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Peer-reviewedCC BY-NC-ND 4.0Medical Science Monitor: International Medical Journal of Experimental and Clinical Research

Alexithymia in Chronic Lumbar Radicular Pain: A Comparative Study of Failed Back Surgery Syndrome and Lumbar Disc Herniation

  • Hudanur Coskun1
  • Gaye Narin2
  • Kubra Neslihan Kurt Oktay3
  • Ebru Yilmaz4
  • Songul Ince5
  • Tuba Uysal6
  • Hulya Kurt Saruhan7
  • Emine Burcu Comruk8
  • Serpil Demirulus9
  • Ozkan Yukselmis10
10 affiliations
  1. 1Department of Physical Medicine and Rehabilitation, Safranbolu State Hospital, Karabuk, Türkiye
  2. 2Department of Physical Medicine and Rehabilitation, Adiyaman Training and Research Hospital, Adiyaman, Türkiye
  3. 3Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
  4. 4Department of Physical Medicine and Rehabilitation, Antalya Medstar Hospital, Antalya, Türkiye
  5. 5Department of Physical Medicine and Rehabilitation, Dinar State Hospital, Afyonkarahisar, Türkiye
  6. 6Department of Physical Medicine and Rehabilitation, Tuzla State Hospital, Istanbul, Türkiye
  7. 7Department of Physical Medicine and Rehabilitation, Van Training and Research Hospital, University of Health Sciences, Van, Türkiye
  8. 8Department of Physical Medicine and Rehabilitation, Osmaniye State Hospital, Osmaniye, Türkiye
  9. 9Department of Physical Medicine and Rehabilitation, Yavuz Selim Bone Diseases and Rehabilitation Hospital, Trabzon, Türkiye
  10. 10Department of Physical Medicine and Rehabilitation, Diyarbakir Dagkapi State Hospital, Diyarbakir, Türkiye
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Abstract

Background: Failed back surgery syndrome (FBSS) involves persistent pain after surgery, with psychosocial factors contributing to symptom burden. Alexithymia is associated with chronic pain, but whether it is surgery-related or a broader feature of chronic lumbar radicular pain is unclear. We compared alexithymia between FBSS and non-surgical lumbar disc herniation (LDH).

Material/Methods: This cross-sectional study included 150 patients: FBSS after 1 surgery (n = 64), FBSS after multiple surgeries (n = 42), and magnetic resonance imaging–confirmed non-surgical LDH (n = 44). Pain, disability, alexithymia, anxiety, and depression were assessed using the visual analog scale, Oswestry Disability Index, 20-item Toronto Alexithymia Scale, and Hospital Anxiety and Depression Scale. The primary analysis compared combined FBSS (n = 106) with LDH (n = 44); secondary analyses examined surgery-related variables. Correlation analyses and exploratory logistic regression were performed.

Results: Patients with FBSS had greater disability and more frequent neurological and functional impairments than patients with LDH. Alexithymia prevalence did not differ significantly between groups and was unrelated to number of surgeries, fixation material, or time since first operation. Alexithymia scores correlated with pain, disability, anxiety, depressive symptoms, and sociodemographic factors. In exploratory logistic regression, HADS total score was independently associated with definite alexithymia; however, this finding warrants caution because events were limited and no predictive or causal inference can be made.

Conclusions: Alexithymia showed no surgery-specific difference between FBSS and LDH and may represent a broader psychosocial correlate of chronic lumbar radicular pain. Psychosocial assessment should be considered in surgical and non-surgical populations, although outcome benefits require further study.

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Cite

BibTeXRIS
BibTeX
@article{coskun2026alexithymia,
  title = {{Alexithymia in Chronic Lumbar Radicular Pain: A Comparative Study of Failed Back Surgery Syndrome and Lumbar Disc Herniation}},
  author = {Hudanur Coskun and Gaye Narin and Kubra Neslihan Kurt Oktay and Ebru Yilmaz and Songul Ince and Tuba Uysal and Hulya Kurt Saruhan and Emine Burcu Comruk and Serpil Demirulus and Ozkan Yukselmis},
  journal = {Medical Science Monitor: International Medical Journal of Experimental and Clinical Research},
  year = {2026},
  month = oct,
  doi = {10.12659/msm.953945},
  url = {https://doi.org/10.12659/msm.953945},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Alexithymia in Chronic Lumbar Radicular Pain: A Comparative Study of Failed Back Surgery Syndrome and Lumbar Disc Herniation
AU  - Hudanur Coskun
AU  - Gaye Narin
AU  - Kubra Neslihan Kurt Oktay
AU  - Ebru Yilmaz
AU  - Songul Ince
AU  - Tuba Uysal
AU  - Hulya Kurt Saruhan
AU  - Emine Burcu Comruk
AU  - Serpil Demirulus
AU  - Ozkan Yukselmis
PY  - 2026
DA  - 2026/10/28
JO  - Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
DO  - 10.12659/msm.953945
UR  - https://doi.org/10.12659/msm.953945
AB  - Background: Failed back surgery syndrome (FBSS) involves persistent pain after surgery, with psychosocial factors contributing to symptom burden. Alexithymia is associated with chronic pain, but whether it is surgery-related or a broader feature of chronic lumbar radicular pain is unclear. We compared alexithymia between FBSS and non-surgical lumbar disc herniation (LDH).  Material/Methods: This cross-sectional study included 150 patients: FBSS after 1 surgery (n = 64), FBSS after multiple surgeries (n = 42), and magnetic resonance imaging–confirmed non-surgical LDH (n = 44). Pain, disability, alexithymia, anxiety, and depression were assessed using the visual analog scale, Oswestry Disability Index, 20-item Toronto Alexithymia Scale, and Hospital Anxiety and Depression Scale. The primary analysis compared combined FBSS (n = 106) with LDH (n = 44); secondary analyses examined surgery-related variables. Correlation analyses and exploratory logistic regression were performed.  Results: Patients with FBSS had greater disability and more frequent neurological and functional impairments than patients with LDH. Alexithymia prevalence did not differ significantly between groups and was unrelated to number of surgeries, fixation material, or time since first operation. Alexithymia scores correlated with pain, disability, anxiety, depressive symptoms, and sociodemographic factors. In exploratory logistic regression, HADS total score was independently associated with definite alexithymia; however, this finding warrants caution because events were limited and no predictive or causal inference can be made.  Conclusions: Alexithymia showed no surgery-specific difference between FBSS and LDH and may represent a broader psychosocial correlate of chronic lumbar radicular pain. Psychosocial assessment should be considered in surgical and non-surgical populations, although outcome benefits require further study.
SN  - 1234-1010
SN  - 1643-3750
ER  -