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Painkillers for Back Pain Linked to Erectile DysfunctionMen regularly using prescription painkillers for back pain are more likely to have erectile dysfunction, according to a new study from the journal Spine.

Long-term use prescription painkillers, known as opioids, have been linked to a number health of problems, and researchers sought to understand the effects the drugs on men with back pain. They analyzed the medical records of more than 11,000 men with back pain and examined how often they received prescriptions for opioids, testosterone replacements or ED medications.

Only 7% of men not using opioids were prescribed ED medications, compared to 19% of men using high-dose opioids for at least four months. Even after adjusting for age, men taking high-doses of opioids were 50% more likely to have ED prescriptions.

Although this doesn't mean that opioids caused ED, the association is still something that doctors and patients should be aware of, said lead researcher Richard Deyo, MD, MPH, of the Oregon Health and Science University.

The use opioids more than quadrupled from 1999 to 2010, according to the CDC. One recent study from the journal Pain estimated that as many as 4.3 million American adults are regularly taking opioids.

Deyo explained that while opioid use is appropriate in some cases, there is "increasing evidence" that long-term use can trigger addictions, fatal overdoes, sleep apnea, falls in the elderly, decreased hormone production, and now, erectile dysfunction.

For the study, Deyo and colleagues identified 11,327 men from Oregon and Washington who received medical care for back pain in 2004. They analyzed the patient's pharmacy records for the six months before and after visiting their doctor for back pain.

Men taking opioids for less than three months were considered to have "acute use"; while those taking opioids for more than three months were categorized as "episodic use" and those using opioids for four months or longer had "long-term use." Taking more than 120 mg of morphine equivalent was considered high-dose use.

While men receiving high-doses of opioids for extended periods of time had the greatest risk, those taking lower doses of opioids also had a higher risk of ED than men not using the drugs ( 12% vs. 7%). Men between the ages of 60-69 were more than 14 times more likely to have ED than men aged 18-29 years. Depression, use of sedative hypnotics, and other health conditions besides back pain were also associated with an elevated ED risk.

Earlier research has suggested that opioids may also worsen disability in back-pain patients. Men with back pain can avoid the potential risks of painkillers with conservative treatments like chiropractic care. Rather than masking the symptoms, chiropractic care can address the root of your pain to provide long-term relief. In fact, studies suggest that chiropractic  is more effective for back pain than some medications.


Deyo RA, et al. Prescription opioids for back pain and use of medications for erectile dysfunction. Spine 2013; 38(11):909-15. doi: 10.1097/BRS.0b013e3182830482.