Assessment of sexual dysfunction, the quality of life and difficulties in broaching sexual issues in patients with chronic low back pain by using cluster analysis

The aim of this study is to investigate the physical and psychosocial problems and the clinical and sociodemographic factors affecting sexual life in patients with nonspecific chronic low back pain (CLBP), thus drawing attention to sexual disability and patients’ concerns in the conservative management of the disease. A total of 140 patients were included in the study. The assessment of disease characteristics, information about sexual life and related factors were evaluated by a self-constructed questionnaire. The Oswestry Disability Index (ODI), Pain Catastrophizing Scale (PCS), International Physical Activity Questionnaire (IPAQ), Tampa Scale of Kinesiophobia (TSK) and Beck Depression Inventory (BDI) were used to assess functional disability, pain-related anxiety, physical activity level, fear of movement and depression severity, respectively. Hierarchical cluster analysis was used to discover relationships among variables. Based on the dendrogram, the intensity of CLBP, the impact of CLBP on sexual life, decrease in libido, sexual satisfaction, frequency of intercourse, painful sexual behavior and questionnaire results (BDI, TSK, ODI, PCS) were in the same cluster. Consistent with this, positive correlations were found between BDI and PCS (p < 0.001, r = 0.481), BDI and TSK (p < 0.001, r = 0.319), and BDI and ODI (p < 0.001, r = 0.408). The other main clusters included demographic and clinical characteristics, ODI and IPAQ scores. The sexual lives of patients with CLBP are affected physically and psychosocially. In clinical practice, it is important to counsel sexual disability patients because of their concerns and hesitations.