Several qualitative studies investigating the sexual activity of people with low back pain (LBP) and/or injury have consistently reported that this population experiences a marked reduction in coital frequency. Approximately 34%1 to 84%2 of males with LBP have reported a decrease in the frequency of coitus. Sexual activity is a known indicator of quality of life3 and is recognized as an integral measure of health and disability; the Oswestry Disability Index Version 1.04 includes “sex life” in its measure of disability, and the World Health Organization's International Classification of Functioning, Disability and Health5 regards sexual relationships as an integral factor in the international standard to describe and measure health and disability.
The reported factors that are attributed to this reduced frequency are not only psychological (e.g., fear avoidance) but also mechanical. One study found that “sex life” was reported as causing additional pain in 84% of patients with chronic LBP and that sex life had improved 2 years postoperatively—this improvement was correlated strongest with a decrease in back pain (measured by visual analogue scale).6 In another sample of patients with chronic LBP, 64% (of a sample that was 89% male) reported worsening of pain due to sexual intercourse.