Lean toward positions where the bed, a wall, or furniture takes your weight — lying down, side-lying, or leaning back — rather than ones that make you hold your weight on one arm or knee for minutes.

Sustaining a fixed, weight-bearing posture builds measurable fatigue in the back and shoulder muscles quickly in lab studies (Kim et al., 2024; Stephenson et al., 2020), and the same kind of load would build up during intimacy. People's fatigue rates vary a lot, so a position someone else finds easy can be exhausting for you (Ma et al., 2013) — start from something your own joints can actually sustain.

Pillows, cushions, and the edge of the mattress can carry weight your joints would otherwise hold. A pillow under the lower back or pelvis changes the curve of the spine; one between the knees stops the hip from twisting; leaning into the headboard or wall lets furniture take your upper-body load.

Lumbar support measurably reduces spinal compression and back-muscle effort in sitting (Gao et al., 2023; Makhsous et al., 2009), and the same logic of redistributing load carries over when you're horizontal. This is a transfer of a general principle rather than something studied for sex positions specifically — but it applies across kinds of intimacy, not only intercourse (for oral, for example — that specific act hasn't been studied either — the person giving can rest their neck and arms on a pillow instead of holding a strained posture). Use enough support that you're not clenching to hold the position.

A position often starts to hurt not because it's wrong but because the angle has loaded one spot. Shift your weight, rotate your pelvis, move a leg, or lean forward or back to move the load off the joint that's complaining. A small angle change is usually enough — try that before you stop and reorganize entirely.

Don't hold one position until it hurts. Changing positions, pausing to stretch, or taking a short break is part of the skill, not an interruption. Holding a fixed posture is exactly what accumulates fatigue and strain (Ma et al., 2013), so building rotation in is how you keep comfort steady over time — not a sign you're doing it wrong.

Height difference, weight, flexibility, pregnancy, and any back, knee, or shoulder history all change which positions are comfortable — there is no standard position that fits everyone.

Among people with lumbar disc problems, the positions they settle into are the supported, lying ones, while weight-bearing ones like standing get avoided (Danazumi et al., 2024); around half of people with lumbar degeneration adjust their position (44–54%), and more than half (55%) feel some discomfort during intimacy (Shimamura et al., 2023). Use that as a clue that your own body's history should drive the choice — not a list of 'best' positions.