Sex, Back Pain and Spinal Stenosis

sex and spinal stenosis back pain

Spinal stenosis and back pain can put a real cramp in your sex life.

Back pain can affect so many aspects of life that it is often not a priority to address problems of sex and spinal stenosis. Patients may, quite reasonably, concentrate on being able to return to work, carry out daily chores and play with the kids or grandkids but ignoring sexual difficulties connected to back pain can have a serious effect on the health of a relationship, as well as self-esteem and general happiness. Sexual dysfunction can also be a sign of worsening spinal stenosis and cauda equina syndrome which could mean that back surgery is necessary to reduce the risk of more severe neurological damage.

Spinal Stenosis, Pinched Nerves and Sex

Spinal stenosis can occur at any place in the spine, be it the neck, the thorax, the lumbar or sacral spine. Foraminal stenosis may be a product of congenitally short pedicles, or it may be that a herniated or bulging disc is putting pressure on spinal nerves or the spinal cord. Fractured vertebrae, spinal slippage, arthritis and inflammation may also cause narrowing of the spaces in the spine and where this leads to pinched nerves myriad symptoms can arise, including sexual dysfunction. When dealing with sexual dysfunction there are a number of issues to address:

  • Are the sexual difficulties really due to spinal stenosis or is there another cause?
  • How is the lack of sex or pain from sex affecting both patient and partner(s) emotionally?
  • Is the pain accompanied by progressive weakness and incontinence?
  • What alternative sexual practices could be employed to restore intimacy?
  • Are pain medications, depression, stress or other issues contributing to sexual difficulties?

Are Back Pain and Sexual Problems Just Old Age?

Many cases of spinal stenosis are due to degeneration of the discs in the spine and as patients are often older when this occurs it may be that they consider a downgrading in sexual function as simply part of being old. This is not always the case as addressing the health of nerves innervating the genital region can restore sensation, arousal, stamina and performance as well as reducing pain. Severe spinal stenosis affecting the cauda equina may cause incontinence, severe leg and foot pain, excruciating lower back pain and sexual dysfunction.

Sex, Back Pain and Emotional Suffering

Sexual problems from spinal stenosis and back pain also affect the partner(s) of patients. The frequency and intensity of sexual activity may lessen, reaching orgasms may be more problematic than usual, one partner may become reluctant to initiate sex or respond to the usual signals and the pain-free partner may actually be worried about hurting their lover. All of these problems can lead to frustration that carries over from the bedroom into the rest of daily life, making it important to communicate openly about sexual difficulties resulting from back pain and spinal stenosis (as well as from other issues).

Talking About Back Pain and Sex

Talking about sex can be difficult but it is vital in order to make sure that the needs of all partners are met. It can help to talk in practical terms, such as ‘it hurts when I/you…’ or ‘this position is more comfortable now.’ Letting the pain-free partner know how bad the pain is, how it affects movement and comfort, and how certain previously enjoyable positions are now likely to trigger pain can help reduce reluctance to initiate what is likely to become unenjoyable and quickly curtailed sexual activity.

Sex and Back Pain – Talk to Partners

Those with chronic pain often find that their libido plummets but that they cannot face telling their partner(s) this for fear of hurting them. Unfortunately, not talking about it may be worse as it can seem like the patient simply does not desire their lover any more, leading to poor self-esteem and confusion. Avoiding having sex and not telling your partner(s) why is a lot worse than the brief moment of embarrassment of explaining how your back pain makes sex painful and then working together to find ways of making sex enjoyable again.

Pain Medications, Libido, Weight Gain and Self-Esteem

In some circumstances it may be that the person in pain is taking medications that reduce libido, cause drowsiness or otherwise affect their sex life. Some pain medications, such as steroids, also lead to weight gain which can make some feel unattractive to their partner(s). Depression over pain, impending surgery, the impact of spinal stenosis on work, recreation and family life can all contribute to a flagging libido and, again, talking about these difficulties and working together to achieve realistic goals is better than suffering in silence.

Sexual Experimentation and Back Pain

Many people with back pain and sexual difficulties find that they need to be more imaginative and experimental. This often unleashes an adventurous spirit and an even better sex life than they had before they were faced with chronic pain. Visiting sex shops together and buying props, supports, and other mobility aids can be particularly rejuvenating for a shared sex life. Whatever problems people are having it is likely someone else has had those too and that there is a mobility aid to overcome physical limitations during sex. This could be as simple as placing a rolled up towel beneath a partner’s lower back and buttocks to raise them up, or it may be that a thigh harness and strap-on works better now than the usual pelvic harness. Sex swings and other supports and props may have once seemed outlandish but seeing them as both practical and fun can make a huge difference in restoring intimacy in a relationship.

better sex with back pain at christmas

Would better sex, despite back pain, be the best Christmas present this year?

Back Pain and Sex Positions

Simple positioning is also important as those with spinal stenosis from a herniated disc or degenerative disc disease are more likely to experience pain when bending forwards. Lying face-up is preferable in such a situation, with a rolled up towel as lower back support. It is helpful to avoid arching the back during sex when suffering from disc herniation and spinal stenosis. Changing the location of sexual activity can also be helpful as an unsupportive mattress may no longer be practical for those with spinal stenosis. A soft floor rug can be invaluable here, providing a firm surface without the risk of friction burns.

Back Pain and Bossy Bottoms

Men with spinal stenosis may find it preferable to have their partner atop them to reduce the amount of movement they are forced to make. The same goes for women with lumbar spinal stenosis who may need to switch from being a top to being a bottom. This kind of alteration in sexual activity may seem inconsequential to many but it can be challenging for some who extend their identity deeply into their sexual practices. Once again, talking with partner(s) about these challenges can make all the difference, and it may be that a top becomes a ‘bossy bottom,’ thereby remaining in control to some degree rather than feeling that their back pain compromises their sexual role. It is also helpful to discuss in advance what will happen if pain suddenly arises during sex; does that call an end to everything or can there be a quick switch to alternative positions or actions to maintain the mood and fun.

Talking To The Doctor About Sex and Back Pain

Sex and spinal stenosis present many challenges and can cause tension and stress, both of which are detrimental to good, pain-free sex. Having a hot bath, a massage or a heat pack applied prior to sex can help release tension from the muscles and make those intimate moments more comfortable and pleasurable. It is wise to talk to a physician whenever sexual difficulties arise in cases of spinal stenosis, especially where severe problems occur. Changes in medication may make a huge difference, as can simply talking things through with a professional.

Counselling and cognitive behavioral therapy may be helpful to some in order to overcome embarrassment and communication problems. Physicians may end up discovering an unrelated cause of sexual dysfunction that is easily treatable and nothing to do with spinal stenosis, or they may recommend back surgery as the sexual difficulties highlight a more pronounced nerve problem than previously recognized.

Overcoming Sexual Problems in Spinal Stenosis

Back pain from spinal stenosis does not mean no sex ever again but it may mean that some adjustments need to be made and many find that such changes are actually fun and exciting. Establishing a proper diagnosis of spinal stenosis is important, as is working out the true cause of sexual dysfunction. Communication, experimentation and honesty are key to overcoming problems with sex and spinal stenosis.

1 reply

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *