Can back pain cause erection trouble, also called erectile dysfunction (ED)? A pinched nerve in the lower back can, in some men, affect the nerves involved in erections, though sources disagree on how directly. We walk through the symptoms to watch for and the questions to bring to your doctor, so write down your symptoms and take them to a visit.
How could a pinched nerve in the lower back affect erections?
ED means trouble getting or keeping an erection firm enough for sex. The NIDDK erectile dysfunction page says it is a common problem and that it is not a routine part of aging. A 2011 BMJ Clinical Evidence review says ED may affect 30% to 50% of men aged 40 to 70, and that about 20% of cases have psychological causes.
Nerve-related ED is one recognised group. A sexual health guide describes neurogenic ED as erections that fail because the nerves controlling them are injured or compressed, and it lists a herniated disc or pinched nerve, especially in the lower spine, among the causes. That same guide says the reason behind neurogenic ED “is not very clear,” which is why the link is worth checking rather than assuming.
ED can also point to other problems. MedlinePlus says ED can be a sign of clogged blood vessels or of nerve damage from diabetes. A 2013 Lancet erectile dysfunction review calls ED a strong predictor of coronary artery disease and says cardiovascular assessment is now recommended for men who present with ED. So a back-related cause is one of several to rule in or out.
Can a herniated disc cause erectile dysfunction?
The NIAMS back pain overview describes a herniated or ruptured disc as “an event causing a disc to compress and irritate nearby nerves,” and says this often occurs at the lumbar level, which is the lower back. Whether that compression reaches the nerves for erections is the open question.
A sexual health guide says a herniated disc or pinched nerve can compress nerves that play a role in erection. A sciatica article on ED says the scientific research on whether sciatica directly causes ED is mixed. It notes that nerve compression in most commonly encountered sciatica is at L4, L5 or S1, which it describes as too high to directly affect the nerves for penile function. A spine clinic’s website argues the opposite for L4–L5 bulges, saying they can contribute through nerve interference, pain-inhibition and pelvic-floor changes. Your clinician, reading your scan alongside your symptoms, is the person who can sort out which account fits you.
Can an L4-L5 disc bulge or an L5-S1 problem cause ED?
One spine clinic’s page links L4–L5 bulges to erection changes. A sciatica article says compression at L4, L5 and S1 is too high to directly affect the nerves for erections. The same article groups L4, L5 and S1 together, so it does not separate L5-S1 from the others. Ask your clinician which level is involved in your imaging and whether that level could plausibly affect your erections.
What are the symptoms of a pinched nerve?
The NIAMS says back pain can radiate “away from the back into the buttocks, leg, or hip,” and lists numbness or weakness in the legs or feet as symptoms to report. The table below pulls together the symptoms described across these pages.
| Symptom | What the description says |
|---|---|
| Pain that shoots or radiates into the buttocks, leg or hip | NIAMS lists it as a back pain symptom. |
| Sharp, burning or electric-shock-like pain, especially with back pain or movement | A sexual health guide says it can indicate nerve compression. |
| Numbness, tingling or pins and needles | NIAMS says to see a doctor if this happens with back pain. |
| Weakness in the legs or feet | NIAMS lists it as a reason to see a doctor. |
| Reduced sensation in the groin or penis, weak or delayed erections, loss of morning erections | A sexual health guide lists these as symptoms of nerve-related ED. |
What could be causing a numb spot on my back?
Tingling or numbness with back pain is on the NIAMS list of reasons to see a doctor. The NIAMS lists many causes of back pain, including sprains, strains, degenerative disc disease, herniated discs, spinal stenosis and myofascial pain. Some of these act on nerves and some act on muscles and ligaments. Which one fits your back is something an exam has to determine. Write the spot’s location and when it started, and bring that to your visit.
Why does my lower back burn?
A burning pain in the lower back is one of the patterns a sexual health guide links to nerve compression, particularly when it comes with back pain or movement. The sciatica article describes radiating leg pain as “sharp, shooting, or burning pain that travels down the back of the leg, often worsening with movement.” Note whether the burning stays in your back or travels into a leg, and whether movement changes it.
How long is too long to have lower back pain?
The NIAMS divides back pain by how long it lasts. Acute back pain comes on suddenly and usually lasts a few days to a few weeks. Subacute back pain lasts 4 to 12 weeks. Chronic back pain lasts longer than 12 weeks and occurs daily. The NIAMS says back pain usually goes away within a few weeks with home treatment and self-care, and that you should see a doctor if it does not improve. If it has not improved after a few weeks, book the visit. The when to see a doctor for back pain guide covers timing in more detail.
How do I relieve lower back pain, and can I release a pinched nerve myself?
The NIAMS lists these steps that doctors often recommend for back pain:
- Cold packs for pain and hot packs to increase blood flow.
- Limit activities that cause pain, but do not lie down all day. Slowly increase activity as you can.
- Over-the-counter and prescription pain relievers for severe pain, as directed by your doctor.
- Physical therapy to strengthen muscles and improve posture.
- Regular sleep, a healthy diet and not smoking.
- Other options such as massage and spinal adjustment by a professionally trained therapist, a device that sends mild electrical pulses through pads on the skin, and acupuncture.
Surgery is considered when other treatments have not helped, and the NIAMS notes it is not right for everyone. For back pain in general, the NIAMS lists physical therapy among options your doctor may recommend. Check with your doctor or physical therapist before starting any exercise routine. Most acute back pain usually gets better after a few weeks of home treatment.
What is the worst thing you can do for back pain?
The NIAMS points to lying down all day, which it lists as something to avoid, and to carrying several items at once instead of making extra trips. It also advises trying to avoid sleeping on your stomach, and notes that you may get back pain if you exercise too hard or too much after being inactive. For a fuller list, see the worst things to do for back pain guide.
What are the worst exercises for lower back pain?
The NIAMS does not name specific exercises to avoid. It advises asking your doctor which exercises are best for you, and whether you should avoid certain activities or exercises. Bring that question to your physical therapist or doctor before you start a routine. The exercise advice for back pain guide explains how to think about fit and warning limits.
Herniated disc erectile dysfunction treatment: what are the options?
The NIDDK says health care professionals treat the underlying causes of ED and then focus on improving sexual function, and that choosing an ED treatment is a personal decision. MedlinePlus says your doctor can offer several treatments for ED, and that getting more exercise, losing weight or stopping smoking may also help. The NIDDK adds that research shows a healthy diet can lower the risk of developing ED or improve ED symptoms.
A sexual health guide lists medicines, vacuum devices, injections, exercises, surgery and psychological support, and says treatment depends on the cause. A ClinicalTrials.gov pelvic floor study describes a planned study of pelvic floor training with biofeedback for ED in men with functional hypogonadism. A registration describes a study, not a result. Do not start or change any medicine on the strength of this page. Your doctor makes those decisions with you.
When should I see a doctor, and what should I ask?
The NIAMS says to see a doctor if your back pain does not improve, or if it comes with any of these:
- Tingling or numbness.
- Severe pain that does not improve with treatment.
- Back pain after a fall or injury.
- Trouble urinating.
- Weakness, pain or numbness in the legs.
- Fever or unexplained weight loss.
The NIAMS says to see a doctor for back pain with trouble urinating or with weakness, pain or numbness in the legs. One spine clinic’s page warns that if compression threatens the cauda equina, sexual, bladder and bowel function can drop together, and it calls that an emergency. Do not wait for a routine appointment if these symptoms appear.
Bring these questions to your visit:
- Could my back be linked to changes in my erections, and which spinal level is involved?
- Do I need a nerve test, imaging or another test? A doctor may use nerve tests, imaging or sleep-erection tests.
- Should my heart, blood vessels and blood sugar be checked?
- Which activities or exercises should I avoid for now?
- Which treatment fits my cause, and what would choosing one involve?
Before the visit, keep a short log of when the back pain started, what it feels like, whether you have numbness or weakness, and when erection changes began. The low back pain red flags guide shows what to record.
By BackToHealthTroy.com Editorial Team
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.