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    Talk openly with your partner continued...

    When a couple starts having less sex without any discussion, not only the relationship, but a sense of trust, erodes. One of Marks’ patients who failed to explain that back pain caused his loss of interest discovered to his dismay that his partner suspected him of having an affair.

    Sometimes, not only does a back patient fear pain, but a partner also worries about hurting the person during sex, according to Lauren Hebert, DPT, OCS, a physical therapist in Dixfield, Maine, and author of Sex and Back Pain. “[Fear] can be just as disabling,” he says.

    In contrast, when partners are open about the problems, they can find alternatives to keep sex enjoyable.

    Take preventive measures

    Planning can make sex better. If your back is sore, taking a pain reliever before sex (as with any physical activity) can help, Marks says. He recommends an NSAID, but other non-narcotic pain relievers are fine, too.

    If you have muscle spasms in the back, a hot shower before sex is a good idea, Marks says. “Sex can be a physical sport. If you’re taking cold muscles in spasm and going through vigorous activity, you could aggravate it.”

    Besides taking a relaxing shower before sex, you could also try icing the troubled area afterward, Marks says. “Icing relieves any overstimulation of the muscles, any excessive stretching or anything like that -- just like an athlete after competing winds up icing whichever body part they’ve had problems with,” Marks says.

    Try new positions

    To make sex more comfortable, “[Couples] may need to modify the positions that they’re in,” Marks says.

    That takes knowing your own body. Some people, such as those with disc problems, feel more pain when they bend forward, Hebert says.

    For these people, the best positions allow the lower back to feel supported and relaxed, experts say. “Usually, the person with the back problem is going to find that they’re going to want to be on the bottom,” Marks says. “The key is, you want to make sure your back is in a well-supported position. It may be that you need to put a pillow underneath your back,” he says. A pillow in the small of the back will support the lumbar region. Placing pillows underneath the knees to make them slightly bent also takes pressure off the back, he says.

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