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Chronic low back pain patient groups in primary care – A cross sectional cluster analysis

Annika Viniol1*, Nikita Jegan1, Oliver Hirsch1, Corinna Leonhardt1, Markus Brugger23, Konstantin Strauch23, Jürgen Barth4, Erika Baum1 and Annette Becker1

Author Affiliations

1 Department of General Practice / Family Medicine, Philipps University of Marburg, Karl-von-Frisch-Str. 4, 35043 Marburg, Germany

2 Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig Maximilians University, Munich, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany

3 Institute of Genetic Epidemiology, Helmholtz Center Munich – German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany

4 Institute for Social and Preventive Medicine (ISPM), University of Bern, Niesenweg 6, 3012 Bern, Switzerland

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BMC Musculoskeletal Disorders 2013, 14:294  doi:10.1186/1471-2474-14-294

Published: 16 October 2013



Due to the heterogeneous nature of chronic low back pain (CLBP), it is necessary to identify patient groups and evaluate treatments within these groups. We aimed to identify groups of patients with CLBP in the primary care setting.


We performed a k-means cluster analysis on a large data set (n = 634) of primary care patients with CLBP. Variables of sociodemographic data, pain characteristics, psychological status (i.e., depression, anxiety, somatization), and the patient resources of resilience and coping strategies were included.


We found three clusters that can be characterized as “pensioners with age-associated pain caused by degenerative diseases”, “middle-aged patients with high mental distress and poor coping resources”, and “middle-aged patients who are less pain-affected and better positioned with regard to their mental health”.


Our results supported current knowledge concerning groups of CLBP patients in primary care. In particular, we identified a group that was most disabled and distressed, and which was mainly characterized by psychological variables. As shown in our study, pain-related coping strategies and resilience were low in these patients and might be addressed in differentiating treatment strategies. Future studies should focus on the identification of this group in order to achieve effective treatment allocation.

Trial registration

German Clinical Trial Register DRKS00003123

Subgroups; Chronic low back pain; Primary care