Back pain can be a real, well, pain in the neck when it comes to your sex life. The pain can make you feel less than sexy, certain positions can make it worse, and you may feel limited or bored because you are forced to stick with the same few “safe” positions.

No more! With a little creativity and patience, you can enjoy all your favorite sex positions and some new ones with some slight changes! Exactly which ones work for you depends on the type of back pain you and/or your partner experience.

Below you’ll find some general tips for enjoying sex despite your pain and some of my top picks for the best positions you can try.

Note: In order to make this article work for couples of all gender identifications, the words "penetrative partner" and "receptive partner" are used throughout these sex position suggestions.

Types of Back Pain

There are two main types of back pain: flexion intolerant pain and extension intolerant pain. For ease, let’s call the people who experience these Archers and Spooners.

Archers experience pain when they sit for long periods of time or bend forward like they’re touching their toes. They’re most comfortable standing up straight or bending - OK, arching - back.

Spooners experience pain when they lie on their stomachs or arch their backs. They’re most comfortable bending forward, like a big spoon.

General Tips for Have Sex When You Have Back Pain

Use Pillows and Props
Avoiding pain can mean getting creative - and using props! Use pillows or rolled up towels to support your body and give you more support. Common areas to place them are under your head, knees, and lower back.

Communicate With Your Partner
The pain-free person needs to check in regularly while the person in pain needs to be open and honest if something hurts

Choose the Right Time
Don't try to tough it out and have sex when your back is killing you. When is your pain the lowest? Get it on then.

Slow Things Down
This is not the time to really go at it. Less jostling benefits your back and slower sex feels extra delicious for everyone.

Stick to Firmer Surfaces
If you don't have a massage table at home, try taking the cushions off your couch and putting them on the floor. More support means less pain.

The 10 Best Sex Positions for Back Pain

Want a few positions to try when your back is bothering you? Here are few that might do the trick.

Doggy Style Position Variations

Doggy style position is one of the most adaptable positions, making it a great option for people who struggle with back pain. Here are a few variations to get you started. Try them as is or mix and match the elements that work for you to make a new combination that feels pleasurable for you and your partner.

Traditional Doggy Style Position

Doggy Style Sex Position

Best For: Receptive Archers or penetrative Spooners

The receptive partner crouches down their hands and knees. It’s important they don’t go down on their elbows as this can cause them to round their backs. The penetrative partner kneels and enters them from behind. Bonus: Arching not only feels good for the receptive partner’s back, it also makes the position deeper & more pleasurable for both partners.

Modified Little Lift Position

Little Lift Sex Position

This position is called the Little Lift, but when it comes to back pain, it works best if the receptive partner puts the pillow under their upper body.

Best for: Receptive Archers

This is great alternative to spooning if the height difference between you and your partner makes it difficult.

The receptive partner lies on their stomach with a pillow under their chest, their weight resting on their forearms, and their head up. The penetrative partner can stand, kneel or lean over the receptive partner while entering them from behind.

Upright Torsos Position

Hooked in Sex Position

Best for: Archers

This position is great for playing with the receptive partner’s chest, shoulders, clitoris or penis or even pulling their hair. In this sex position, both people kneel upright on the bed. The receiving partner’s back presses against the penetrating partner’s chest. Experiment with different arm positions that are most comfortable.

To accommodate differences in height, you can put pillows under the shorter partner’s knees. Or, have the penetrative partner place their legs inside those of the receptive partner who then adjusts the width and subsequent height of the spread.

Receiver-on-Top Position Variations

Traditionally called woman-on-top, or cowgirl, this position puts the receiver in control, allowing the penetrative partner to relax more. Generally, people with back pain should do less of the work and movement during sex, so this can be a great option when the penetrative partner is the one with pain.

Cowgirl with a Pillow

Cowgirl Sex Position

Best for: Penetrative Archers

Any variation of cowgirl is fantastic as long as the partner on the bottom has a pillow under their lower back to support their natural arch. Once that’s taken care of, go buck wild. The receptive partner can face towards or away from their partner, squat or kneel, and bounce, thrust, circle, or move their hips in any motion that feels amazing.

Pitcher’s Mound Position

Pitcher's Mound Sex Position

Best for: Penetrative Archers

This variation is a great way to change up cowgirl and to get super close and connected to each other.

The penetrative partners sits in a sturdy, armless chair or on the couch while the receptive partner climbs on top and slides into place, facing forward or away from them. The receptive partner’s feet may reach the ground, be bent up to rest on the chair, or bent back so that they're essentially kneeling on the chair. Play around with bouncing up and down, rocking your hips back and forth, and thrusting and lifting.

Reverse Missionary Position

Reverse Missionary Sex Position

Best for: Receptive Spooners

Receiver on top isn’t only beneficial for penetrative partners with back pain. This version is fantastic for receptive partners who feel more comfortable standing up or bending forward. It’s also really gentle and deeply intimate.

The penetrative partner lies down with a pillow under their lower back, if needed. The receptive partner straddles the penetrative partner then leans forward so they’re lying down, face-to-face. This keeps the receptive partner’s back rounded forward instead of arched.

Missionary Sex Position Variations

Different versions of missionary let the receptive partner relax and do less of the work.

The Pancake with a Pillow

Pancake With a Pillow Sex Position

Best for: Receptive Spooners

The receptive partner lies down with a pillow or towel under their lower back. They bend their knees and pull their legs towards their armpits. The penetrative partner kneels upright, leaving lots of room to play with the receptive partner’s clitoris or penis, or leans forward for extra body contact, kissing, and cuddling.

Coital Alignment Technique (CAT)

Coital Alignment Technique

Best for: Archers

CAT is designed to stimulate the clitoris but it’s also a fantastic missionary variation for penetrative and receptive Archers.

The couple gets into missionary position with the penetrative partner supporting themselves on their hands and the receptive partner supporting their lower back if necessary. The penetrative partner then slides up so their penis or sex toy points slightly downward. Instead of thrusting, the couple rocks their hips together. While the penetrative partner pushes downwards, the receptive partner pushes their hips upwards. This one's pretty sublte and gentle but, when done correctly, it can be very pleasurable!

Other Good Positions For Back Pain

Spooning

Spoon Sex Position

Best for: Penetrative Spooners or receptive Archers

Spooning had long been considered the go-to position for people with back pain. In addition to being really gentle, it’s also deeply intimate. Given that dealing with back pain often feels lonely, isolating and burdensome, the connection spooning offers will benefit you beyond it’s back-saving gentleness.

In this position, both partners lie on their sides. The receiving partner lies with their back to the penetrating partner who can enter either vaginally or anally. The angle is great for hitting the G-spot and prostate. Plus, it makes stimulating the clitoris or penis of the receiving partner easier.

The Spork with a Pillow

Spork Sex Position

Best for: Receptive Archers

If you feel bored or limited by your sex position options, the Spork position is your answer.

In this position, the receptive partner lies down with a pillow or towel supporting their lower back. They raise one leg toward their shoulder and out slightly, without bending the knee too much. The penetrative partner positions themselves at a 90 degree angle to enter them.

Get It On!

No matter what sex positions you try out, the most important factors are to stay curious and be mindful of your bodies. Pay attention to which movements and positions feel comfortable and pleasurable and which hurt. And remember: things can change over time. Keep exploring and trying new positions to build a library you can choose from, no matter what’s going on with your bodies that day.