Maximising Pleasure and Minimising Pain: Sex positions for enjoyable intimacy

Maximising Pleasure and Minimising Pain: Sex positions for enjoyable intimacy

As a Consultant Physiotherapist, I have had the privilege of working with many patients who suffer from a variety of musculoskeletal issues, such as back pain, knee problems, arthritis, and joint issues. Through my experience, I have noticed that a common concern among my Patients is how to engage in sexual activities without aggravating their conditions.

“Limitations and pain may bind the body,
but medical insight can unlock the doors to intimacy and connection once more.”

– Luis Ribeiro | Club Health Founder & Clinical Director

I usually advise my patients that every individual’s body is unique, and what works for one person may not necessarily work for another. However, based on my experience, I can provide a few general guidelines to help alleviate discomfort during sexual activities.


Avoid positions that put a lot of stress on your back, knees, or other joints. Positions that involve a lot of bending, twisting, or kneeling may be uncomfortable or painful. Instead, try positions that put less stress on your joints, such as lying on your back or side.


If you have bad knees or arthritis, you may find it helpful to use a pillow or cushion to support your joints during sex. For example, if you’re lying on your back, you can place a pillow under your knees to reduce the pressure on your joints.


It’s important to communicate with your partner about your physical limitations and discomfort. This way, you can work together to find positions that are comfortable for both of you.

Communication with your partner is crucial | Image by Freepik


If you start to feel discomfort during sex, don’t be afraid to take a break. Stretching, changing positions, or taking a break altogether can help reduce pain and discomfort.


There are many other forms of sexual activity that don’t require as much physical exertion or joint movement. For example, mutual masturbation, oral sex, or using sex toys can be enjoyable and comfortable alternatives.

Here are some specific sex positions that may be beneficial for those with bad backs, knees, arthritis, and joint problems:

  1. Spooning: This position involves lying on your side with your partner behind you. This position can be comfortable for those with back pain or arthritis in the hips, knees, or ankles.
  2. Missionary with a pillow: This position involves lying on your back with your partner on top of you. Placing a pillow under your hips or lower back can provide support and reduce pressure on your joints.
  3. Cowgirl: This position involves the partner on top while the other person lies on their back. This position can be comfortable for those with back pain or arthritis in the hips, knees, or ankles.
  4. Doggy style: This position involves the partner behind while the other person is on all fours. Placing a pillow under the hips can help reduce pressure on the lower back and hips.

It’s important to remember that these positions may not work for everyone and may need to be modified based on individual needs and limitations. Consulting with a Physiotherapist or Sex Therapist provider can help provide further guidance and support. With the right adjustments and communication, those with joint problems can continue to enjoy a fulfilling and enjoyable sex life.

In summary, it’s vital to understand that everyone’s body is different, and there is no one-size-fits-all solution when it comes to engaging in sexual activities with musculoskeletal issues. Therefore, it’s essential to communicate with your partner, listen to your body, and work with a healthcare professional, such as a physiotherapist, to develop an individualized plan that works best for you.

To close, I would like to highlight the importance of taking care of your body outside of sexual activities. I usually advise my Patients to engage in regular exercise to strengthen their muscles and joints, maintain a healthy weight, and practice mobility exercises to help improve flexibility and reduce stiffness.

Strength Training at Club Health

If you would like to schedule a complimentary call with our Patient Care Team, or one of our Rehabilitation Experts, please tap on the Chat button below or fill in our Contact Form and we will get back to you within the hour (7am – 8pm).

“Physiotherapy is more than just a treatment; it is a pathway to rediscovering the beauty of movement and connection.
Let us embrace the power of movement and reclaim our bodies as vessels of love and intimacy.”
– Luis Ribeiro | Club Health Founder & Clinical Director