I had horrible lower back spams on Cialis at any dose.
Cialis (tadalafil) can indeed cause back pain as a side effect in some users. The mechanism behind this side effect is not fully understood, but there are some theories:
## Mechanism of Cialis-Induced Back Pain
The back pain associated with Cialis use is thought to be related to the drug's effects on smooth muscle tissue[1][6]. Specifically:
1. **PDE11 Inhibition**: Cialis has a greater affinity for phosphodiesterase 11 (PDE11) compared to other PDE5 inhibitors like Viagra or Levitra. This increased PDE11 inhibition is believed to be the likely explanation for the higher incidence of back pain and myalgia seen with Cialis[5].
2. **Smooth Muscle Effects**: The pain is characterized by diffuse bilateral discomfort in the lower lumbar, gluteal, thigh, or thoracolumbar muscular areas. This suggests that Cialis may affect smooth muscle tissue in these regions[6].
3. **Timing**: Back pain typically occurs 12 to 24 hours after dosing and usually resolves within 48 hours[6]. This delayed onset suggests that the mechanism may be related to the drug's metabolites or downstream effects rather than immediate action.
## Characteristics of Cialis-Induced Back Pain
- **Prevalence**: Approximately 3-6% of men who take Cialis experience back pain[4].
- **Severity**: The pain is generally reported as mild to moderate, though severe cases occur in less than 5% of reports[6].
- **Duration**: It typically resolves without medical treatment within 48 hours[6].
- **Exacerbating Factors**: The pain is often exacerbated by recumbency (lying down)[6].
## Management
In most cases, the back pain resolves on its own. However, when treatment is necessary:
- Over-the-counter pain relievers like acetaminophen or NSAIDs are usually effective[6].
- In rare cases, mild narcotic pain relievers may be used[6].
- Only about 0.5% of users discontinue Cialis due to back pain[6].
It's important to note that while the exact mechanism remains unclear, the back pain associated with Cialis use is not linked to any significant underlying pathology based on diagnostic testing[6]. If you experience persistent or severe back pain while using Cialis, it's advisable to consult with your healthcare provider.
Citations:
[1]
Cialis side effects: Common, mild, and serious
[2]
Cialis Side Effects: What They Are and How to Manage Them
[3]
Cialis (Tadalafil): Side Effects, Uses, Dosage, Interactions, Warnings
[4]
https://www.forhims.co.uk/blog/a-complete-guide-cialis-tadalafil-side-effects
[5]
Cialis Back Pain May Be Due To Greater PDE11 Affinity Than Viagra, Levitra
[6]
Side Effects of Cialis (tadalafil): Interactions & Warnings
[7]
Tadalafil - StatPearls - NCBI Bookshelf