaged, and anxiety about sexual performance can add to these feelings.
The irony is that while people may stop having intercourse due to their pain, sex can actually help reduce discomfort by mobilizing "stuck" segments in the spine. An orgasm can result in the release of endorphins, which have a natural pain reducing effect. Lastly, the restoration of intimacy to a couple which has not had that closeness due to pain will often help bring back a sense of normalcy to the individual in pain, and to the relationship.
If It Hurts, Improvise
The problem is, many people recovering from various types of back pain find that intercourse can be uncomfortable, and actually exacerbate their pain. This is definitely a place where experimentation and innovation can reap huge rewards.
You may find that as a couple you may have to temporarily (or permanently) change your model of what actually constitutes sex (different positions, surfaces, even styles).
The take home point here is, don't give up! You can find something that works. It may take some trial and error, but the rewards for all of your research will be huge for you and your partner.
Andrew Kirschner, D.O., is a board-certified physician with a private practice in Bala Cynwyd, Pennsylvania, and a consultancy in Miami, Florida. He specializes in treating individuals and couples with musculoskeletal and back pain. To learn more about his practice, please visit BackTogether.org.