Etiological Differences in Chronic Low Back Pain Matter for Women's Sexual Health and Well-Being: A Comparative...

Chronic low back pain (CLBP) is a common and disabling condition that can negatively affect sexual health. Although CLBP is classified as specific or non-specific based on underlying pathology, whether these etiologies differentially influence women's sexual function and sexual quality of life remains unclear. This study compared these outcomes between women with specific and non-specific CLBP.

In this comparative cross-sectional study (2024, Rasoul Akram Hospital, Tehran), 102 married women aged 15-49 years with CLBP were enrolled (51 specific, 51 non-specific). Data were collected using validated Persian versions of the Female Sexual Function Index (FSFI) and Sexual Quality of Life-Female (SQOL-F) questionnaire. Group comparisons were performed using independent t-tests and chi-square tests. Multivariable linear regression was applied to adjust for potential confounders. Results are reported as mean differences and β coefficients with 95% confidence intervals (CIs).

Mean (SD) FSFI scores were 23.97 (3.01) in the specific CLBP group and 23.72 (4.14) in the non-specific group (mean difference: 0.25, 95% CI: -1.17 to 1.67; p = 0.70; Cohen's d = 0.07). SQOL-F scores were similarly low and comparable (mean difference: 0.16, 95% CI: -1.28 to 1.60; p = 0.62; Cohen's d = 0.04). No clinically meaningful differences were observed across FSFI domains. Higher sexual activity frequency was associated with higher FSFI scores. In the non-specific CLBP group, cesarean delivery (β = 2.80, 95% CI: 1.37 to 4.23; p = 0.01) and nulliparity (β = 4.10, 95% CI: 1.74 to 6.46; p = 0.02) were associated with better sexual function.

No meaningful differences were observed between CLBP etiologies; however, low scores in both groups highlight the need to integrate sexual health into multidisciplinary CLBP care.