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When it comes to your sex life, low back pain can have serious impact. You may start avoiding bedroom encounters for fear of triggering more pain, and if your partner gets no explanation for your seeming loss of interest, your relationship may feel strained, too.

That’s why people with chronic back pain should bring sexual problems into the open, with their partner and with an understanding doctor who can help, says Michael R. Marks, MD, MBA, a spokesman for the American Academy of Orthopaedic Surgeons.

Sexual trouble related to back pain “is probably more common than physicians think and for patients to admit to,” Marks says. It’s still a bit of a taboo subject, but during 25 years of practice as an orthopaedic surgeon, he discusses the issue routinely with his patients, he says.

While a few patients will volunteer that back pain interferes with sexual intimacy, most won’t broach the subject, he says. “I think that there’s a lot of embarrassment about it.” But many are relieved to be able to finally talk about it, says Marks.

Still, many doctors don’t ask, he says, so patients might need to take the first step. “If your physician may not quite know how to broach the subject, it’s OK for you to,” he says.

Those with sexual problems related to chronic back pain often have disk disease or arthritis in the spine, but patients who are recovering from back surgery may also struggle.

But no type of chronic back pain rules out having an active sex life, Marks says.

Talk openly with your partner

As for back pain and sex difficulties between partners, “It’s something that’s really important to discuss,” Marks says. Over the years, his patients have confided that they are reluctant to tell their partners that they can’t have sex because it hurts too much or that they want to change longstanding sexual positions to ease the pain.

Chronic back pain can also lead to moodiness or depression. “When you’re depressed, it’s hard to perform,” Marks says.

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