Well-being was found to be associated with psychosocial resources and subjective evaluations to a greater extent than with objective measures in patients with chronic back pain, according to a study published in Pain Medicine.

A total of 239 patients with nonspecific low back pain for ≥45 days were evaluated for well-being indicators (eg, anxiety, depression, and affective distress) and sociodemographic indicators (eg, age, education, and marital and occupational status). Study participants were also asked to report on pain intensity, objective and subjective disability, number of pain locations, psychosocial resources, biographical factors, and several somatosensory function profiles, and were categorized into 3 well-being profiles: cluster 1 for patients with generally high well-being (n=51), cluster 2 for moderate well-being (n=104), and cluster 3 for low well-being (n=77). 

Patients in cluster 3 scored highest on indicators of depression, anxiety, and affective distress and had lower levels of perceived control over life. The majority of differences between well-being profiles for socioeconomic, psychosocial, and biographical measures had weak to moderate effect size. However, larger effect sizes were observed between clusters for differences in pain intensity and subjective, but not objective, pain disability, with the largest effect sizes observed for differences in psychosocial resources, especially for mental health and resilience.

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Study limitations include its cross-sectional design and restricted sample size.

“Interventions to promote self-assessment of functioning and resilience may…contribute more to improving well-being in chronic pain patients than trainings targeting objective disability,” concluded the study authors.

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Wettstein M, Eich W, Bieber C, Tesarz J. Profiles of subjective well-being in patients with chronic back pain: Contrasting subjective and objective correlates [published online September 28, 2018]. Pain Medicine. doi: 10.1093/pm/pny162