Q: Until my wife had a work injury to her back three years ago, we had sex five to 10 times a week. Now it is once every two months. She was a Size 5 and is now a 14. I enjoy her company, and am trying to be supportive. Her weight is an issue for both of us. Her self-esteem is low. Because of continuing pain, she is not very active and can’t shake the weight. I tread lightly around the issue. We have tried various positions, toys and mutual masturbation, and discussed fantasies with other people. I know the actual introduction of another would be a trap that would be hurtful and end the relationship. The kicker is that I work 150 miles from home. I’ve only been home three days a week for the past six years. As you can tell, we are already drifting apart. I would like an impartial third-party opinion.


A: I can guess your wife’s feelings on the matter: She feels unattractive to you, so she stays physically distant because then there are fewer opportunities to be rejected by you. She feels like she is contributing less as a partner, not only because of the lack of intimacy, but also because her injury prevents her from pulling her weight when it comes to housework, parenting or even household income. She doesn’t feel like the same woman she was, and a sense of uselessness is giving her little desire to take measures to improve the situation. Chronic pain is a bitch that gets into your head, not just your body.

A condition like your wife’s often needs to be managed by medication, surgery, physical therapy, chiropractic adjustments and ongoing exercise. All this takes a lot out of a girl, and it’s very easy to give up and just resign to the pain (speaking from experience, here). First things first, if she’s strayed from her pain-management regimen, she needs to get back on it. She was probably shown exercises to help strengthen the area surrounding her injury. Exercise not only gets us in shape but it also helps prevent pain by keeping muscles and bones powerful. If you’re two of the millions eating the Standard American Diet (SAD) — high in saturated fat, sugar and animal products — then a diet change is also necessary to regain health. Skip the processed foods in favor of whole foods; prepackaged meals are notoriously less healthful than fresh ones. Also, additives such as MSG and aspartame have been shown to increase sensitivity to pain.

Taking a warm bath or long shower before you’re about to be intimate can also ease your wife’s suffering and help de-stress her. If she takes medication, make sure she’s timing the doses so she’s feeling the most pain-free when you plan to have sex. Any spontaneous moments you used to enjoy are a thing of the past (for now, anyway). Plan date nights in advance so you can make preparations to maximize pleasure. Although heavy use of marijuana has been proven to lower sex drive, many women find that ingesting it only occasionally actually revs up their libido. Minnesota has legalized medical marijuana. It wouldn’t hurt your wife to try a little weed, if she hasn’t already.

Continue to be supportive and patient. Be her exercise partner, drive her to acupuncture appointments, cook healthful meals. Be home more often — living with chronic pain can be very isolating. Physical, nonsexual contact is as essential to the human condition as intimacy, so hold her hand and touch her often.

Finally, there are dozens of couples’ and family therapists in the metro that deal specifically with issues related to chronic pain. Just type the magic words into Google and make an appointment. If your wife can recover from what happened to her, then your sex life can recover and start thriving again.