Is low back pain linked with erectile dysfunction? Often, yes: men with long-lasting low back pain report more sexual problems, and in the studies the main reasons are pain, low mood and avoiding movement. Back pain is not on healthdirect's list of causes of erectile dysfunction, though nerve damage such as a spinal cord injury is. And one ED medicine, tadalafil (Cialis), can itself cause back pain.
Does low back pain cause erectile dysfunction?
Not directly, as far as the Australian sources go. healthdirect's causes of erectile dysfunction include "health problems that affect the nerves, like spinal cord injury", but not back pain (healthdirect — erectile dysfunction), and Australian Prescriber lists spinal cord and peripheral nerve disorders, and neurological conditions such as multiple sclerosis (Australian Prescriber). Most back pain is not that kind of problem: "More than 9 out of 10 cases of back pain are not caused by a serious medical problem", and in most cases no specific cause is found (healthdirect — back pain). A disc pressing on a nerve is a separate question: can a pinched sciatic nerve cause erectile dysfunction? For MS: can multiple sclerosis cause erectile dysfunction?
How common are sexual problems with back pain?
Common in the studies, which are small. Of 100 sexually active patients with chronic low back pain in Morocco, 81% said the pain caused sexual difficulties, and men were affected more than women (90% against 72%) (Bahouq et al., BMC Musculoskelet Disord 2013). In 101 Tunisian men with chronic low back pain, average age 52, 83% scored as having erectile dysfunction on a standard questionnaire (the IIEF-5) (Rouached et al., Fr J Urol 2026). Neither study included people without back pain for comparison, so neither shows that the back pain was the cause.
Why does back pain get in the way of sex?
Mostly through pain and mood. In the Moroccan study, 97.5% reported a painful position for sex, lying on the back most of all, and sex became less frequent; 14.8% reported a lower sex drive (Bahouq et al.). Among 697 Italian outpatients with low back pain, sexual disability went with depression, avoiding activity and dwelling on the pain (rumination) (Ferrari et al., J Phys Ther Sci 2019). People with chronic back pain are at higher risk of psychological distress (healthdirect — back pain), and stress, anxiety and depression are causes of erectile dysfunction in their own right (healthdirect — erectile dysfunction). Some pain medicines play a part too: Australian Prescriber links "chronic opioid use" with erectile dysfunction, and healthdirect says opioids are not usually recommended for back pain because of their side effects. For anti-inflammatories: can ibuprofen cause or help erectile dysfunction?
Can Cialis cause back pain?
Yes — it is one of tadalafil's common side effects. In the 12-week trials in the Australian product information, back pain was reported by 6.5% of men taking 10 mg or 20 mg against 3.2% on placebo, and by 2.9% against 1.3% on the 2.5 mg or 5 mg daily dose; muscle pain and pain in the arms or legs were also more common (Cialis product information). Back pain and muscle pain are in the Australian leaflet's list of side effects (Cialis CMI), and Australian Prescriber notes that tadalafil's "low back and leg pain" often goes away when the medicine is stopped. The European sildenafil label lists muscle pain and pain in the limbs as uncommon, and not back pain (EMA — Viagra). If back pain started after tadalafil, tell the doctor who prescribed it. More in what are the side effects of Cialis?
When does back pain need urgent care?
When it comes with numbness or weakness in the legs, or changes in bladder or bowel control. healthdirect also lists pain that comes on very quickly and is severe, pain after a significant injury, fever, not being able to walk, and unexplained weight loss as reasons to call triple zero (000) or go to an emergency department (healthdirect — back pain). A disc pressing on the nerves to the bladder and genitals is covered, with its warning signs, in the sciatica page linked above; injuries in can back problems or injuries cause erectile dysfunction?
What helps?
Treat the back, and have the erections checked in their own right. Keeping active is the most effective way to manage non-specific back pain, most acute episodes pass on their own, and back pain that is not better after about 6 weeks is worth a GP visit (healthdirect — back pain). Erectile dysfunction is often the first sign of cardiovascular disease, high blood pressure or high cholesterol, and your doctor will first treat any underlying condition (healthdirect — erectile dysfunction). ED medicines need a prescription in Australia (healthdirect — ED medicines).
The short answer
Low back pain and erectile dysfunction often go together, mostly because pain, low mood and avoiding movement get in the way of sex; ordinary back pain is not a listed cause of erectile dysfunction. Tadalafil can cause back pain, so mention it if both problems started together. Other conditions are in our guide to ED and health conditions.
