Lower back pain from having sex can ruin the mood for men and women alike. Symptoms expressed during sex are actually very common for various reasons, including structural issues, functional issues and mindbody explanations. However, since sex is a rewarding part of life and a crucial aspect of pair bonding, it is very important to address these symptoms in order to prevent significant collateral damage to self-esteem, confidence and intimate relationships.
Sexual intimacy is a physical exertion that requires a healthy body and mind. Physical and psychoemotional problems are both common impediments to a satisfying sex life and both can be the direct causes of pain in the lower back that is expressed during sex.
This vital topical essay investigates why sex can worsen existing low back pain, as well as the possibility of sexual relations being the direct cause of lumbar dorsalgia in a great number of patients. We will detail both anatomical and mindbody mechanisms of symptomatic activity during intimacy.
Structural Causes of Sex-Related Low Back Pain
Sex requires movement and positioning that can exacerbate existing symptoms and possibly even contribute to new expressions of pain in the lumbar region. The muscles that regulate sexual activity are innervated by the lumbar and sacral spinal nerve roots. These are the same nerve roots that are often structurally compressed within the central and/or foraminal canals in the lower back due to herniated discs, atypical spinal curvatures and spinal stenosis, among other possible causations.
The sacroiliac joint is commonly stressed during sexual positioning and can be a primary source of pain in many patients. Hypomobile sacroiliac joint conditions might make flexibility and intimate movement very painful, while hypermobile sacroiliac conditions can make the joint unstable and create massive pain.
Piriformis syndrome is often negatively impacted by sex, since the movement of the hip activates the muscle and can cause it to clamp down firmly on the sciatic and/or pudendal nerves. Sciatica is a common consequence and for patients who suffer pudendal compression, sexual dysfunction might also occur, since this structure innervates the genital regions.
Muscular lower back pain due to injury and imbalance will certainly become worse during sexual intercourse. The muscles of the lower back, including all the postural muscles, are active during sex and if compromised, are likely to suffer symptomatic escalation.
Bending the spine in particular ways can aggravate a diversity of structural issues in the vertebral column, even when these conditions are not normally symptomatic during day to day life. These conditions might include herniated discs, spinal stenosis, foraminal stenosis, spondylolisthesis, scoliosis, hyperlordosis and hypolordosis.
Mindbody Lower Back Pain from Having Sex
Mindbody causes of lower back pain are very commonplace during sex. In some instances, sex simply acts as a trigger for an unrelated psychogenic lower back pain syndrome to flare-up, while in most cases, the underlying issues driving the symptomatic imperative are actually directly related to sex in some way. Common associations between psychoemotional issues and sexual intimacy include feelings of distrust for a partner, feelings of guilt for one’s own past actions, poor body image, regret for having or not having children, reminders of past infidelity and any number of circumstances that can create tension between 2 people.
Sex is a perfect trigger mechanism for related and unrelated psychogenic syndromes, since it involves considerable exertion, movement and flexibility, all of which are well known instigators of pain in compromised tissues. People who subconsciously want to avoid intimacy or sex can use the pain for secondary gain, while people with other psychosomatic imperatives can utilize the pain for primary gain in order to camouflage the true underlying psychoemotional issues that are seeking conscious attention, but are buried by the flare-up of agony.
Relieving Lower Back Pain from Having Sex
Sex can be enjoyed by any adult, at any age of consent and in virtually any physical condition. However, concessions might have to be made in order for both partners to feel relaxed, satisfied and comfortable with the circumstances. The way to facilitate great sex, despite any impediments that might exist, is open and honest communication. Flexibility of body is far less important than flexibility of mindset. In essence, it is vital for both partners to want to be together and accept compromises in activity, position and exertion in order to best fulfill each other.
Physical therapists are experts at helping couple to address the structural issues that might require attention in order to enjoy a satisfying sex life. There is no reason to be shy about discussing intimacy with your therapist and we routinely suggest that couples do so together in an open and productive manner.
However, for mindbody-enacted pain (which in our experience causes the majority of sex-related lower back pain conditions and contributes to virtually all), the work must be done internally to resolve the causative issues that are responsible for pain. To facilitate this process, we highly recommend utilizing knowledge therapy, as this path towards a cure can get to the heart of the troublesome psychological concerns that are directly responsible of causing or contributing to the torment. Remember that even the most structural pain syndromes definitely suffer from psychological overlay, so even if you have an anatomical explanation for pain, it is worth it to try knowledge therapy and see how much pain still remains when you are finished. You will be amazed how much might have been psychosomatic influence, rather than structural pathology!
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