UPFRONT | Roundup Study offers suggestions on what to do when sex is a pain in the back For many people, intimacy in the bedroom often takes a back seat to low back pain, say researchers, who have scientifically determined the best sexual positions to pre-vent spinal muscles from seizing up at an inopportune moment. In what they believe is the first biomechanical study of its kind, researchers at the University of Waterloo have found that certain positions are better than others for keeping different kinds of back pain at bay. And they’ve thrown out the long-held belief that spoon-ing – where partners lie side-ways curled back to front – is the only pose for back-saving sex. “Before now, spooning was often recommended by phy-sicians as the one position that fit all. But as we’ve discov-ered, that is not the case,” said Natalie Sidorkewicz, a PhD candidate and lead author of the paper published in Sep-tember in the journal Spine. “What that failed to do was recognize that there are all sorts of triggers for back pain,” she said. “So someone may find relief in one posi-tion that may cause pain for someone else.” To conduct the study, the researchers recruited 10 het-erosexual couples, with an average age of about 30, to have sexual intercourse in a controlled laboratory setting. Each participant was fitted with remote sensors, which tracked how their spines moved when they engaged in five common sex positions. Infrared and electromagnetic motion capture systems – such as those used to animate figures in video games and films – showed how the men’s and women’s spines flexed when they assumed each position. “So we were able to actu-ally determine what angle the spine is at, at each moment in time that they’re having sex,” said Sidorkewicz, adding that electrodes on participants’ skin also captured activity in their core and hip muscles. The findings were used to create an atlas, or set of guidelines, that recommends different sex positions and thrusting techniques based on what movements trigger a patient’s pain. Overall, the study found both men and women em-ploy a lot of spinal motion during sex, said Sidorkewicz. “In general, to make any posi-tion more spine-sparing, we’re recommending that the individual who’s controlling the movement use more of their hips and knees, rather than their spine,” while their partner keeps a more neutral supine position. “A great example of both these recommendations is the missionary (position),” she said, advising that a woman lying on her back place a cushion or other support un-der the curvature of her spine. The researchers also found, for instance, that kneeling behind one’s partner during intercourse can prevent back pain caused by flexion in both partners. “Any family doctor will tell you that couples often ask them how to manage their back pain during and after sex,” said senior author Stuart McGill, a professor in the fac-ulty of Applied Health PAIN MANAGEMENT Sciences. “Many couples will remain celibate because one night of love-making can lead to months of back agony. “Until now, doctors have never had any hard science to base their recommenda-tions upon.” And having a bad back that interferes with one’s love life is more common than many people realize. Survey studies suggest that 84 per cent of men and 73 per cent of women report significant decreases in sexual relations due to lower back pain, Sidorkewicz said. “Right now, if a patient were to come to a chiroprac-tor, physiotherapist or a phy-sician asking for resources on this, anything that is currently out there is not based on sci-entific data,” she said. “So we are now providing that to help guide those clini-cians to make better recom-mendations for those pa-tients. So the idea is to improve the quality of life of these couples by helping them maintain more of a healthy sexual relationship.” Although this study fo-cused on how a man’s spine and muscles move during intercourse and orgasm, the scientists also gathered data on female par ticipants, which they hope to publish later this year or early next. Future papers include sim-ilar studies on people with existing back and/or hip pain to test the effectiveness of their initial recommenda-tions, which would then be further refined for various patient groups. The guidelines should also help doctors and other health providers feel more comfort-able about discussing the delicate topic of sexual posi-tions, Sidorkewicz said. “We’re hoping to help facil-itate that dialogue between the patient and practitioner and also between couples who are struggling with this daily.” – Sheryl Ubelacker, The Canadian Press www.canadianchiropractor.ca 14 Canadian Chiropractor October 2014
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