Counseling on Sex and Low Back Pain is sensitive but necessary. After gaining the trust of my patients, this does become a common topic. You could imagine, it can be difficult to keep a straight face while fielding very graphic and detailed questions. But, there has been some research on this very topic as sex is instinctual, with physical, pyschological and emotional components.
What we do know is back pain does contribute to lack of desire, poor performance, and reduced frequency. Couples naturally have barriers to having sex. Lack of time, too tired, life stresses, etc. Adding back pain can cause that one more barrier to reducing physical intimacy. To some couples, that can have a lasting effect. We do not need scientific studies to show that any pain will make physical activities difficult. But, never the less, there has been studies, based on surveys, indicating definite decrease in frequency, desire and satisfaction.
At the same time, there are studies indicating recovery from episodes of disk herniations, have corresponding return of sexual parameters. Some of the studies indicate people return to sexual activities in about 3-4 weeks after successful lumbar discectomy. Other studies have looked at the rates of sexual dysfunction in people with chronic low back pain. Population studies indicate chronic low back pain people have higher rates of dysfunction, but, even in the group of patients with chronic low back pain, stratification of the data does show some factors such as younger age, lower BMI, lower duration of the condition is associated with higher rates of sexual activity, and function.
In relationship to sexual activity and lumbar spinal fusion, or lumbar disk replacement, fortunately the data indicates improvement in the sexual parameters in patients who have undergone the surgery.
So, what is the bottomline?
First of all, the topic of sex and low back pain is common to most patients. Surprisingly, my patients seem to speak freely about the issue. In terms of patients with chronic low back pain, exercise, weight management, use of NSAIDS, and depression management also improves sexual parameters of desire, and performance. Studies confirm common sense. Anything you do to improve your pain, or strengthen your back can improve your sex life.
For many, there are certain positions that increase stress on the back, and therefore affects the sexual experience. Without being too graphic, certain lying down positions, or hyperlordotic postures can increase discomfort. But, in general, pain will be your guide to activity levels.
For spinal fusion, or disk replacement patients, I would doubt this will even be a possibility in the initial post op phase. But, with pain as your guide, eventual the desire curve will intersect the pain curve, allowing you to determine the proper time to resume activities. As stated above, for simple discectomy patients, usually there is a 3-4 week delay before activity. Spinal fusion or replacement patients typically wait longer.
Sex and Low Back pain is a “whisper” topic for many of my patients. But, it really is one that is comtemplated, if not verbalized. Anything that improves your back pain, should improve your physical capacity to have sex. Pain will be your guide. Learn ways to reduce the pain.
On a lighter note, headaches are rarely associated with low back pain.
- Tekgül ZT, Pektaş S, Turan M, Karaman Y, Çakmak M, Gönüllü M. Acute Back Pain Following Surgery under Spinal Anesthesia. Pain Pract. 2015 Nov;15(8):706-11. PubMed PMID: 25469794