Effects of manual therapy plus sexual advice compared with manual therapy or exercise therapy alone in the management of individuals with radicular LBP: A Randomized Controlled Trial - Trial PACTR202002785212512

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Summary

Individuals with low back pain (LBP) are usually taught how to perform activities of daily living, but infrequently are they counseled on how to perform sex.1 Sex can be very essential just like other activities, but sometimes difficult to talk about.2 Talking about sex has become a thing of shy and so many of our clients suffer its detrimental effects at the expense of our shyness. At times, it is absurd and ridiculous to talk about sex, but believe it as you may also argue that sex and life are part and parcel of each other and sex forms one of the central aspects of every relationship.3 . Even though inappropriate sexual contact can cause LBP, the actual statistic is yet to be examined because the problem is not widely reported.1 However, studies 4,5 indicate that 34-84% of individuals with LBP pain experienced a decline in the rate of sexual activity and sex was accountable for increasing the pain in 64% of individuals with LBP5. In addition, the most commonly experienced problems during sex by individuals with LBP were finding suitable sexual positions and problems with hip movements.4 Studies 13,14 have indicated that sexual behavior or ejaculation decreases pain sensitivity by stimulating the release of endogenous opioids (EOs) peptides, potentially to avoid tight sexual arousal from becoming unpleasant and raise its reward value. Sexual intercourse is highly linked to analgesia in humans17 and rats18,19 and is also rewarding.20 This may indicate the possibility of developing or exacerbating LBP obliviously during sexual intercourse as the partners may not likely recognize any pain due to opioids’ analgesia. Sexual intercourse has been identified as a significant indicator of people’s lives and one of the inherent measures of health and disability. Sex can be as much a part of the human experience as eating and drinking. If sex is an activity in which people with LBP are interested, there is no reason to limit them.

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