Best sex position with lower back pain: 4 moves to ease discomfort

This is the best sex position with lower back pain, according to an osteopath

Man and woman lying in bed together with woman leaning on top of man, laughing and smiling, representing best sex position with lower back pain
(Image credit: Getty Images)

The best sex position with lower back pain will be different for everyone, depending on where the pain is and when they tend to experience it, but finding the move that works for you can be transformative. 

Any movement that requires bending the spine backward, forward, thrusting, or supporting bodyweight can cause intense discomfort for those who already experience back pain. Even just lying down is an issue for some people as the pain tends to be caused by one or more problems affecting the spine and surrounding tendons and tissues. 

Perhaps it's no surprise that studies, from the University of Bologna, show those who have to deal with lumbago (aka lower back pain) tend to have less sex overall compared to the rest of the population. The good news is, if you want to get your love life back on track, it's entirely possible to explore many of the best sex positions while avoiding the biggest causes of lower back pain

What causes lower back pain during sex? 

There can be several reasons why someone might experience lower back pain during sex, says Phyllis Woodfine, an osteopath with over 20 years of experience. "Pain during sex, or dyspareunia as it's also known, is often not a subject volunteered by patients. However, it's probably more common than people realize. There are many possible causes of lower back pain during sex, some of which require further investigation if the pain is persistent." 

Assuming there are no sinister causes of lower back pain, she explains, it may be caused by: 

  • Sacroiliac joint instability: The sacroiliac joint links the pelvis with the lower spine and if ligaments or muscles are a little lax here, it could be painful to put pressure on the area or move it quickly.
  • Disc injury: If you've experienced any issues with the tissue between the bones in your spine, or even a so-called 'slipped disc', this could be causing the pain "due to the muscles protecting the area being in spasm," says Woodfine. 
  • Arthritic changes: With age, the protective cartilage on the end of our bones in our spine can break down, a condition known as osteoarthritis. "With inflammation and tight muscles around the lower back and buttocks add to the discomfort or pain," says the osteopath. 

Best sex position with lower back pain

1. Missionary

Illustration of the missionary sex position with pillow underneath partner's lower back

(Image credit: H.Maddison)

Missionary is the best sex position for lower back pain, explains Woodfine. "It may be suitable for a person with disc problems, with pain being worse when the back is in extension," she says. Extension means arching your back, so opt for moves like the closed missionary sex position or the butterfly sex position where a bed or table supports your spine, and avoid ones like doggy style where your back is unsupported.

To make missionary sex better, the person on the bottom could pull their knees into their chest and place support underneath them. "Using towels or pillows to support the pelvis or lower back can help reduce discomfort," adds the osteopath. 

2. Side by side

Illustration of the side by side sex position with pillows underneath partners' backs

(Image credit: H.Maddison)

"Lying side by side facing one another is a suitable position where flexion, bending forwards, causes pressure on the lower back," says the osteopath. If you experience pain when sitting down for a long time, this position could also alleviate some tension. 

If you're looking for one of the best oral sex positions to do with lower back pain, this could also be a winner. The sideways 69 sex position, for example, requires both participants to lie down on their sides at either end of the bed, as pictured. 

3. Spooning

Woman and man lying in spooning position with pillows underneath their backs

(Image credit: H.Maddison)

"Spooning is similar to side by side with the penetrative partner laying behind the other person," she explains. "This is more likely to be suitable for someone who finds pain worse when arching their back but is OK with bending slightly forwards."

In general, this position is a good one for those who prefer more clitoral stimulation during sex as well, since the partner in front can stimulate their own with a pick of the best bullet vibrators, or the partner behind can reach around and lend a hand. Less chance of back pain and more chance of orgasm, it's a win-win. 

4. Speed bump

Illustration of couple having sex in the speed bump sex position with pillow positioned underneath for comfort

(Image credit: H.Maddison)

However, if you don't find arching your back too painful, Woodfine says that the speed bump sex position with the pillow positioned slightly differently could be a good option to try. "A position for someone who does not find arching the back too painful is face down, supporting the upper body with their arms or putting a pillow under the chest." 

Similar to the cobra pose in yoga and the prone bone sex position, this move could help to stretch out the muscles in your abdominal area which also support the lower back, and reduce the stiffness in your lower back. But, the osteopath warns, "Take your time so you are aware when you are exacerbating the pain." 

Is lower back pain during sex preventable? 

Yes, in many cases, it's possible to prevent lower back pain during sex. "You can stretch the muscles before and, maybe after sex, have a hot shower to relax the muscles," suggests Woodfine. "You can also change your position to one that's more comfortable. But if the pain persists, you should have it investigated."

The most important thing to remember, if you experience any kind of discomfort during sex, is that you can stop at any time. It's entirely possible to be intimate without sex and, at the end of the day, sex is supposed to be enjoyable for everyone involved so if it's not working for you, seek professional guidance and try something else. 

Grace Walsh
Health Channel Editor

Grace Walsh is woman&home's Health Channel Editor, working across the areas of fitness, nutrition, sleep, mental health, relationships, and sex. In 2024, she will be taking on her second marathon in Rome, cycling from Manchester to London (350km) for charity, and qualifying as a certified personal trainer.

A digital journalist with over six years experience as a writer and editor for UK publications, Grace has covered (almost) everything in the world of health and wellbeing with bylines in Cosmopolitan, Red, The i Paper, GoodtoKnow, and more.