The Management of Sexual Disability Related to Low Back Pain: A Cross-Sectional Survey of Italian Physiotherapists

Sexual disability is an emerging topic in the management of low back pain (LBP); nevertheless, sexual counseling skills are not widespread amongst professionals. The clinical behavior of physiotherapists in this field was not studied thoroughly; therefore, it is not clear if and how physiotherapists collect information related to sexual disability and how they manage it. This survey aimed to investigate knowledge, beliefs and attitudes of Italian physiotherapists in managing this disability. An online survey with 28 questions was distributed from February 2nd to July 10th 2023 via the newsletter of the Italian Association of Physiotherapy, email and social media. The questionnaire queried on participant demographics, assessment and treatment procedures, beliefs and potential barriers, sex, expertise, previous educational background, and geographical area. 448 physiotherapists completed the survey, with 69.87% not investigating LBP-related sexual disability routinely. 85% of physiotherapists diagnosed sexual disability in 0-10% of patients treated for LBP. Sexual disability is reported by physiotherapists at random in 54.91% of patients. When it is diagnosed, 90.41% of physiotherapists would choose evidence-based procedures, but only 19.96% of them would directly involve the patient's partner. Postgraduate education and professional expertise positively influence beliefs and attitudes. Main barriers and difficulties in the field are the perceived lack of expertise, other therapeutic priorities, cultural attitudes of patients, and fear of violating patients' privacy. The beliefs and attitudes of Italian physiotherapists in the management of sexual disability are characterized by scarce attention and feeling of inadequacy, but they show the potential to adequately treat this disability.