I’ve been living with chronic joint pain for about 4 years now – so, roughly as long as I’ve identified as kinky. I wonder often if there’s a correlation there…
Different doctors in different areas of medicine have variously diagnosed me with patellofemoral syndrome, gout, the ever-vague “depression-related pain,” and (newest and so far unconfirmed) fibromyalgia. Whatever my mysterious pain stems from, it seems to be here to stay, and I have to figure out how to live with it. That includes finding ways to keep it from hindering my sex life.
I’ve been doing lots of reading lately on the intersections of chronic pain and BDSM – most notably Raven Kaldera’s excellent anthology Kneeling in Spirit, which is about submissives with disabilities. Between that book, Ignixia’s workshop on pain and kink at last year’s Woodhull Sexual Freedom Summit, and my own firsthand experiences, I’ve pulled together this list of insights you might find useful if you’re a kinkster who suffers from chronic pain, or if you play with people who do.
A pain scale is an invaluable communication tool.
I often advocate a 1-to-10 pain scale for use during any sadomasochistic scene, because it makes it easy for the bottom to communicate how much pain they’re currently feeling and/or how much pain they’d like to be feeling. But this scale isn’t just for paddle smacks and nipple pinches – you can use it to quantify your regular ol’ chronic pain, too.
I can say, for example, that my elbows are at a 5 right now, while my hands and ankles are at a 3 – and this might affect what my dominant chooses to have me do. If a particular activity mid-scene causes a sudden flare-up, it’s easier for me to spit out “My knees are at an 8” than it would be to construct a request for mercy in my subspacey haze.
As kinksters, we already have language for discussing and measuring pain; we might as well use it in positive ways outside of the dungeon, too.
Some chronic pain can be eroticized.
Please don’t assume this is true of everyone, or every type of pain – I know people who developed chronic conditions and immediately gave up all sadomasochistic activities, because they were experiencing enough discomfort in their regular lives and didn’t want to bring it into their sex lives, too, if they could help it. But for me, some of my joint pain can be made into a sexy thing if my partner and I recontextualize it together.
For example, while it’s agonizing for me to kneel for more than a few minutes due to my shitty knees, I can often get through it if I know my dominant wants me to and I would please him by sticking it out. I’ve knelt for long periods during human furniture scenes, bootblacking scenes, and oral service scenes, and while I can’t sustain that position for as long as a spryer submissive could, I’m able to enjoy my pain more when I feel like it has a purpose (i.e. making my partner happy).
Along similar lines, being taken care of when my pain is especially bad can be sexy in and of itself for me, because I’m into nurturing D/s dynamics. There are lots of ways to reframe pain into a hotter thing than it is on its own.
Communication protocols can set both partners at ease.
The dominants in Kneeling in Spirit emphasize again and again that they need their submissives to be honest with them about their bodies’ current status. This is difficult for me in more vanilla relationships – I feel like I am whining or bumming my partner out – but in D/s, it can be redefined as a mandated part of your dynamic. A dominant can, for example, require their submissive to text them a report on their current pain levels at the start or end of every day, or can choose a particular word or phrase that means, “Tell me how your body feels right now.” A couple could agree on an emoji code (e.g. black dot for “okay,” red dot for “bad,” double exclamation points for “too bad to do kink tonight”) or could share an online calendar where the submissive has to record certain health information daily. You get the idea.
If you’re a submissive and you have trouble communicating this stuff without feeling guilty or whiny, just remember that part of how you serve your dominant is by taking care of the things they love – and that includes you. Keep in mind Mollena Williams-Haas’ “prime directive” for submissives: “It is the primary responsibility of the slave to protect the master’s property at all times, up to and including protecting the property from their master.”
A variety of pain produces a better endorphin rush.
That is to say: if someone already has an achy back, maybe flogging their back isn’t the best way to go. Or, if their pain manifests as surface-level skin irritation, maybe they don’t want to be scratched or slapped, but would instead prefer a deeper, thuddier sensation.
When a body gets accustomed to a certain type of pain, it can stop sending out endorphins in response to that pain – so it might take a different type of pain altogether to get those endorphins flowing again. Consider what tools you have at your disposal that could achieve that.
Pain can be an opportunity for creativity, rather than a limitation.
I once had a friend-with-benefits with whom the “benefits” were primarily rope bondage, which he loved (so do I). He told me once that I’m very fun to tie up, and I scoffed. “You have to be joking,” I said. “My joints are so bad that there are tons of ties you can never do with me.”
He furrowed his brow. “That’s exactly why you’re a fun rope bottom for me,” he replied. “It’s an interesting challenge, figuring out which ties are going to work for your body.”
It had literally never occurred to me to think of my condition that way before. I’m no longer regularly in touch with that dude but his words have stuck with me. I think of them every time I feel like a useless submissive, a broken toy, for being unable to sustain certain positions. Many doms and tops love an opportunity to be crafty and clever – and that includes being in charge of a body that works a little differently than most.
Is chronic pain a part of your sex life? How do you like to deal with it?
The Cowgirl is marketed as essentially a slicker, more luxurious update to the Sybian. Alicia Sinclair has a habit of doing this: she previously called her Le Wand “a refined classic wand massager with upgraded features and gorgeous design,” despite it being a buzzier, louder, reskinned 
The Cowgirl is a few inches bigger than the Sybian in all dimensions, which would, I suppose, make it more comfortable to sit on for certain kinds of bodies. However, for mine, it’s definitely less comfortable. I have a hip condition which makes it painful for me to spread my legs wide, especially if I’m putting weight on my knees at the same time. My knees themselves also have some mobility and chronic pain issues; keeping them bent for long periods can be agonizing. So, as you might imagine, rideable vibrators aren’t exactly my favorite thing. The Cowgirl requires my legs to splay wider than the Sybian does, so it gets painful more quickly for me. There’s been many a Cowgirl testing session when I’ve climbed off the toy only to collapse in pain, needing to stretch out my hips and knees for long minutes before I’d feel normal again. What could be a sexy foreplay toy or even the “main event” for some people is so physically debilitating to me that I usually can’t do much of anything after using it.
In addition to its corded remote control (which is blessedly easy to use and plays nicely into my