Chronic low back pain can limit everyday activities, including sex. New research presented at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), found that 70 percent of patients consider sexual activity "relevant" to their life quality, and patients who receive surgical treatment for spinal spondylolisthesis (DS) and spinal stenosis (SS)--common degenerative conditions most often occurring in older adults--were twice as likely to report no pain during sex.
"Our current research sheds light on the effect that spinal surgery has on a patient's sex life and begins to describe the impact spinal disease has on this very important aspect of life," said senior study author Shane Burch, MD, an orthopaedic surgeon at the University of California, San Francisco.
Researchers reviewed data from the Spine Patients Outcomes Research Trial (SPORT) of 1,235 patients diagnosed with DS or SS. Patient responses to the question, "In the past week, how has pain affected your sex life?" were used to determine sex-life relevance. Patients selecting the options, "unable to answer" or "does not apply to me," were placed in the sex-life non relevant (NR) group. Patients selecting other options were placed into the sex-life relevant (SLR) group. The mean age of patients in the NR and SLR groups were 68 and 63 years, respectively. Seventy percent of patients were in the SLR group.
There was a higher association of being in the NR group for patients who were female or unmarried, or had a coexisting joint problem or hypertension. At baseline, 40 percent of SLR patients reported having some level of pain related to sex.
The study included 825 patients, 449 with SS and 376 with DS. A total of 294 patients received nonoperative treatment, and 531, surgical treatment. The nonoperative patients were more likely to report pain related to sex at all follow-up time frames (from 41 percent compared to 20 percent). The percentages remained constant during annual visits at one year, two years, three years and four years after surgery. Prior studies found that 41 percent of physicians routinely question patients with lumbar disc herniation about sexual problems.
"Our current research has two important findings," said Dr. Horst. "The first is that sexual activity and sexual function is an important consideration for patients with degenerative spine conditions. The study also shows that sexual function is a more relevant consideration for patients who are married, younger, and male. The second important finding of our study is that patients with degenerative conditions of the spine treated with surgery reported less pain with their sex-life compared to patients treated without surgery. This finding lasted throughout the four years of follow-up."