• Markus Wettstein, Wolfgang Eich, Christiane Bieber, and Jonas Tesarz.
• Department of General Internal Medicine and Psychosomatics, Medical Hospital, Heidelberg University, Heidelberg, Germany.
• Pain Med. 2019 Apr 1; 20 (4): 668-680.

ObjectiveThe detrimental impact of nonspecific chronic low back pain (CLBP) on quality of life is well known. However, patients with CLBP represent a remarkably heterogeneous group, and not all of them report compromised well-being.MethodsIn this study, we investigated this heterogeneity by identifying profiles (or clusters) of well-being and their correlates in 239 CLBP patients. To take the multidimensionality of subjective well-being into account, we included multiple well-being indicators (depression, anxiety, affective distress, perceived control over life). For an in-depth characterization of the well-being profiles, we assessed 1) sociodemographic indicators (age, gender, education, marital status, occupational status), 2) pain-related measures (pain intensity, subjective and objective pain disability, number of pain locations), 3) psychosocial resources (mental health, resilience, perceived support), 4) biographical factors (trauma), and 5) somatosensory profiles based on quantitative sensory testing.ResultsBased on two-step cluster analysis, we identified three distinct well-being profiles, characterized by either generally high well-being (cluster 1, n = 51), moderate well-being (cluster 2, n = 104), or consistently low well-being (cluster 3, n = 77), respectively. Most differences between the derived well-being profiles regarding sociodemographic, psychosocial, and biographical measures were of weak to moderate effect size. Larger effect sizes were observed for differences in pain intensity and subjective, but not objective, pain disability. Finally, the largest effects were found for differences in psychosocial resources.ConclusionsOur findings suggest that not only in nonclinical samples, but also in patients with chronic pain, well-being is more closely associated with psychological resources and subjective evaluations than with objective parameters.© 2018 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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