Scarlett Letters: What Sexual Positions Won't Hurt My Back? 

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Dear Scarlett,

I have a pinched nerve in the lower part of my back and need some advice for sexual positions that won't hurt it.

Signed,

Back in the Sack (female, 44)

Dear Back in the Sack,

Many people suffer from back pain, especially in their lower backs. For some, chronic pain leads to depression or avoidance of sexual activity, which can strain relationships and rob them of an important source of pleasure.

First and foremost, consult your doctor or physical therapist for advice specific to your injury. There is no one-size-fits-all sex position for people with back pain. It really depends on the type of injury and other aspects of your health and fitness. Your doctor is familiar with your body and can let you know which positions to avoid.

One of the keys to coping with back pain is managing inflammation and keeping muscles relaxed. A hot shower before sex can loosen the muscles, and icing the site of your injury afterward can reduce inflammation. If you have undergone physical therapy, you should have a list of exercises and stretches aimed at strengthening your muscles and reducing pain. Doing some of those before or after sex may also be a good idea.

Another key is knowing which movements trigger your pain and what is a comfortable range of motion for you. If touching your toes or sitting for a long time causes pain, you might try spooning — where your partner enters you from behind as you both lay on your sides. That may minimize the flexing of your body and the nerve irritation it causes. If arching your back is a trigger, the missionary position could be right for you. 

Again, your doctor or physical therapist can best help you determine the right positions for your individual case. Don't be embarrassed to ask. Sex, and especially orgasm, can relieve tension and release endorphins. That's what Marvin Gaye would call "sexual healing"!

Love,

Scarlett