Spinal posture, mobility and stability in individuals with erectile dysfunction symptoms: A case-control study

J Back Musculoskelet Rehabil. 2026 Jan 7:10538127251413132. doi: 10.1177/10538127251413132. Online ahead of print.

Abstract

BackgroundSpinal biomechanics interact with pelvic floor function. Since erectile dysfunction (ED) involves pelvic floor impairment, assessing the spine may inform ED pathophysiology and management.ObjectiveTo compare spinal posture, mobility, and stability between individuals with ED symptoms and healthy controls.MethodsThis case-control study included 66 participants (ED group, n = 33, age=45.18 ± 9.49 years; control group, n = 33, age=41.58 ± 7.71 years). The severity of ED was questioned with the International Index of Erectile Function (IIEF-5). Spine posture and mobility were assessed with the Spine Mouse device (IDIAG M360®, Fehraltorf, Switzerland), and spine stability was assessed with the McGill trunk muscle endurance tests and Sahrmann test.ResultsThe ED group had a mean IIEF-5 score of 11.85 ± 4.40, indicating moderate ED. Sagittal spinal angles of the groups were similar (p > 0.05). Sagittal sacral mobility was less in the ED group (44.24°±20.67°) compared to the control group (52.58°±11.12°) (mean difference: -8.33°, 95% confidence interval (CI): -0.99 to -0.01, d = 0.50, p = 0.046). Trunk muscle flexor (mean difference: -8.85 s, 95% CI: -1.60 to -0.57, d = 1.09, p < 0.001), extensor (mean difference: -8.66 s, 95% CI: -1.22 to -0.22, d = 0.73, p = 0.004), left side lateral flexor muscle endurance test scores (mean difference: -5.52 s, 95% CI: -1.15 to -0.15, d = 0.65, p = 0.010) and Sahrmann test score (p = 0.021) were lower in the ED group compared to the control group.ConclusionsSacral mobility and spinal stability are impaired in men with ED, while spinal posture remains unchanged. Incorporating assessments and targeted interventions for spinal mobility and stability into ED management and physiotherapy programs may be beneficial.

Keywords: erectile dysfunction; mobility; posture; spine; stability.