To my mother-in-law, who I know reads my blog, feel free to stop reading now. 😉
One of the least talked about (on the surface, although you can find stuff if you search for it) is how much of an impact chronic back pain has on your sex life. We all hear about how sex is important in a relationship, which means not having sex due to a flare up, for fear of causing a flare up, or just because your everyday pain level means sex=some level of pain puts more stress on a relationship that already has a lot of stress due to a myriad of other complications chronic pain causes.
Most info that comes up in a Google search reference one or both 2014 studies from the University of Waterloo that looked at the back biomechanics of men and women during sex in several different positions. Basically, if it hurts to bend forward, use positions where your back will arch outward and vice versa if bending backward causes pain. Supportive props are also useful, especially if stability is important, as is the case for me. Sometimes, though, the pain is just too much to make sex feasible no matter how careful you are. More about that later.
Another factor in the sex and chronic pain scenario is how pain medication effects sex drive and/or ability to orgasm. A lot of pain meds cause tiredness and dizziness. For instance, due to a flare up, I’ve been on muscle relaxers pretty much constantly for almost six weeks. So I’m tired and have a varying level of brain fog at all times. Not exactly things that put one in the mood (and I still have pain even with the muscle relaxers) Others, like gabapentin (which I’ve been taking more of due to this flare up), often don’t lower sex drive but do cause anorgasmia, the inability to orgasm, especially in women. At the very least, many people report difficulty orgasming. And that’s a mood killer too, not to mention frustrating as all get out. Muscle relaxers can also make it more difficult to orgasm.
The best advice for all of this that I’ve found is to check out toys. Less work for you (and often your partner(s) too) when you’re tired and more stimulation to try to overcome the side effects of your pain meds. Get yourself a super powerful vibrator with all the bells and whistles, and talk with your partner(s) about incorporating stimulation aids into your sex life. I like this site for their good advice and high quality toys that have been tested and/or screened to not include any cheap materials that can cause irritation to sensitive tissue (or even infection). Also, learn how to clean your toys properly. It matters. No matter where you go to get your toys, online or local, research the seller. Make sure they have a good reputation.
Sometimes, though, sex just isn’t feasible. Add that to the list of things I lose as a chronic pain sufferer, but also cause loss for my spouse, who already sacrifices a lot of time and energy to care for me and pick up the slack for all the physical tasks of everyday life I can’t do.
And this brings me to the aspect of sex and chronic pain that I rarely come across: the emotional and mental toll. I guess the advice is lumped in with all the other loss and pain and grief: meditation, acceptance, patience, etc. Talk with your partner(s). Work through these issues together and support each other. You might also find that your best friends will talk with you about this stuff. Seek therapy if you need it or talk to your doctor.
There is also coitus reservatus, sometimes called Karezza,which I haven’t tried, but sounds like something worth exploring. Basically, it’s the idea of getting sexual satisfaction without orgasm. There are also tantric practices along this line of thought.