Which Sex Positions Are Easier on a Sore Back, According to Researchers

# What the studies looked at Researchers led by professor Stuart McGill and colleagues at the University of Waterloo used infrared and electromagnetic motion-capture systems to record how couples' spines moved during a range of sex positions. The goal was practical: identify positions that reduce problematic spinal motion for people who want to remain intimate while managing back pain.

# Two pain patterns that guide choices The studies separate back pain into two movement-intolerance patterns that affect what hurts:

• Flexion-intolerant: pain worsens when the spine rounds forward, for example during bending to touch toes or sitting with a rounded back.
• Extension-intolerant: pain worsens when the spine arches backward or when lying on the stomach.

The central finding is that a position that is comfortable for one pattern can increase pain for the other. That makes a single recommendation—"spooning is always best"—unreliable.

# What the research found for men The male-focused study recorded spinal motion across positions and linked those motions to the two intolerance patterns.

• Men with flexion intolerance did better in doggy-style. This position reduces spinal rounding and allows thrusting through a hip hinge rather than pushing with the spine. Doggy-style also keeps the torso orientation that limits forward rounding.
• Spooning increased spinal flexion for these men, making it a poorer choice despite its reputation as a gentle position.
• Men with extension intolerance—whose pain increases when the spine arches or they lie on their stomach—tended to find missionary (man on top) and spooning less provocative because those positions reduce spinal extension.

Lead author Natalie Sidorkewicz highlighted that tailoring position choice to a person's pain triggers produces better outcomes than one-size-fits-all advice.

# What the research found for women

• Women with flexion intolerance were helped by spooning and by a doggy-style variation where the partner rests the upper body on the hands rather than elbows. That modification reduced spinal rounding while still allowing intimacy.

# Practical, short-action tips

• Identify your trigger: note whether bending/rounding or arching/lifting the chest makes pain worse. That determines which positions to try or avoid.
• Flexion-intolerant people: reduce spinal rounding. Try doggy-style or positions that allow a hip hinge. Avoid spooning if it causes rounding.
• Extension-intolerant people: reduce lumbar arching. Try missionary with a pillow under the lower back or spooning to keep the spine more neutral.
• Use small adjustments: pillows, changing where weight rests (hands vs elbows), and hinging at the hips can change spinal demand without changing the basic position.
• Communicate and experiment slowly with a partner to find comfortable angles and supports before full activity.

# Bottom line The studies provide practical guidance: match positions and simple supports to whether your back pain is provoked by flexion or extension. Small adjustments—pillows, hip hinge, or using hands for upper-body support—can change spinal motion and make intimacy less painful.