Q: Long ago, I made love every day. Now I have low back pain. What can I do?
Dr. Klein: Back pain is a common obstacle to sexual pleasure. For starters, I suggest you discuss it with your partner(s), explaining what positions are particularly uncomfortable and comfortable. Find out how your partner(s) feel about these positions, and use the comfortable ones. This is true for whatever oral, manual, and anal sex you do, in addition to intercourse. For example, you’d probably be more comfortable doing cunnilingus on your back with the woman above you than lying between her feet and putting your head between her thighs, hyper-extending your lower back. Most people with chronic pain don’t like to admit the way it interferes with sex. But if you acknowledge it and take steps to minimize it, you can enhance your sexual pleasure. So take something like Advil an hour before sex. If possible, a hot bath and 3 minutes of stretching before sex will help a lot. Invite your partner to massage your back for a few minutes before the sex gets especially energetic. Even a half-glass of wine or beer can help you feel looser (don’t use more, because it may affect your sexual functioning). Don’t give up. Consider your pain a strong message that you need to find new positions for sex, and that you need to enlist your partner in this adventure.