Psychosocial Profiles in Adults With Chronic Musculoskeletal Pain Attending Self-Funded Manual Bodywork Therapy in Japan: A Cross-Sectional Latent Profile Analysis.

BACKGROUND: Musculoskeletal pain presentations are heterogeneous, but routine intake assessment often relies on individual symptom scores rather than multidimensional psychosocial patterns. In this study, we aimed to identify self-reported psychosocial profiles among adults with chronic musculoskeletal pain attending a self-funded manual bodywork therapy service in Japan. METHODS: We analysed baseline data from consecutive adult attendees. Of 21,498 eligible participants, 20,341 had complete profiling data, and 12,235 with pain duration ≥ 3 months formed the primary analytic sample. Latent profile analysis used four standardized total-score indicators: pain intensity, Central Sensitization Inventory-9 (CSI-9), Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia-11 (TSK-11). Solutions with two to 10 profiles were evaluated using fit, classification precision, profile size, stability, parsimony and interpretability. RESULTS: A six-profile solution was retained: high pain/lower fear (1028; 8.4%), globally low burden (645; 5.3%), low-to-moderate burden (2686; 22.0%), intermediate burden (4113; 33.6%), globally elevated burden (575; 4.7%) and psychosocially elevated burden (3188; 26.1%). Catastrophizing and kinesiophobia more strongly differentiated profiles than pain intensity alone. High pain/lower fear showed high pain intensity with comparatively lower kinesiophobia, whereas psychosocially elevated burden showed prominent catastrophizing and kinesiophobia despite less extreme pain intensity and CSI-9 scores than globally elevated burden. CONCLUSIONS: Six self-reported psychosocial profiles were identified in this self-funded chronic musculoskeletal pain cohort. The findings are descriptive and hypothesis-generating and require longitudinal and external validation before prognostic or treatment-stratification use. SIGNIFICANCE STATEMENT: Using routine intake data from 12,235 adults with chronic musculoskeletal pain, this study identified six self-reported psychosocial profiles that were not reducible to pain intensity alone. The findings support future validation of brief multidimensional intake assessment for profile-informed stratified care.