The results of SpineUniverse's national survey on Sexual Satisfaction and Back Pain (read the article Back Pain and Its Impact on Sexual Satisfaction for survey results) indicate that back pain is ruining the sex lives of many people.

While the statistical results of the survey are important, it is essential to remember that behind the numbers are real people. People who care about their sexual satisfaction and about their partner's satisfaction. People who are currently frustrated and even depressed about the effect of back pain on their sex lives.

So what can they do to improve their situation?

Most experts agree that three tips can help you have better sex…even with back pain:

Tip # 1: Talk it Out
For some people, talking about sex comes naturally; for others, their faces turn red even thinking about maybe talking about sex.

Nonetheless, you and your partner need to find a way to discuss your back pain, and how it will affect-—or already does affect—your relationship.

Take the time to talk through the five issues below:

• Back pain: How severe is the pain? Where does it hurt? What movements or positions relieve or increase the pain?
   
• Sex drive: Is your back pain killing your sex drive? If it is, then you've got to discuss this. If you simply start avoiding having sex and don't explain why, you’re your relationship with your partner can be damaged. It's better to identify that it's a problem, and not just theirs…and then find a solution together.
   
• Emotional impact: What does back pain do to your emotions? Do you feel less attractive to your partner? Depressed?
   
• Physical limitations: Living with back pain means living with physical limitations in multiple aspects of your daily life. What physical limitations do you now need to work around during sex?
   
• Intimacy: What physical and non-physical steps can enhance intimacy? (Yes, intimacy means more than sex.) Within the limitations caused by back pain, what else can you do to feel close and connected?

Tip # 2: Practical Changes
Here we go, the nitty-gritty details of what to do (or not do). (It's okay if you skipped ahead to this part, but be sure to go back and read the rest of the article.)

Position Matters
It may not be the sexiest thing to think about, but you have to remember your diagnosis as you're having sex. Do you have spinal stenosis? A herniated disc? Degenerative changes in your spine? Your diagnosis is vitally important during sex because what's causing your pain influences how your body reacts to different positions. For example:

• If you have spinal stenosis, your back pain will likely get worse if you arch your back during sex.
   
• If you have degenerative disc disease or a disc herniation, your pain will likely increase if you bend forward during sex.

So if you can identify which positions naturally reduce your back pain, you can then adapt your position during sex to make the experience less painful, given your particular condition. For example:

• Men who have degenerative disc disease may find their back pain during sex is diminished by lying on their back with a pillow placed under their low back, while their partner then straddles them on top.

Change the Place
As we've learned from Hollywood movies, sex doesn't happen just in a bed. And perhaps being out of bed will actually help reduce your back pain. For example:

• If you prefer lying on your back during sex, a firm surface, such as a rug on the floor, may be more comfortable for you.

But remember, back pain is individual, and perhaps your pain is less during sex if you're on a soft mattress. You need to figure out what's best for you and your partner.

Relax Your Back
Back pain is often made worse by your muscles becoming tense and even knotted around the painful area. Going in a hot tub before sex, having a soothing massage, or even just using heat or ice packs on the affected area can all ease away muscle pains prior to sex.

For more practical tips about back pain and sex-—and more details on sexual positions-—go to Sex and Back Pain.

Tip # 3: Talk to a Medical Specialist
We know, talking about sex with your doctor isn't the most appealing idea (unless your doctor is Dr. Ruth). But think of this: When Viagra first became available, many men were too embarrassed to talk about erectile dysfunction with their doctor. Then Bob Dole appeared in one of their commercials, and that made it easier to talk to your doctor about sex. (Perhaps the thinking was—'If Bob Dole, a politician, can admit he has a problem, maybe I can, too!')

Besides, doctors have heard it all and they're ready to help. Your physicians care about all aspects of your physical and emotional well-being; they won't judge, pity or mock you. So take a deep breath, push past the potential embarrassment, and talk to your doctor about how back pain is affecting your sex life. Often, doctors can give very useful advice. For example, even a modest change in a medication can make a world of difference for your pain.

Because sex is more than…
Sex is more than just the sum of its physical parts—it's more than a formula of physical steps that lead to the "perfect" experience. A lot of what we see in movies and on TV these days makes sex the pinnacle of a relationship, the one thing that most clearly defines you as a couple (think Grey's Anatomy).

But for the vast majority of people, sexual satisfaction depends on numerous factors, not just physical performance. Factors such as emotional connectedness, a bouquet of flowers sent for no reason, attentive listening, saying thank you for the little things, or sending the kids to Grandma's for the night, can all add to sexual satisfaction.

And none of those things are limited by your back pain. You can still have a satisfying, intimate relationship—back pain or not.

To learn about Dr. Ammerman’s practice, click here.