Association between disability and alexithymia in lumbar disc herniation: A cross-sectional study

Abstract

Background: Lumbar disc herniation (LDH) is a common cause of low back pain (LBP) and disability. Psychosocial factors, including alexithymia, may influence patient-reported outcomes, but evidence in LDH remains limited. We examined associations among alexithymia, pain intensity, and disability in LDH. Methods: In this cross-sectional study, 105 patients with LDH confirmed by clinical examination and magnetic resonance imaging (MRI) were assessed. Pain intensity was measured using the Visual Analog Scale (VAS), disability with the Oswestry Disability Index (ODI), and alexithymia with the 20-item Toronto Alexithymia Scale (TAS-20). Spearman correlations tested relationships between TAS-20 scores and demographic/clinical variables. Results: Mean age was 51.6 +/- 13.0 years; 66.7% were female. Possible/definite alexithymia was present in 39.0% (n = 41). BMI showed weak positive correlations with TAS-Difficulty Identifying Feelings (DIF), TAS-Externally Oriented Thinking (EOT), and TAS-total. Higher education and employment were weakly negatively correlated with TAS-DIF, TAS-Difficulty Describing Feelings (DDF), and TAS-total. Symptom duration showed weak inverse correlations with TAS scores. ODI showed weak positive correlations with TAS-DIF and TAS-total; VAS was not correlated with TAS scores. No significant associations were observed with age, sex, smoking, marital status, comorbidities, disc pathology, or neurological deficits. Conclusions: Alexithymia is relatively common in LDH and shows weak associations with disability and selected sociodemographic factors but not pain intensity. These findings should not be interpreted as evidence of prediction or causality. Psychological assessment may help identify emotional processing difficulties and support comprehensive rehabilitation.