One of the most common health complaints among Americans is lower back pain, which affects up to two-thirds of all men and women at some point in their lives. Less widely recognized is the association between chronic low back pain and erectile dysfunction.
For centuries, writers have likened human anatomy to a marvel of engineering and art, both complex in its design and beautiful in appearance. Like an expensive car, the body is an assemblage of individual components that function smoothly together as long as all of those components are scrupulously maintained. Let one part go unattended to, and it may eventually fail, setting off interactions with other components that may cause them to fail or perform poorly.
Interconnectedness of Bodily Structures
When one considers the interconnectedness of all the structures and organs of the human body, it becomes somewhat easier to see how problems in one area can quickly turn into problems for other areas too.
In an article posted at HealthCentral.com, California physiatrist Christina Lasich, M.D., a specialist in pain management and spine rehabilitation, cites a recent study of men under 50 with lumbar spine disease. More than one-third of those men, relatively young in age, suffered from erectile dysfunction too.
Physiatry, for those unfamiliar with the term, is a medical discipline that seeks to restore and enhance functional ability and quality of life to people suffering from physical disability or impairment.
Research into Subject Limited
Despite the high incidence of erectile dysfunction among men with chronic back pain, many of them still relatively young, the link between back pain and ED has not attracted the research attention it deserves, according to Lasich. She says that many lay people theorize the ED among back pain sufferers is caused somehow by hormonal imbalances, such as those caused by long-term opioid use to manage pain. She points out, however, that low blood levels of testosterone are not known to cause ED.
Rather, Lasich suggests, the link between spinal problems and ED is more likely to arise from problems related to the nervous system. She points out that Erectile Function is controlled by “two different nerve centers in the spine: the parasympathetic input from the sacrum and the sympathetic input from the thoracic-lumbar pathway.” Any damage to the these areas of the spine, whether traumatic or because of neglect, can lead to sexual dysfunction.
Spinal Surgery Might Not Help
And erection problems that arise from spinal injury or disease will not necessarily disappear once the spine is repaired. Lasich notes that another study of men under 50 who underwent spinal surgery showed that the resulting improvements in erectile function were minimal.
Lasich is quick to point out that surgery to correct spinal damage can sometimes salvage sexual function. She cites the case of a 35-year-old man who had suffered from mild ED since the age of 18. In his case, spinal surgery did lead to improvements in erectile function. Anecdotal evidence indicates that men with mild erection problems are more likely to regain normal erectile function after spinal surgery.
Back Pain Hardly Conducive to Sex
As previously noted, chronic low back pain can lead to erection problems in men. However, both men and women who experience acute episodes of lower back pain may find it difficult to get excited sexually, wincing at the very thought of how sexual activity might aggravate the pain they’re already enduring.
This relationship between back pain and sexual dysfunction makes it important for those with chronic back pain to discuss their concerns with their sexual partners and their doctors as well. Sexual dysfunction related to back pain “is probably more common than physicians think and for patients to admit to,” according to Michael R. Marks, M.D., a spokesman for the American Academy of Orthopaedic Surgeons. In an interview with WebMD.com, he said he makes it a practice to routinely quiz his back pain patients about the impact of the disability on their sex lives.
Some Patients Reluctant to Talk Sex
Marks acknowledges that it’s sometimes difficult to get to the truth about the effects of back pain on the sexual function of his patients. While some welcome the opportunity to discuss the effects of their pain on sexual intimacy, most won’t broach the subject voluntarily, he says.
Given this natural reluctance of most back pain patients to bring up the subject, many doctors in his field are happy to let the matter go unaddressed, says Marks. To back pain patients with concerns about their pain’s impact on sexual function, he urges them to bring up the subject themselves.
Erectile Function Explained
As most men today are aware, an erection begins not in the penis but in the brain. When the brain receives signals of physical stimuli to the genitals or generates feelings of sexual desire, it sends a flood of nitric oxide coursing toward the pelvic region. On its way, the nitric oxide triggers secondary chemical reactions, one of which leads to the synthesis of a substance known as cyclic guanosine monophosphate, or cGMP.
A major player in erectile function, the cGMP signals the smooth muscle tissue that lines the inner walls of arteries to relax. As the muscle tissue relaxes, arteries dilate, thus increasing the volume of blood they can carry. This facilitates the erection process that requires robust blood flow to achieve and sustain erection.
How Back Pain Affects Sexual Function
There are a number of ways in which the body parts involved in back pain can interfere with erectile function, according to Kenya-based physical therapist Eunice Kabana. In an article posted at BusinessDailyAfrica.com, she considers three specific links between chronic back pain and erectile dysfunction.
- Hip flexors are the muscles that run from the lumbar spine through the groin to the hip. When these muscles tighten, they cause compression in the pelvic region that can impede blood flow. And, as you’ve seen, strong blood flow is essential for optimal erectile function.
- Spinal stenosis, a narrowing of the space between individual vertebrae, can put undue pressure on the nerves and blood vessels that pass through those spaces. Among the nerves that might be pinched in such cases is the pudendal nerve that carries sensation from the external genitalia to the brain, control center for the nervous system.
- Herniated discs, a rupturing of the fibrocartilaginous discs that separate one vertebra from another, can interfere with a wide array of bodily functions, not the least of which is erectile function.
Doing Nothing Isn’t the Answer
The natural reaction to acute pain in the lower back is to do nothing for fear that virtually any movement will exacerbate the underlying condition and increase pain. However, certain exercises can help to strengthen the back and relieve the pain. At the same time, other exercises that might be worthwhile for those without back problems can aggravate the situation, according to WebMD.com. Check with your doctor or physical therapist to help you develop an exercise program tailored specifically to your condition.
Some exercises that can help strengthen the back and relieve pain include partial crunches, hamstring stretches, wall sits, and press-up back extensions. You should probably avoid leg lifts, toe touches, and sit-ups.
How to Do Them
To perform partial crunches, lie on the floor or exercise mat with knees bent and feet flat on the floor. You can put your hands behind your neck or cross your arms over your chest. Tighten your stomach muscles and raise your shoulders off the floor. Don’t use your arms to pull your neck off the floor or lead with your elbows. Once you’ve reached a raised position, hold it for a second and then slowly lower your back to the floor. Repeat 10 or 12 times.
For the hamstring stretch, lie on your back with one knee bent. Loop a towel under the ball of your other foot. Slowly pull back on the towel raising the leg until you feel a gentle stretch down the back of leg. Hold that position for 15 to 30 seconds. Do two to four times for each leg.
Doing a Wall Sit
To perform a wall sit, stand 10 to 12 inches with your back facing the wall. Lean back until your back is flat against the wall and then slowly slide your back down the wall until your knees are slightly bent, taking care to keep your back flush against the wall. Hold that position for about 10 seconds and then slowly slide your back up the wall again. Repeat 8 to 12 times.
For press-up back extensions, lie on your stomach with your hands planted on the floor palms down directly beneath your shoulders. Push against the floor with your hands to slow raise your shoulders above your hands. If you can comfortably do so, put your elbows on the floor below your shoulders and hold that position for several seconds.
ED Drugs Might Help
Viagra and the other oral ED drugs that temporarily improve blood flow to the penis can help some men who suffer from erection problems related to lower back pain. How much they help depends to a large degree on the amount of damage done to the nerves and blood supply that are involved in erectile function.
To purchase these drugs in the United States, you will need a prescription, which you can obtain from your doctor. With a doctor’s prescription, you can buy the drug at the local pharmacy or choose instead to order it from a reliable online supplier, such as eDrugstore.com. If you opt to go that route, the prescription can be faxed or scanned and emailed to eDrugstore along with your order.
Alternatively, eDrugstore can set up a complimentary online consultation with one of its team of licensed U.S. physicians. If it’s determined that you’re an appropriate candidate for the drug, a prescription will be authorized. To get started, click below to access eDrugstore’s Erection Problems page.