Rubin D
Calif Med. 1970 Dec;113(6):12-5.
The restrictions imposed upon sexual activity by neck, back and radicular pain syndromes are of serious concern to the patient. In recent years the subject of When, and even How is raised with increasing frequency, and the patient expects the physician to reply with appropriate answers. The reply must be tempered by the level of the patient's recovery, the evaluation of what other activities the patient can perform without pain or with minimal pain and the method to be used. Sexual activity may precipitate recurrent pain or aggravate existing pain in the same manner as lifting, pushing, pulling or any other physical activity, if performed too early or too vigorously in the course of recovery from neck, back or radicular pain syndromes. In dealing with the problem of recovery from painful musculoskeletal or neuromuscular states, timing is of the utmost importance. Unless a timetable is specifically outlined, recurrences are common, and the condition may become chronic. The inability of the patient to deal satisfactorily with the sexual aspect of his daily living may, in itself, lead to emotional tensions and guilt feelings which may delay or prevent recovery. There is need to handle this problem at every level of the involvement in order to achieve a desirable end result-namely, the absence of pain and its replacement with pleasure.
颈部、背部和神经根疼痛综合征对性活动造成的限制是患者极为关注的问题。近年来，何时以及甚至如何进行性活动的问题被越来越频繁地提及，患者期望医生能给出恰当的回答。回答必须根据患者的恢复程度、对患者在无疼痛或疼痛极小的情况下能够进行的其他活动的评估以及所采用的方法来加以调整。如果在颈部、背部或神经根疼痛综合征的恢复过程中过早或过于剧烈地进行性活动，那么它可能会像提举、推、拉或任何其他体力活动一样，引发疼痛复发或加重现有疼痛。在处理因疼痛性肌肉骨骼或神经肌肉状态恢复而产生的问题时，时机至关重要。除非明确制定一个时间表，否则复发很常见，病情可能会变成慢性。患者若无法令人满意地处理日常生活中的性方面问题，这本身可能会导致情绪紧张和内疚感，进而可能延迟或阻碍恢复。需要在参与的各个层面处理这个问题，以实现理想的最终结果，即无痛且充满愉悦。
