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Safety Positions for Healthy Sex Following Back Pain

B.Arun.* MPT, CMPT

Abstract: Sexual rehabilitation is never a part of low back rehabilitation in India. Sex is enjoyment, which should be liked by both the partners, around the world about eight out of every 10 people has experiencing back pain at some time in their lives, Back pain could cause difficulty in day-to-day activities. Crisis on partners relationship may occur due to unsatisfactory sex. India a Cultural Rich & Religious country will posses mysterious side on sex and people live in India have closed mouth attitude on sex. Fear about pain during sex is the first thing which produces fear on sex. The partners should understand the facts on pain and accommodate the new positions for happy and healthy sex. Variety of recommended positions is there which help to alleviate pain and gives good support and satisfaction to both partners.

Key words: Sexual Rehabilitation, Sex, Low Back Pain, Physiotherapy

INTRODUCTION Sex is pleasure, it is a wonderful feeling experienced by both partners. The interpersonal relationship between the partners brings a firm emotional bond. Sexual activity has not only produced by physical, emotional aspects but also biological aspects in human. The strong union between the partners may be wrecked due to a variety of causes. One of the major causes for the breakage is unhappiness or dissatisfaction. Pain may produce disappointments during sexual activity for both the partners. Pain in the back is one of the major causes of it.1 Sexuality is an integral part of normal and healthy relationships. It need not be the first thing abandoned when you are bothered by a flare-up of Back pain.2 Though it is chronic it should not prevent one from enjoying this part of the relationship. Low back pain is the most common musculoskeletal problem encountered by most adult population around the world. Four out of five adults will experience http://www.srji.co.cc

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significant back pain sometime during their life. After the common cold, problems caused by the back are the most frequent cause of lost work days in adults under the age of forty-five. 3, 7 In the Indian scenario, rehabilitation of back pain concludes when a patient has significant reduction of pain or he has got ability to do all ADL activities, like day to day activities or handling job task ect.. Very few rehabilitation protocols followed in India focuses on the other parts of rehabilitation. Mostly sexual rehabilitation is not the choice of treatment for patient living in India. Sexual inhibited common by activity acute is pain. but frequently Sexual

Literatures supports that the physical activity during sex produce similar stress to back same like lifting, pulling ect.. On while performing a vigorous movement in the pelvic region there is an increased stress at the back. During anterior tilting of pelvis, the back muscles get compressed with ligaments and other soft tissues. The repetitive activity produces more stress to the muscles, fascia and bones around the back result in pain. People with back pain are usually aware which positions could cause pain and they are able to find out which positions tend to increase or provoke pain. During vigorous sexual activity there is more stress in the lumbar region which can prevent active participation of the individual and most of the time back pain ruins their intercourse. A good scheme to keep enjoying sex is to choose sensuality over sexuality. Back pain may ruin sexual life and may wreck the relationship between the partners. So finding the positions which help to reduce or minimize pain is important for a successful sexual life. Modified positions are there to reduce stress in the back and help in safe sex. Conditions like herniated disk, spinal arthritis, & Sacroiliac joint dysfunctions need modification of the positions. 7 Fear of pain may ruin the sexual life between the partners. Back pain http://www.srji.co.cc

dysfunctions following back pain is the complaint infrequently discussed with the therapist. The reasons for this closed mouth attitude are multiple. People who are suffering with it feel that they may be the only ones having the problem and therefore embarrassed to talk about it, even with the doctor or to the therapist. Some doctors do not feel comfortable with the subject, or may not even recognize it as a problem.4

WHY PAIN OCCURS DURING SEX? During the sexual activity between the partners there are number of musculoskeletal activity happens.

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Apart from it the modified positions will also help to ease pain. Physical fitness doesnt mean that the partner is able to handle the pain. Mental fitness is as important as physical fitness. Understanding the problem between the partners is very important for

between the partners. In fact it tells to accommodate the position to get rid of pain. Back pain is more of psychological than physical. The most part of pain depends on mental status of the person.

HOW TO ASSESS IT? Various Back disability scale has an inclusion of sexual relationship questionnaire. Like, Oswestry has one part which focuses on sexual relationship. The scale by Laumann et al., 2005, has come up with a scale to find out sexual dysfunction in males. The scale will be helpful in evaluating the dysfunction.

managing for the problem. Having a good communication and developing a positive attitude can reduce the anxiety and apprehension between the partners. Sexual intercourse provides a natural pelvic tilt movement which is to be encouraged to relieve lower back pain. Partners must create and use of other sexual techniques that can spare the back, like touching, atmosphere creation and oral sex. Create an atmosphere that is very romantic and not be rushed, relaxed and peaceful. Begin with oral method and followed with recommended potions.

HOW TO MANAGE IT? Learning up a new posture or pain relieving methods like massage or ice prior to the sex helps in reducing pain and stress. Usually people with back pain are aware of which positions those cause pain and they usually avoid such positions or movements.
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RECOMMENDED POSITIONS No single position is good for all. Positions depend on the type and cause of back pain and are best consulted with the rehabilitation staff. Generally recommendations include positions like the Missionary position for both men and women. 1 If a male partner complains of back pain, he can be at the top of women will help to reduce stress at back, or man can lie at the side of woman either on the front http://www.srji.co.cc

People with Back pain should take a proper rehabilitation measures so that to cure pain, there are variety of treatment measures in physiotherapy, no single treatment is best of for all patients. treatment Combination various

approaches help in regaining the function as well as reducing the pain in patients.

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or at the back. If a female partner complains, she can be at the top with variety of positions like in bed or sitting in a chair.
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General advice given to partners are placing a towel at the back reduce the lumbar curvature which helps to prevent pain. People with back pain can be advised on good sex through illustration described by Fahrni in 1976. These illustrations give guidelines to people with back pain.

Depending on the type of back pain, the position alters. For example, patients with annular bulge will have an increase in pain during flexion whereas for a patient with facet problem pain will increase with extension movements. There are no hard and fast rules in dealing pain.

ILLUSTRATIONS FOR DIFFERENT POSITIONS

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Vol.1 No.2 2012 References

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1. Danielle Kloeck, Sex and Back pain Webb Physiotherapists Inc, http://www.physionline.co.za., 2010, www.spine-dr.com 2. Anthony delitto et al., exercise based therapy for Low back pain Sep 2010, uptodate.com. 3. Jerry corners, MD. Sex and Back pain Healthy back institute, www.losethebackpain.com. 2010 4. Dr.Kraus. Back and neck pain, www. Lowback - pain .com 2008. 5. Louise F. Lynch Sex and back pain information-causes, Diagnosis

and

treatments.

healthynewage.com, 2011. 6. Kamiah A Walkier, Tips for Better sex....even with back pain www.spineuniverse.com, 2008. 7. Grieves.P, Common vertebral joint problems, Elsevier, 2003.

CORRESPONDENCE
*Vice principal, K.G.College of Physiotherapy, Coimbatore 35. Email: barunmpt@gmail.com, Mob: 09994576111.

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