Study design: Case-control study. Objectives: (i) To describe the prevalence of sexual dysfunction in chronic low back pain (CLBP) patients, (ii) to compare the range of sexual function outcomes between patients with CLBP and healthy controls and (iii) to investigate which factors are associated with sexual function within the cohort of individuals with CLBP. Setting: Low back pain (LBP) clinic of Qazvin University of Medical Sciences, Qazvin, Iran. Methods: A total of 702 patients with CLBP and 888 healthy controls participated in the study. The Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF) and Premature Ejaculation Diagnostic Tool (PEDT) were used to evaluate sexual function. In addition, quality of life, anxiety, functional status and pain intensity were assessed in patients. Univariate and multiple linear regression analyses were performed for the identification of factors associated with sexual function. Results: The prevalence of sexual problems in female patients with CLBP was 71.1% (n ¼ 177) while the corresponding figure for healthy women was 36.8% (n ¼ 161). Erectile dysfunction was present in 59.5% of male patients and in 24.5% of healthy males. Higher sexual function in both male and female patients with CLBP were being younger, lower duration of back pain, lower BMI, higher education level, being unemployed, physically active shorter sick leave, lower level of pain intensity, lower disability, higher family income, lower levels of depressive and anxiety symptoms, and higher psychical functioning and mental functioning. Conclusions: CLBP patients report considerably higher prevalences of sexual problems compared with healthy controls. Sex therapy and sexual management should be added to routine care and treatment of patients with CLBP.

Sleep problems are common in people with low back pain (LBP), however the mechanisms on how sleep influences pain are complex. To date there is a lack of prospective research on the timings and the development of sleep problems in those who have LBP, such information would be useful to identify individuals at risk of poor outcome. Aims are to investigate the predictive role of sleep problems on self-report recovery and pain intensity using logistic regression reporting Odds Ratios (OR). An observational cohort of 761 chronic LBP patients recruited from a pain management clinic participated, and completed data at baseline, and at 6 month follow-up (n = 682). Results show an increased odds of reported non-recovery (OR 1.52) and pain intensity (OR 2.69) for those who report sleep problems at baseline. Further analysis on the experience of sleep problems through time show that those with developing sleep problems (i.e. no sleep problems at baseline but reported sleep problems at follow-up) were at increased odds of reporting non-recovery (OR 2.17) and pain intensity (OR 2.95), as was those who reported sleep problems at both baseline and follow-up, for recovery (OR 2.88), and pain intensity (OR 3.45). Those with resolving sleep problems (i.e. sleep problems present at baseline but not at follow-up) were at a decreased odds of non-recovery (OR 0.50) and pain intensity (0.49). Presenting, persistent, and developing sleep problems have a significant impact on recovery for those with LBP, clinicians may wish to consider treatment options that can address sleep problems.

The Brief Persian QoL.BD is a psychometrically sound measure with acceptable validity and reliability and provides a rapid assessment tool for measuring QoL in patients with BD.

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