Hi. Noted your history of having erectile dysfunction and pain in low back. Surely this needs to be taken into consideration. Erection is a complex process involving the nerves, hormones and psychology and any defect at any or a combination of these factors can cause the problems. Hence I would advise you the following: First of all consult an Urologist or a Sexologist to get a clinical examination, evaluation and tests of blood for hormones and so on. Color doppler of Penis and its blood supply. Neurological evaluation that supply the erectile tissues and investigations like MRI of the lower spine may help to find out the cause. Many of the causes are treatable like if Testosterone is less then injections will help. If the problems is due to stress and anxiety then proper medications will help. If the problem is neurological then an opinion and management of a Neurologist may be needed. Hence it is important first to find the cause so that an appropriate investigations and management can be done to get results. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon